Reasons behind need for bigger hospital

I am grateful for the clarification of the politics of the planning of the size of GWH from Dr Chris Barry (SA February 2) – a former GP colleague. As always, money was a major factor.

However, I would like to make a couple of clinical and sociological points that persist. At the time, we in PMH were already treating many patients as day cases (ahead of many other hospitals) and it is obvious that there is a limit to the number of patients that are suitable for such care.

In addition, it was known that the population of Swindon was increasing – and has continued to do so since the GWH was opened. It was also clear that people were living longer and many of the elderly lived alone, so they were more difficult to discharge from hospital because they lacked family support.

Care in the community (zealously prioritised by politicians) was lacking due to a shortage of frontline professional staff (and money). And there was (and still is) a shortage of residential and nursing home beds into which hospital patients could be discharged.

It is to be hoped that bringing social care under the same Government Department as health care may help make the movement of patients out of hospital simpler – but still safe.

Malcolm Morrison

Retired Surgeon

Prospect Hill

Vaccine nationalism

"No, EU can't have our jabs!" screamed the Daily Mail. In the week the UK marked 100,000 coronavirus deaths, brexit fanatic newspapers have grabbed onto this 'defend-our-vaccines campaign' to try to make a bogeyman of the EU once again, saying we could approve the vaccine faster because we've left the EU. However, we were still in the transition period, under Single Market rules until January and we were perfectly free to order the vaccine early then, just as any EU or EFTA countries were should they have chosen.

The underlying problem is vaccine nationalism itself, and the EU principle on this is not “We only have to do what is best for our country', but ' Do what is best for all of our citizens as well, so we do this together". That has taken time to agree, and the European joint medical sourcing processes need improving, but it is going in the right direction. You can't stop a pandemic in one country alone. It's not about being "world beating", it's about the whole world beating the virus. We need vaccines for all and this requires a global effort. Boris Johnson claims our early rollout of the AZ/Oxford vaccine as a British victory, yet there is no such thing as a "UK vaccine". It's a worldwide team effort - all Coronavirus vaccines are being developed through the international collaboration of scientists and tested in various countries. The EU gave £3billion in development funds towards the work. AstraZenica itself is an Anglo-Swedish multinational pharmaceutical company with the role of producing and supplying the Oxford vaccine worldwide. Their production facilities operate in the Netherlands, Belgium, Italy, Germany, Australia & USA among others. The first batch of UK jabs were cultured in Italy and manufactured in Belgium. So while Oxford University's ground-breaking scientific development is worthy of celebration, it had huge global input and the vaccine has only been brought to us all due to AZ's continental operations - a truly pan-European team effort of which we should all be proud.

Therefore we must say no to vaccine nationalism – vaccination is not a contest between countries. First world countries shouldn't be scrambling to out bid poorer countries for first dibs on the vaccine. In a pandemic, no one is safe until everyone is safe. To this end the EU has exempted 160 of the world's poorest countries from export bans on medical supplies during Covid. We need much more of this approach.

Even as the UK press screams blue murder at the EU, London and Brussels have been very quick to soften their tone and are now working out solutions together. The shame of it is, as full EU members we used to host the European Medicines Agency, and this row could never have happened then. Our own, very high standard British Medical Agency virtually set the tone for the whole of Europe. We need to turn towards more of that kind of cooperation and away from the kind of belligerent and potentially disastrous isolation advocated by our popular press. For all our sakes!

Steve Rouse