SIR – I took advice from GPs in Canada, Australia plus Singapore in the late 1980s before starting the arduous task of computerising a GP surgery with 8, 000 patients within the early 1990s.
We found it was very hard work, summarising and entering each patient’s full past medical history with their repeat prescription medication and known allergies. The first lesson we learnt about software management was: rubbish in, rubbish out.
The NHS has appalling software engineering management, which was already obvious by 2000, but instead of investing in a brand new system built from scratch with direct input from the medical professionals who use it daily, it has wasted enormous sums upon software consultants trying to patch this now sunk ship.
The problem was perfectly illustrated by the photograph associated with Dr Gordon Caldwell ( “‘Pointless form filling’ fuelling record delays within hospitals”, report, January 22 ), with the more than two dozen forms currently required from the NHS for a routine admission to hospital. This partly explains why we get such poor patient outcomes compared with other countries with the same per capita spending. The terrible frustration for medical staff is leading to doctors and nurses retiring plus younger ones emigrating, while NHS managers employ agency staff at vast expense as partial replacements.
The answer is to employ the very best software program engineers available globally to construct a new fit-for-purpose computer system appropriate for the NHS. They must be instructed by physicians on the agreed medical objectives, including the dovetailing of different specialist departments within economically realistic budgets.
Dr Peter Sander
SIR – I do not write this lightly and is prompted to do so after seeing that hospitals in Wales are planning to send patients home from hospital without a care package. To me, this is reasonable. We speak from your experience of 46 years working in NHS hospitals and latterly in general practice.
It offers been the case for many years that families seem to relinquish all responsibility for the care associated with their relatives as soon as they are within hospital, and hence we end up with thousands of medically fit patients blocking beds with regard to weeks on end. Is it any wonder that A& E departments are unable to find beds for those who need them urgently? Something has in order to change, plus as unpleasant as this particular may seem, surely a more acute patient is more deserving of a precious bed.
I actually cared regarding both associated with my parents in home until their death in the particular past two years, as well as working continuously during the pandemic. It was the hardest time of my life, but I owed it to them to keep them out of hospital. It had been also extremely fulfilling to be able to provide all of them a dignified death in their own house and bed.
SIR – Caroline Plaisted ( Characters, January twenty two ) describes the unacceptable problems faced simply by her family in Ministry of Defence properties.
My daughter and her husband reported the catalogue associated with broken fixings, faulty lighting and no hot water for two weeks (forcing them in order to shower in the mess) in their RAF housing.
The latest mishap involved a broken back-door lock, which necessitated barricading the door internally with heavy boxes. After two weeks within this state, and with Christmas fast approaching, my daughter called a locksmith out from her own cost. The £700 bill will be still outstanding despite numerous promises from Pinnacle, which has a Government contract for military accommodation.
Surely these amateur operators should be taken to task by ministers.
SIR – The maintenance of married quarters is a permanent problem, which I first met in 1961.
The remedy is quite simple: stop contractors from subcontracting many times over. A self-employed tradesman who undertakes the particular third, fourth or fifth subcontract will never have sufficient profit to do the work correctly. That is when they skip the undercoat and paint over cobwebs.
Doncaster, South Yorkshire
SIR – In 1978 the complaints about rotting window frames in my naval married quarters received no attention till I submitted a photograph of our alarm clock buried in a snowdrift that had formed upon the windowsill between the curtains plus the closed window.
Tate and slavery
SIR – I was disappointed to read your description of Tate Britain’s rehang ( “Tate’s art rehang is usually ‘polemic against the past’”, statement, January 22 ). It is definitely several months away from completion, with numerous works still to be added.
When finished, the great figures of British art will be even better represented than they were before, along with more works by such artists as Hogarth and Spencer, not fewer. Several rooms will become dedicated to beloved historical numbers such as J M W Turner, William Blake, the particular Pre-Raphaelites, Henry Moore plus John Constable – including his Flatford Mill, which usually your article said would be absent.
Tate Britain’s brand new displays will certainly explore art’s complex relationship with social and cultural history – including, inevitably, colonialism and empire – but as part of a much broader journey through the centuries. I look forward to visitors discovering these several varied plus fascinating stories when we finish our rehang at the end of May.
Director, Tate Britain
SIR – You record ( January twenty two ) that Tate Britain can be to rehang its collections to emphasise historic links to colonialism and slavery in Uk art. All of us must certainly expect, therefore , an exhibition in its entrance hall explaining to visitors as they arrive that will Sir Holly Tate, the founder and benefactor of the gallery, made the money that paid for it and many of the paintings within the sugar cane fields of the particular West Indies.
The black labourers that grew the cane Sir Henry refined into sugar were not slaves themselves yet descendants associated with slaves. They were exploited and ill-remunerated nonetheless, plus justifiably rebellious, as in Jamaica within 1865. One wonders why curators so exercised by these matters choose to function in the gallery therefore intrinsically related to the really things these people so detest. The lack of self-awareness and the sheer hypocrisy of some among our social elites is certainly simply comical.
Professor Lawrence Goldman
St Peter’s College, Oxford
SIR – Speculation about the particular King swapping stockings and breeches worn at coronations by his male predecessors for a military uniform ( review, January 22 ) ignores an important fact.
The majority of the King’s subjects live in Commonwealth realms this kind of as North america, Australia, New Zealand as well as the Bahamas, where he is Head associated with State. Consideration must be given to our traditions. Our military uniforms are as relevant because those of Britain. A neutral dress is more appropriate, and makes all the particular realms feel included. Placing a crown on someone wearing a military uniform might look extremely odd.
When Queen Elizabeth II has been crowned since monarch associated with all the then realms, their names were spoken aloud, plus we expect the same at this coronation. It is a Commonwealth service and not just for that British.
Thomas A Wardle
The BBC is blind in order to the many benefits of golf
SIR – Golf has many benefits: thanks to the handicap system, it can be played by the particular whole family members, despite age and skill differences; if reasonably match, one can play throughout one’s life, and it can be played all over the world. It will be easily accessible via member clubs, pay-as-you-go night clubs and a huge range of excellent golfing societies.
Our own wonderful club strongly encourages junior golf. We have the range associated with enthusiastic committees covering almost all sectors of membership interest, culminating in the super seniors, whose ages range from the early 80s to the mid-90s. There is plenty of opportunity intended for male, female, young and old players to meet plus play together – something quite unique in sport. You would think this would be lauded and encouraged, but not by the BBC, apparently ( “BBC Masters coverage heading to get long grass”, Sport, January 25 ). Golf is simply not really on its agenda, despite a certain amount of lip service more than the many years and some protection of major events.
We are in the ridiculous position where a British golfer can win a significant international tour event and this may not even be mentioned by the particular BBC. Surely a few words on a result and a list on a corner of the screen from the top 10 gamers in the particular competition is not a lot to ask.
SIR – Matthew Lynn gives an optimistic view associated with Britain’s place in the fusion power race ( “Britain can end up being a nuclear fusion superpower if all of us don’t blow it”, Comment, January 7 ). He quite rightly points to previous failures in order to capitalise on leads within nuclear energy.
However , We take issue with him over the particular causes of us falling behind in the past 30 years. The particular Central Electricity Generating Board (CEGB) learned the lessons of the 1950s and 1960s, whenever contracts had been placed with several consortiums to build advanced gas-cooled reactor stations. They all independently tried to design, build and commission stations plus they just about all failed. The CEGB had to create a research and development department in order to salvage the particular stations, which they did with great cost and along with varying degrees of success. They also realised that a future programme needed not only technical expertise but also the ability to manage large, complex projects.
After a few false starts, a very successful design and construction department emerged. The particular model had been to provide overall design plus control, with the work being done by companies. They settled on the pressurised water reactor design, which used a well-tried Westinghouse reactor. Construction started on Sizewell B in 1988 and the station went upon line within 1995 – built to time and inside budget. Ironically it is now owned by EDF Energy, which has a reputation pertaining to not building stations in France in order to time or budget.
Sizewell B was the prototype of what was planned as a series of stations to become constructed over the following two decades, mainly on sites along with existing nuclear licences. Replicating the design would certainly have been cost-effective both in construction plus running. If this had happened we would now have the large, basic, carbon-free generating capacity, protected from worldwide fuel costs.
Unfortunately Margaret Thatcher thought she knew better. The programme has been scrapped, the particular CEGB had been disbanded and subsequently private companies were encouraged to produce electricity simply by burning our own natural gas supplies. As Mr Lynn says, Tony Blair failed to reverse the trend, but the price to the taxpayer would have already been huge, plus the knowledge and organisation had been lost.
SIR – That the joint French and German Brand new Year drinks party at the German ambassador’s residence ran out of French-supplied champagne ( Peterborough, January 21 ) not just demonstrates French parsimony but also highlights the Germans’ tact.
Had the Germans substituted the “very pleasant German red” for their own superb Sekt (sparkling white wine), the particular whole assembly would have realised that will Sekt is usually as good as, if not better compared to, champagne.
Johann St Clare Stracey
Harrogate North, Yorkshire
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