Letters: Patients deserve to know that their health is in the hands of a real doctor
SIR – You report (December 11) concern on the part of the British Medical Association and other medical organisations that a “blurring of the roles” of physician associates – who have no formal medical training – and fully qualified doctors could contribute to “a dangerous ambiguity in patient care”.
The Doctors’ Association UK has already found numerous instances of patient harm, when associates have undertaken tasks that should have been done by doctors. The General Medical Council is now set to regulate them, but the real question is: should there be physician associates at all?
When patients arrive at a surgery, will they be seen by a physician associate with two years’ training or a real doctor with many? Will patients be told? Will they get a choice?
You report that associates will not undertake tasks that only doctors are qualified to do. So, who will judge whether their condition merits seeing a doctor rather than an associate?
What seems to be ignored is that a doctor’s ability to recognise whether a patient may have a serious condition only comes from years of examining and dealing with minor symptoms, so as to be able to differentiate between normal and abnormal. With a few obvious exceptions, they shouldn’t be shielded from the apparently trivial.
The Government’s envisaged “massive expansion” of physician associates will further erode primary care.
Dr Stefan Slater
Edinburgh
SIR – The rise of physician associates is not the first initiative to blur the identity of who exactly is providing healthcare.
When I was a newly qualified doctor, nurses wore different uniforms and caps, so you could tell from the other end of the ward whether someone was a sister, state registered nurse, state enrolled nurse, student nurse (and in which year of training) or an auxiliary nurse.
Many hospitals now have the same uniform for everyone, so only a small badge will tell you who you are speaking to. This allows the wards to look better staffed than they are; if there is only one qualified nurse on duty, working with healthcare assistants, this will not be obvious to the casual observer.
Dr Hilary Aitken
Kilmacolm, Renfrewshire
SIR – I spent 50 years as a registered pharmacist. My qualification involved three years at university followed by another year to enable registration as a member of what was then called the Pharmaceutical Society of Great Britain, which provided regular inspections of practice competence. This qualification had to be on display. Terms such as “physician associate” or “clinician” offer no assurance of the standards of advice on offer.
M J Shucksmith
Fordingbridge, Hampshire
British culture
SIR – Mark Dunn (Letters, December 14) misunderstands what is meant by multiculturalism.
The essentials of British culture include the idea that men and women are equal, that being gay is accepted and not shameful, that everyone should be allowed to express their views peacefully, that religions can be joked about, and that being offended is a choice you make. It includes a lack of deference to those in authority and, most of all, it includes a sense of fair play. Nobody minds what clothes you wear, what music you listen to or what food you eat.
My list is not comprehensive, but it seems there are too many cultures in this country, not all religiously or ethnically based, that don’t accept these fundamental aspects of Britishness.
Julian Gall
Godalming, Surrey
SIR – Multiculturalism is not a binary choice. It is appropriate to allow different cultures to follow their customs and practices rather than expecting them to be abandoned on arrival here. I suggest that mutual respect is a more useful idea.
All sections of our society should be expected to conform to this country’s well-established laws while they celebrate their own traditions. Equally, we should not appease the feelings of others by being complicit in undermining our long-held traditions.
Don Hamilton
York
Rural ghost towns
SIR – Last weekend, my wife and I had supper in our rather excellent village pub. It is recognisably one of the best, most picturesque pubs in the area but on a Saturday night, a couple of weekends before Christmas, we were the only people in there.
Walking down the attractive main street, it was not surprising that the pub was empty. The place was like a ghost town: there were no lights on in any of the houses along the road, not even Christmas lights, other than those put up by the local parish. The sad truth is that those remaining residents in the village now play host to a majority of second homes.
So rather than bemoan the fact that they have to pay double council tax (Letters, December 13), second-home owners should ask themselves what more they can do to support the local communities they are slowly but surely deconstructing.
After all, if second homes continue to proliferate, eventually there will be no one to staff the local economy for them to support.
Dicky Biddle
Dittisham, Devon
SIR – I would like to thank Jack Rear for his observant article on Hillingdon (“How I found happiness in Britain’s most miserable town”, Features, December 13).
My family and I have lived here for eight years and, although we’ll never win an award for glamour, I think it’s the local people that make it worthwhile. We can also boast of a well-run council, good schools, good transport connections and thriving high streets. What’s so bad about that?
Marcus Lawrence
Hillingdon, Middlesex
Double trouble
SIR – I once bought a new suit from a high-street outfitter that came with two pairs of trousers (Letters, December 13).
Within a week I burnt a hole in the jacket.
C F Goodall
Cheltenham, Gloucestershire
Drakeford’s record
SIR – Mark Drakeford, who has announced he will be stepping down as First Minister of Wales (report, December 14), was instrumental in the following: closing the border during the pandemic, thereby preventing people from visiting friends and relatives in Wales; more than doubling the council tax bill for some second-home owners in Wales; introducing the 20mph speed limit in many Welsh towns and villages, against the will of the majority of those consulted (in certain circumstances preventing the building of new roads and bridges in Wales); overseeing a general decline in the Welsh health service; and failing to recognise the importance of English tourism to the Welsh economy.
He will not be missed.
Ian Pinson
Clun, Shropshire
The King’s GP
SIR – Thank you for your positive article on Dr Michael Dixon (Features, December 13). It was refreshing to read a balanced opinion on the benefits of combining traditional treatments with complementary therapies.
I worked with Dr Dixon for nine years as a strategic manager in his Devon practice. He was a kind and very caring GP, and tremendously popular with patients. Complementary treatments were available to those who wanted them, and were never foisted on patients. His work at NHS Alliance was proof of his total commitment to general practice and to helping all those involved in healthcare.
King Charles and his family have a wonderful GP.
Wendy Evans
West Harptree, Somerset
Why veggie firms fail
SIR – I’ve been vegetarian my whole life (veggie parents) and am not surprised to read about the demise of Heather Mills’s firm and other meat-free food brands (Features, December 14). Their problem is very simple: most of their products are unpalatable or, at best, bland.
When I buy expensive food I expect the taste and texture to match the promise made by the cost – not the opposite. I wonder if they believe that their admirable ethical intentions automatically make their products good.
Sadly, the one truly excellent vegetarian sausage – the Sausalata, made by Granose – was withdrawn from sale some years ago, and nothing since has come close.
Tim Gant
Amport, Hampshire
Fast food is gobbling up classic French cuisine
SIR – Jane Shilling’s observations on the decline of French cuisine (Comment, December 11) are, sadly, only too true, as we have seen in the 34 years since we bought a second home on the Brittany coast. The four-course menu has all but disappeared from local restaurants, the explanation being that cheese has now become too expensive. Classic French sauces no longer accompany the plat de résistance, as the knowledge and skills to prepare them have not been passed down. Time after time, the choice in many restaurants seems limited to one meat, fish or vegan dish, “le hamburger or fish and chips”.
On a visit last month, further evidence of Americanisation was provided by giant posters for Black Friday deals in all the shops.
Peter J Howard
Bothenhampton, Dorset
SIR – Jane Shilling may see the French facing culinary humiliation with the opening of the first Krispy Kreme outlet in Paris. But that is nothing compared to the demolition of Les Halles, the Covent Garden of Paris, to make way for the vast multi-storey shopping centre of the Westfield Forum des Halles, where the doughnut chain has just opened its branch.
Little did I think in the late 1960s, as I sipped my midnight soupe à l’oignon at a restaurant amid the porters and barrow boys who were on their break, that within a couple of years the culinary heart of the city would be torn out.
Thankfully, the brasserie Au Pied de Cochon lives on, as does E Dehillerin, the specialist shop that sells the finest kitchen equipment to the catering trade and keen cooks. And even if the fried-chicken chain Popeyes has recently opened its first branch at the Gare du Nord, there is still Terminus Nord brasserie across the way where, only the other day, I ate a delicious suprême de volaille.
John Adamson
Cambridge
Count down to Christmas with angels or Pooh
SIR – I haven’t seen traditional Advent calendars in supermarkets in recent years (Letters, December 14), but they can be sourced online. My wife’s Christian calendar has been handed down from previous generations. As an atheist who never grew up, I still favour my Winnie the Pooh calendar.
Dave Alsop
Gloucester
SIR – In our house, each year for our Advent calendar I paint a Christmas tree on A3 card, hang this on the wall then add appropriate pictures each day. These range from sweet animals and odd cartoons to anything we think suitable, but we always end up with a Nativity on December 24.
Sue Mason
Long Sutton, Lincolnshire
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