Serve the

people

Thank you for promoting debate on the health service. The problems besetting it are extensive and some are complex, but none is insuperable. There are a few simple principles that politicians must apply to resolve them and deliver the health service the public needs.

First of all talk with, listen, and report back to the people. They are both the potential recipients of the service and partners in specifying how it should evolve. Second, listen to the staff who provide the service. Value them, do not bully them, and pay particular attention to those who tell you what you do not want to hear. Third, do your job properly. Do not tell lies or finesse the truth and do your homework.

Finally, never forget that the priority of a public service is to serve the people and act accordingly. If these principles are followed, the public might begin to regain some trust in the good faith and competence of politicians and their appointees in health boards. As of now, they do not subscribe to them and consequently are no longer trusted.

If they cannot or will not apply them, they are jeopardising the service for us and our children and betraying the electorate, who will vote accordingly.

George Venters,

chairman,

Scottish Health Campaigns Network.

Quality

of care

IN Sam Galbraith's letter (September 7), he argued that bigger was better, claiming that greater volumes mean greater safety in neurosurgery and that the same principle applied in all other specialities. Really? This might be true of the skills required to carry out highly complex procedures, but is it true of caring?

Do patients get better, more compassionate care if they are processed in bigger units? Isn't it likely that personal care and attention is best when there is a greater staff-to-patient ratio and a greater staff-time-to-patient ratio?

One of the reasons for the multiple campaigns across Scotland against the closure of local and smaller services is that people are more important than procedures and, in fact, there is no evidence that larger hospitals have lower incidences of medical mistakes or hospital-acquired infections. For the vast majority of patients, maybe their needs would be better met by local people who care, and who have the time to care, in smaller facilities.

Dr Bob Leckridge,

23 Hayford Mills,

Cambusbarron, Stirling.

Maternity

fears

AS a pregnant mother, I am writing to highlight the problems currently facing women in Caithness, and north Sutherland, where a review of the consultant-led maternity unit (based in Wick) is being carried out. The nearest alternative maternity unit is Inverness (up to three hours away by road in good weather conditions). I am not aware of anywhere else on the British mainland where pregnant women would have to make a journey of up to three hours to a maternity unit. My due date is February 28 and I am extremely worried about the fact that, at the end of February last year, this road was blocked at different times on three consecutive days. The alternative - helicopter - is not always feasible due to weather, if indeed one is available at all (not always the case) and once a woman is already established in labour, she is not allowed to travel by helicopter.

Many local women are now saying that, should the unit be downgraded, they will take the decision not to have any more children, as having a baby in a midwife-led unit, with no consultant experience close by, is too risky. It will only be a matter of time before the first mother or baby dies during childbirth, and that is why the overwhelming majority of the local population are backing a campaign to keep our unit with the full consultant-led cover it has always benefited from.

Ms Aelex W Miller,

chairman, Royal Burgh of Wick Community Council, 1 Coghill Street, Wick.

Ahead only

of Romania

I AM so pleased that at last a national newspaper is taking up the cudgels against the decimation of our hospitals. I am not generally a politically motivated person but I cannot remember any issue angering me more than this one and I have yet to speak to anyone who does not feel the same way. My local hospital, Inverclyde Royal, is proposed to be downgraded to a glorified cottage hospital. The first hour after a heart attack, stroke, or serious trauma is the most important. For Inverclyde's citizens, this will be spent in an ambulance to Paisley.

If we are to believe the health board, this will be just as good as being in hospital. Such patronising remarks are an insult to the intelligence. Perhaps we should not expect more from a board which has already removed our maternity hospital, despite the fact that Inverclyde has the second worst live birth statistics in the EU, ahead only of Romania.

Similar catastrophes are happening across Scotland. I suggest that our politicians, and Mr McConnell in particular, put all of these changes on hold. I also think the campaign groups need to consider co-ordinating their efforts. Instead of a few thousand protesters at individual sites around the country, tens of thousands making their point on the steps of our new parliament building may well be more effective.

Nick Robinson,

4 Burns Drive, Wemyss Bay.