ONCE again the NHS is in crisis. Essential staff are sacked, beds closed, GPs are scolded for “over production” because they have exceeded their targets. When will the mandarins realise that patients are not widgets on a production line for which targets can be imposed and delivered? If a patient needs a half hour of a doctor’s time to help him/her come to terms with an unexpected cancer diagnosis, that is what the doctor will do because the professional ethos demands it.

All targets do is waste valuable time. Already nurses spend 40% of their time on computers, much of it designed to capture data needed for targets which also encourage managers to be deceitful and massage figures and make desperate efforts to rob Peter to pay Paul.

The alarming rates of hospital acquired infections that we now suffer (and die of) could be more easily avoided if staff had the time to practise the aseptic techniques that prevent HAIs.

This government is too fond of suggesting useless ideas to improve patient care; I don’t know whether to be horrified or amused at the appointment of “dignity nurses” given that treating patients with dignity should be central to the job of a nurse. Unfortunately, some modern nurses have not been properly trained in the skills needed to treat elderly patients with dignity. I fear for the existence of a once superb institution which I have always been passionate about.

Claire Rayner
President, Patients Association

FIRST-HAND DATA: During 40 years in medical practice as junior doctor, consultant physician, army doctor and Premiership club doctor, I have dealt with many thousands of emergencies in A & E departments, wards, homes, barracks, hotels and digs. I cannot recall an occasion when information that was not available from the patient, relatives or ambulance personnel would have been vital in dealing with an acute problem.

If unknown drugs are involved, they are more likely to be illegally obtained and therefore unrecorded. Certainly there are not common situations that would justify spending tens of billions of pounds in providing immediate data.

Dr Barrie Smith
Birmingham

PATIENT POWER: Giving patients a copy of their health records would offer some safeguard against the risks of total dependence on a computer database. Unfortunately, many healthcare professionals assume giving such access invites complaints, rather than promoting an active interest in patients’ own health.

Joyce Robins
Co-director, Patient Concern
London SW5

IT GLITCHES: Government computer projects will continue to be expensive disaster areas as long as politicians and senior civil servants remain scientifically illiterate (Anatomy of a £15bn gamble, Focus, last week). Grandiose projects of immense complexity are conceived in ignorance of computing realities and then subjected to ministerial fantasies during development. The inevitable results are astronomical costs and incompetent systems.

The disasters with the NHS IT project will be nothing compared to Blair’s identity card fantasy, which involves integrating numerous rickety government databases with complex scanning technologies that are still in their infancy.

Alan Bailey
Warrington

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