SIR – My wife and I have very recently moved back to North Herts from Berkhamsted. We wanted to be nearer family and friends in our home area for our retirement. One factor which affected our decision to move from Berkhamsted was the rapid and appalling

SIR - My wife and I have very recently moved back to North Herts from Berkhamsted. We wanted to be nearer family and friends in our home area for our retirement.

One factor which affected our decision to move from Berkhamsted was the rapid and appalling decline in services at Hemel Hempstead Hospital. Savage cuts and transfer of services to an already overloaded Watford Hospital caused us considerable concern.

We wrongly assumed that the Lister Hospital, a mile or so away from where we now live would not be affected in the same way. The same NHS chainsaw is being wielded here by administrators who would appear to have no interest in the health of those who they are meant to serve and probably have no medical qualifications or experience to make the value-judgements necessary for patient care.

No, their only criteria are the targets. No matter that my step-mother contracted MRSA after a leg operation in a hospital named after Lord Lister, the pioneer for aseptic care. Once she had been shuffled off to a cottage hospital with her wounds still oozing, her treatment was presumed successful and ticked off in the target figures box.

I worked for many years as a physicist developing immuno-diagnostic tests for an American healthcare company and their only interest was the quarterly profit figure. Nothing else was of concern, except not to fall foul of the US FDA and to beat the competition.

I spent the last five years before my retirement working in a major cancer hospital and it became increasingly obvious that if one went private, life-saving drugs including some still on clinical trials would be available which certainly were not for ordinary folk who paid only their National Insurance contributions.

And to think: this is under a Socialist Government. Doing things not even the most rabid Tory would dare suggest in public. Although of course we would not expect that Party to be any real opposition to any measure Blair has implemented. Illegal invasions of sovereign countries with no justification except lies, included.

ROBERT SUNDERLAND

New Oak House

Little Wymondley

SIR - Having just returned from a stay in Ward 8A of Lister Hospital, following knee surgery, I am appalled to read of the proposed cuts at The Lister.

The care I received from nurses, ancillary staff, etc was magnificent and could not have been bettered in any medical facility.

I do feel that there are many ways in which substantial ongoing savings could be made rather than the quick fix which is proposed.

For example, much equipment is used once and then discarded due, it is said, to Health and Safety regulations, with advice from the appropriate bodies, this could be reused.

The food served (compliments to the caterers) was very generous and could be cut down. I also think that patients could be asked for a contribution for food after all, we would have to pay for this if at home.

In the staff at the Lister we have a most valuable resource of people who work with a commitment to care which could be bought with high salaries.

Let these staff go at your peril, Nick Carver, for if you do, we will be screaming for replacements next year.

MRS SHEILA PEDRICK

Bedford Road

Hitchin

SIR - With regards to the secretaries being made redundant, to enable patient records to be sent to India for typing would be a tragedy.

Having had a recent stay at the Lister I dealt with the secretary by phone for advice and found her very helpful and caring. I am sure many of us would not get the same treatment if they were to go. Also the pressure would be too intense for the consultants as they have a very busy schedule. They deserve to earn what they do.

The nurses work hard too. It seems to me that the people that request these ideas are never seen and they should be the ones to be axed. Also the paperwork could be cut in half. Maybe this would save the secretaries and the nurses from being made redundant!

LYNN DAWSON

Old Bourne Way

Great Ashby

Stevenage

SIR - Patient Care Will Not Be Affected, reading the article on medical typing outsourcing and the companion article on consultant salary drops, closing wards, cutting down staff, combining pathology services, having QEII as the medical records store etc, it beggars belief that the Chief Executive, Nick Carver, and the Human Resources Director, Danny Mortimer, can assure the general public that there will be no deterioration in patient care.

Nick Carver says the financial situation has worsened since the decision by the PCTs not to refer as many patients as previously. But how did the Trust get into such a parlous state in the beginning? When the previous CEO left four or five years ago it was assumed by most of the staff that the new Chief Executive, Nick Carver would reverse the situation. It has steadily escalated. Everything has been blamed for this except poor management. Consultants, administration staff, and even porters (whose earnings are in themselves a scandal for the work they do) - everyone except frontline healthcare staff is under threat. Where are the management cuts? Who is going to step forward and accept responsibility for the massive deficit?

Have the Trust Management considered the changes there have been to staff morale? The consultants on the new pay scheme will have their salaries cut, but not those who are on the old contracts. This will cause resentment among the consultants. The junior doctors will not have the teaching guidance to the same degree as at present.

Some of the consultants will just move leaving gaps. The secretaries will be dealing with work originated elsewhere and those using the system now have reported that there is no actual time saving as the printing, inserting in patient's notes, checking etc takes longer when using typing done by someone else.

For those to be redeployed it is a can of worms. It usually ends up with someone getting a job that is lower graded but with protected pay and then you end up with an office where one or two people are being paid substantially more for doing the same job as others. The staff at the hospital know that 700+ jobs will be going - the general feeling is who next? It is very difficult to maintain a detached working attitude when there are constant threats to security of job tenure. Can the general public accept that, after all the changes and cuts, the service provided will be as good? How stupid does the Trust Management think members of the general public are?

NAME AND ADDRESS

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