IOur article on physician associates highlights the bullying and downright disgusting attacks on trained healthcare professionals who work under unbearable pressure to keep our patients safe (“Rise of physician associates risks ‘care inequality’, doctors warn”). The same doctors who are striking today rely on nurses, care assistants and, yes, physician associates to care for their patients while they sunbathe outside the hospital. I have worked with all types of NHS staff and PAs deserve their status as healthcare professionals who deliver excellent care under supervision, just like nurse practitioners and others.
In a world where my 85-year-old mother has to wait in line at 7:30 to see anyone, let alone a doctor, I thank those who have spent more than five years training, like PAs, to help patients like her. I speak as a physician who is ashamed that my profession cannot understand the mental harm it causes.
Dr. Shaun Meehan
Formby, Merseyside
The debate over PA oversight reveals a number of growing fault lines in the NHS. Firstly, the General Medical Council disgraced itself by its decision to suspend GP Sarah Benn after she took part in a perfectly peaceful Just Stop Oil protest; so the GMC is the last institution that would supervise anyone. Secondly, PAs are the Tory government’s attempt to provide cheap medical care; but of course in medicine, as in other aspects of life, cutting corners and cutting standards is never cheap. Since there won’t be enough consultants to supervise the influx of PAs, the legal profession will be rubbing its hands in glee.
A better solution is to abolish GPs altogether, deploy nurse practitioners in the former GP practices and promote GPs to the role of ‘physician assistants’, so that the entire workforce can once again practice appropriate medicine within the secondary referral setting.
Dr. Robin Russell-Jones
Marlow, Buckinghamshire
Blame it on neoliberalism
It is astonishing how Simon Tisdall can talk about the need for constitutional reform (to solve America’s “Trump” problem) without discussing neoliberal economic reform (“America’s big problem is not Biden, but the threat to democracy that Trump poses”).
The radical Tea Party was formed in response to the 1989 U.S.-Canada Free Trade Agreement. Within a decade of its unpopular implementation, millions of middle-class Americans and Canadians in the heartland of the country were left unemployed.
It is the same neoliberal economic policies that are being implemented in Britain, France, Italy, Spain and Germany. Most of these countries are also moving to the right as more and more people become frustrated with their impoverished economic reality. You can tinker with the constitutional margins all you like, but until you tackle the 80% of people who are falling further and further behind, while a minority are getting vastly richer, we will continue to witness the rise of the right in the G20.
Sherwood Hines
Berlin, Germany
Horses for courses
While I appreciate David Mitchell’s columns, I have to criticize his statement that “nobody cares which horse wins unless there’s money at stake” (“Contrary to all expectations, we seem to hate it when bookmakers lose”).
The British public has a long history of cherishing racehorses, a recent example being Frankel, whose chances were too slim after his first race to support him for the rest of his winning career. The racing public still loved him, and thousands turned up to see him run without supporting him. From the unbeaten Eclipse in the 18th century (“First Eclipse, the rest nowhere”) to Nijinsky, Brigadier Gerard, Dancing Brave, Red Rum, Arkle and Desert Orchid, people love a brilliant racehorse. Last year I paid £90 (plus travel) to see Frankel at his stud in Newmarket. It was worth every penny to be in the presence of a superstar. I am a football fan, but I wouldn’t pay £90 to meet retired – or current – players, no matter how famous.
Jim Hatley
Bright
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I can find billions too
While Will Hutton is absolutely right that there is capital available in existing pension funds to support growth, there is another source staring us in the face (“Labour needs billions to fund its plans – and I know where to find it”). The Department for Work and Pensions’ huge annual budget, currently distributed individually to the most financially disadvantaged members of society, could be used collectively to obtain bulk rebates on behalf of claimants to increase the purchasing power of existing benefit rates. Creating a special, not-for-profit financial vehicle (a rebate card) to channel all purchases of food and everyday consumer goods could also provide a sustainable source of income for charity advice and support agencies without raising taxes or cutting benefit rates.
Vaughan Thomas
Norwich
AI? It’s just dumbing down
There’s a lot wrong with what the slightly oddball Ray Kurzweil has to say about AI, the most egregious being his model of it gradually becoming as intelligent as us until it approaches parity (Q&A). In fact, it’s not just that AIs are improving, it’s that we’re being coaxed into accepting false mediocrity as adequate and authentic. We’re slipping back to meet it halfway, just as social media is stultifying communication. Image generators are to art what table dancing is to sex. But the AIs and their culture-rewriting progenitors won’t care, and increasingly neither do we. So that’s okay. The singularity will happen, probably sooner rather than later, when we’re culturally stupid enough to say it is.
Brian Reffin Smith
Berlin, Germany
New balls please
Simon Cambers writes about Wimbledon’s decision to continue using the gender-specific terms “ball boy” and “ball girl”, while the US and Australian Grand Slams have opted for gender-neutral alternatives (“Ball kids? No thanks, we’re sticking to boys and girls, says Wimbledon”). I’m rather taken with the French term “ramasseur of balls“, which means “ball collector”. The feminine form “ramasseuse of ballscan also be translated as “ball collector”, so the gender-neutral principle would be maintained in English.
Michael Bulley
Chalon-sur-Saône, France