Physician associates are heroes, not villains

Your article about physician associates underlines the bullying and frankly disgusting attacks on trained health professionals who are working under intolerable pressure to keep our patients safe (“Rise of physician associates risks ‘care inequality’, warn doctors”). The same doctors on strike today are relying on nurses, healthcare assistants and, yes, physician associates to care for their patients while they are in the sun outside hospitals. I have worked with all types of NHS staff, and PAs deserve their status as health professionals delivering excellent care under supervision, as do nurse practitioners and others.

In a world where my 85-year-old mother has to queue at 7.30am to see anyone, never mind a doctor, I thank those who have trained more than five years, as PAs have, to help patients like her. I speak as a doctor ashamed that my profession cannot understand the mental harm it is causing.
Dr Shaun Meehan
Formby, Merseyside

The debate over the supervision of PAs reveals a number of widening fault lines in the NHS. First, the General Medical Council has disgraced itself by its judgment to suspend the GP, Sarah Benn, after she took part in a perfectly peaceful Just Stop Oil protest; so the GMC is the last institution to be supervising anybody. Second, PAs are the Tory administration’s attempt to provide medical care on the cheap; but of course in medicine, as in other walks of life,cutting standards and corners is never cheap. As 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 get rid of GPs entirely; get nurse practitioners to run what used to be GP surgeries; and promote GPs to the role of “physician associates” so that the entire workforce can start practising proper medicine again within the secondary referral setting.
Dr Robin Russell-Jones
Marlow, Buckinghamshire

Blame neoliberalism

It’s surprising 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, it’s the menace to democracy posed by Trump”).

The radical Tea Party was formed as a response to the 1989 US/Canada Free Trade Agreement, which, within a decade of its unpopular imposition, threw millions of middle-class Americans and Canadians in the heartland out of work.

It is the same neoliberal economic policy at work in Britain, France, Italy, Spain and Germany. Most of these nations are also lurching to the right, as more and more people become frustrated with their impoverished economic realities. You can tinker at the constitutional margins all you want, but until you deal with the 80% of the people who are consistently falling further and further behind, while a minority get hugely more wealthy, we will continue to witness the rise of the right in the G20.
Sherwood Hines
Berlin, Germany

Horses for courses

Much as I enjoy David Mitchell’s columns, issue must be taken with his statement that “nobody takes an interest in which horse wins unless they’ve got money riding on it” (“Against all odds, it seems we hate bookies losing”).

The British public has a long history of taking racehorses to their collective heart, a fairly recent example being Frankel, whose odds after his first race were too short to make him worth backing for the rest of his winning career. The racing public still adored him and thousands turned up to see him run without having backed him. From the undefeated Eclipse in the 18th century (“Eclipse first, the rest nowhere”) to Nijinsky, Brigadier Gerard, Dancing Brave, Red Rum, Arkle and Desert Orchid, people do love brilliant racehorses. Last year, I forked out £90 (plus travel expenses) to see Frankel at his Newmarket stud. 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 any retired – or current – players, no matter how famous.
Jim Hatley

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I too can find billions

While Will Hutton is quite right that there is capital available in existing pension funds to aid growth, there is another source staring us in the face (“Labour needs billions to fund its plans – and I know where it can be found”). The Department for Work and Pensions’ huge annual budget that is currently distributed individually to the financially weakest members of society could be used collectively to capture bulk discounts on behalf of claimants to increase the purchasing power of existing benefits rates. Creating a special purpose, not-for-profit financial vehicle (a discount card) to channel all purchases of food and everyday consumer goods could also provide a sustainable revenue source for charitable advice and support agencies without increasing taxes or cutting benefit rates.
Vaughan Thomas

AI? It’s just dumbing down

There are many things wrong with what the slightly strange Ray Kurzweil has to say about AI, the most egregious being his model of it gradually getting as intelligent as us, until it approaches parity (Q&A). In fact, it’s not just that AIs are improving, it’s that we are being persuaded to accept meretricious mediocrity as adequate and authentic. We’re sliding backwards to meet it halfway, just as social media dumbs down communication. Image generators are to art what table-dancing is to sex. But the AIs and their culture-rewriting begetters won’t care, and increasingly neither do we. So that’s all right, then. The singularity will occur, probably sooner than later, when we are culturally stupid enough to say it has.
Brian Reffin Smith
Berlin, Germany

New balls, please

Simon Cambers writes about Wimbledon’s decision to continue with the sex-specific terms “ball-boy” and “ball-girl”, when the American and Australian Grand Slams have opted for sex-neutral alternatives (“Ballkids? No thanks, we’ll stick to boys and girls, says Wimbledon”). I’m quite taken with the French term “ramasseur de balles”, which means “ball-gatherer”. The feminine form “ramasseuse de balles” also translates as “ball-gatherer”, so the sex-neutral principle would be maintained in English.
Michael Bulley
Chalon-sur-Saône, France

The Guardian

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