Torsten Bell is correct in his analysis of the exodus of nurses from the profession (“When nursing staff head for the door, senior doctors are right behind”, Comment). As a now retired nurse of more than 40 years’ experience, I can speak with some authority about why retention is so poor. Nurses never expect huge salaries or they wouldn’t have entered the profession in the first place. They do, however, expect to feel valued. If they were offered incentives such as subsidised housing, car parking and meals on duty (just like our MPs get), they would be less inclined to leave. Most nurses aren’t nomadic and value the chance to work flexibly to accommodate family life. A little nurturing would go a long way to improving retention.
Teresa Curtis
Cheadle Hulme, Stockport
I am a consultant paediatric surgeon and am unable to function without the trained, talented, experienced nurses who are part of our team. We do not delegate. We have our overlapping roles and inform and guide each other. I am frequently guided by my nursing colleagues. They have skills I will never attain. My ability to work efficiently is dependent on these nurses. Delegation implies a hierarchy between surgeons and nurses that does not exist except in their salaries, which in turn does not reflect relative worth.
Alan Bailie
Belfast
I was intrigued by the hierarchical world portrayed by Torsten Bell. He says that if nurses leave, so will doctors, as they have “no nurses to whom they can delegate”. As a retired senior nurse of 40 years’ experience, I do not recognise this relationship. Nurses and doctors do different but equally valuable work, within independent autonomous professions. Nurses do not wait for the doctor to “delegate work” – they get on with caring for the patient using their own significant clinical skills and expertise. They excel when they work in mutually respectful teams planning the patient’s care with doctors, physiotherapists, pharmacists etc, and it is in those high-functioning teams where job satisfaction and therefore staff retention are at their highest.
Bell rightly suggests that “weak staff engagement, such as self-reported commitment to the job, sees nurses heading for the exit”. However, “engagement” in this context means all staff members, whatever their profession, feeling involved and in control.
Jenny Kay
London SE21
Trusts should not be saving
I am not at all surprised that 90% of state schools will have in-year budget deficits in the coming year but I am surprised that many academy trusts still claim to have reserves to draw on after a decade of real-term reductions inflicted by the government (“90% of our schools will run out of cash – heads”, News).
Why have such reserves been maintained or even built up when they ought to have been spent on the education of their pupils at the time? Why have too many academy trusts incurred top-heavy administrative/managerial costs during this period of financial stringency? Academy apologists claim that “many trusts are having to use some or all of their reserves”. So they should.
Prof Colin Richards
Spark Bridge, Cumbria
Tax the rich to level up
Will Hutton shows us how the government could “comfortably raise the £40bn needed to plug the fiscal black hole”, focusing taxes on “capital, property and wealth” (“The future offers only variants on austerity? Bunk. There are ways to invest and grow”, Comment). But why stop there? Why not raise more revenue by taxing the income of the wealthy with higher rates than at present? Those earning over £150,000 could face a rate of 50% and over £250,000 perhaps 60%, the same level, William Keegan reminds us, as for most of Thatcher’s premiership (“We’ve had enough austerity, thank you”, Focus). Capital gains tax needs to be equal with income tax, a tax on bonuses is definitely required (and a vote-winner) and windfall taxes should include banks as well as oil and gas companies.
With so much talk about the need for efficiency, and with the tax gap standing at £32bn a year, HMRC could certainly benefit from the return of many of the tax inspectors culled during George Osborne’s austerity years, to properly tackle tax evasion and avoidance. Plugging the fiscal black hole is the immediate priority, but high-quality public services and a suitably funded levelling up programme are not out of the country’s reach.
Bernie Evans
Liverpool
Focus on the early years
I enjoyed Kenan Malik’s article on rethinking our idea of the good society by focusing on “human flourishing” rather than agonising about how not to channel welfare to the “undeserving poor” (“If this chaos does not make us rethink our idea of the good society, whatever will?”, Comment). In pursuit of human flourishing, he arrows in on neglected areas of policy: a proper system of state-funded childcare, a well-resourced transport system and a decent framework for social care for the elderly.
These areas are certainly important but, given our knowledge of what enables humans to flourish, we should be focusing resources on improving the first 20 years of a person’s life: trying to ensure that every youngster has skilled and stable parenting, a healthy lifestyle, decent housing set within a healthy communal and physical environment and access to excellent educational/training facilities at every level. We know that “deficits” in these aspects of early life render it extremely difficult to flourish in later life. If we are serious about the principle of equal opportunity and wanting everyone to have the chance to flourish, these aspects must become an essential part of contemporary policy.
Ray Weedon
Berkhamsted, Hertfordshire
Growing pains
David Mitchell echoed so much that I have said for years (“Pull up a chair for my anti-growth crusade”, New Review). Why do we always seek to grow? We already use too much of the Earth’s resources and to continue to do so in pursuit of “fashion”, especially in furniture, is indefensible. At 86, I have dining room chairs that were bought secondhand 40 years ago, through an ad in the local paper. They are oak and still going strong. A chair is bought to give us something to sit on, not to impress.
Patricia Bray
London SE12
