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SIR – You report that a study in the British Medical Journal has found that patients are at risk from virtual GP appointments (report, November 29). It is always amusing when a statement of the obvious is confirmed by the results of a scientific study conducted by experts.
It has been clear from the outset that virtual or telephone GP consultations cannot accurately replace a face-to-face clinical assessment, and therefore carry the risk of harming the sick by misdiagnosis or underestimating the severity of a condition.
As a medical student in the early 1960s, I was taught that a correct and detailed assessment required the taking of a careful clinical history, followed by a meticulous examination, which should include inspection, palpation, auscultation and percussion.
With a virtual consultation, the patient is completely denied the last three methods of assessment and is therefore subjected to a less than adequate evaluation, with all of its associated risks.
Malcolm H Wheeler FRCS
Emeritus professor of surgery
Bonvilston, Glamorgan
SIR – More than a century ago, Sir William Osler, regius professor of medicine at Oxford, encouraged medical students to “learn to see, learn to hear, learn to feel, learn to smell and to know that by practice alone you can become expert”. A face-to-face consultation utilises all our critical senses – rather than hearing alone.
Peter Toghill
Emeritus consultant physician
Whatton-in-the-Vale, Nottinghamshire
SIR – My GP retired this year. He always came to the reception and started his assessment by watching how you walked to his room. He used a hand-held heart monitor as he said it was more accurate than the automatic blood pressure monitor, since he could assess the heartbeat through his stethoscope.
A virtual or telephone consultation cannot replace these vital tools.
Indeed, many GPs these days seem more interested in their computer monitor than in making eye contact with the patient.
Bring back the traditional GP for the sake of the nation’s health.
David Barlow
Churchtown, Cornwall
SIR – Last week I received an unexpected letter advising that I had a telephone appointment with a gastroenterologist in early December.
This was the result of a referral made by my GP 14 months ago. Several months after my GP appointment, my symptoms worsened, and I was told the waiting time was still more than a year. I sought an appointment with a private gastroenterologist and received a diagnosis and treatment.
Telephone consultation for my abdominal pain? The mind boggles.
Maureen Oxley
Blackpool, Lancashire
Pension justice
SIR – Sir Steve Webb’s assertion that compensation for the neglect of 1950s women by the Department for Work and Pensions (report, telegraph.co.uk, November 24) is “unlikely” flies in the face of the parliamentary support our campaign has won over the years.
MPs of all parties back the fight by Women Against State Pension Inequality (Waspi) for fair and fast compensation, with more than 160 having written to the Parliamentary and Health Service Ombudsman (PHSO) on our behalf in recent months.
For four years, ministers have ducked behind the PHSO, saying they can’t comment while it investigates. Once it is concluded, that excuse will be expunged, and candidates who go into a general election without a commitment to compensation are unlikely to secure votes from the 3.6 million women affected.
At every turn, we’ve faced negativity and defeatism from so-called experts. But we continue to succeed in our battle. After all, the ombudsman has already agreed with us publicly that maladministration took place. Now the political parties will be under huge pressure to agree a proper remedy. We have no intention of letting them get away with anything less.
Angela Madden
Chair, Women Against State Pension Inequality (Waspi) campaign
Chesterfield, Derbyshire
Hilary Simpson
Chair, Waspi 2018
Lynda Armstrong
Waspi International
Carole Archibald
Waspi Dundee
Susan Bolland
Waspi Cunninghame
Sandra Broadbent
Waspi Devon
Gill Campbell
Waspi Brighton District
Jane Cowley
Waspi Northumberland
Lynne Craighead
Waspi Scottish Borders
Rhona Cunningham
Waspi Glenrothes and North East Fife
Deborah Dalton
Waspi South East Essex
Elizabeth Daly
Waspi 2018 West Dunbartonshire
Debbie de Spon
Waspi Norfolk
Ann Edwards
Waspi Wigan and Makerfield
Sheila Forbes
Waspi Moray
Ann Fraser
Waspi Cunninghame
Janet Fulster
Waspi Wigan and Makerfield
Ann Greer
Waspi Argyll and Isles
Wilma Grey
Waspi Northern Ireland
Sue Harding
Waspi International
Rosemary Jordan
Waspi North Lincolnshire
Pamela Judge
Waspi 2018 Ceredigion
Christine Lutley
Waspi Worthing
Deborah May
Waspi South Coast and Bognor
Carol Mercer
Waspi Halton, Widnes and Runcorn
Carol Morley
Waspi Hertford and East Hertfordshire
Judy Moss
Waspi Suffolk
Frances Neil
Waspi South East Essex
Vanda Nolan
Waspi North Staffordshire
Carla O’Hara
Waspi 2018 West Lothian
Jill Robertson
Waspi Northamptonshire
Judith Robertson
Waspi 2018 Salford and Eccles
Yvonne Robinson
Waspi North East Hampshire/Surrey Borders
Karen Sheldon
Waspi Suffolk
Shelagh Simmons
Waspi Solent and Isle of Wight
Carol Smith
Waspi Devon
Christine Smith
Waspi Newcastle, Wear & Tees
Elizabeth Stanley
Waspi 2018 Stroud and District
Anne Todd
Waspi North East Hampshire/Surrey Borders
Deborah Wailes
Waspi Leigh
Finding suitable work
SIR – Regarding bringing in labourers from Asia to work on farms in Cornwall (Features, November 28), surely the employment exchanges could match claimants to such work.
In 1974, while an aspiring musician, I worked at Smethwick employment exchange in Birmingham. Claimants gave their main occupation (labourer, accountant), plus suitable alternatives. When vacancies arose locally they were suitably matched.
They would then be summoned to the exchange and an interview would be arranged. Should a claimant not attend, or turn down the job offer without good reason, unemployment pay would be suspended, pending investigation. In my fairly short time there, this happened regularly.
As now, unemployment was rising, but such a system, and weekly signing on, kept claimants actively looking for jobs – or good excuses – and limited long-term unemployment. With suitable training, it would limit immigration, too.
Geoffrey Williams
Salisbury, Wiltshire
SIR – I volunteered for a charity helping young people to apply for jobs and write CVs (Letters, November 29).
One lad was insistent that his GCSE grades be listed in an order completely at odds with the convention of highest to lowest grade. There seemed no rhyme or reason to this, until he told me proudly that, doing it his way, the grades would spell “FUDGE”.
Liz Winton
Cardiff
Pudding and pies
SIR – The Scottish hotel that is refusing to serve mince pies as a pudding (report, November 29) is quite right.
I love mince pies but I eat them as a snack with a cup of Assam or Ceylon tea. I have never enjoyed them as pudding.
James B Sinclair
St Helier, Jersey
Rubbish roads
SIR – Many people see the poor repairs to potholes (Letters, November 29), but they are only part of a wider mix of road surface aberrations.
Our towns’ and countryside’s minor roads are riddled with broken drains, sunken surrounds, failed patch repairs and poor quality bodges by virtually every utility company.
Council authorities appear to accept the condition of these road surfaces, thinking them irrelevant in Britain’s highway priorities – quite wrongly, since this infrastructure supports couriers, cyclists, public transport and emergency service traffic.
The £8 billion to go on pothole repairs must be well scoped and shared, or it will do nothing for road users.
A T Patrick
Cheltenham, Gloucestershire
SIR – What happened to the quick fix touted a few years back: namely filling potholes with recycled plastic bottles? I believe a company was formed in the UK, but have heard nothing since.
Martin Gaskill
Culcheth, Cheshire
SIR – A few years ago, I drove over a pothole and stopped to see what had caused the bump. I was relieved to see that the vehicle behind me was a police car. The officer inspected the hole and it was repaired next day.
Always drive in front of a police car.
Robert Ward
Loughborough, Leicestershire
Telegraph’s future
SIR – I would guess that many readers are, like me, appalled at the prospect of the Telegraph being sold to a company in which Abu Dhabi has a holding.
Perhaps we have a role to play: we could let our MPs know our concerns, with the strong suggestion that they in turn make representations to the Culture Secretary. We cannot just sit by and let this sale happen.
Fay Thompson
Lytham St Annes, Lancashire
Multilingual radio
SIR – As the reader to whom Chris Ryder so kindly refers (Letters, November 28), perhaps I could let him know that Radio Swiss Classic’s brief announcements are available in languages besides German.
If he consults the menu on the left-hand side of its main webpage, he will see that he has the choice of listening to them in French, Italian and English too.
Jeremy Thomas
Birmingham
Embracing additions to the traditional paella
SIR – It may be a culinary faux pas to purists to add meat other than rabbit or chicken to paella (Leading Article, November 28) but frankly paella with just one or two ingredients are quite monotonous in taste.
I dined with Spanish colleagues in a fish market restaurant in Zaragoza and introduced them to a mixed paella, which was contemptuously dismissed as una paella turística before the meal.
The ingredients were many and varied, including a chorizo-like sausage and various delicious seafoods. It was declared the best paella that my colleagues had ever eaten. Similarly, the different types of taste offered by an American-style “fully loaded” pizza are not found on the two-tone pizza menus in Italy.
Jeff Snowden
Leeds, West Yorkshire
A national duty to protect the Elgin Marbles
SIR – As a student in the 1960s, I hitchhiked around Greece with some friends. We got up early to go to the Acropolis and wandered all over the Parthenon, which was then surrounded by broken statues and rubble. There were only a few people there. Nothing was looked after or protected.
We didn’t think anything of it at the time. Life was free and a bit rough (we slept on beaches, graves, haystacks, hard stony ground at Delphi and the flat roofs of hotels). We went to many important sites in Greece and it was the same messy story: Epidaurus, Mycenae, Delphi and Knossos in Crete. Recently we revisited Knossos. It is very different now; there are walkways and all important aspects of the site are roped off.
I understand that the Elgin Marbles were bought at very great expense in order to protect them (Letters, November 29). If the Greeks are now prepared to look after their ancient and wonderful heritage properly, then maybe there is a case for returning them.
Cilla Alexander
Rickmansworth, Hertfordshire
SIR – I visited the Acropolis Museum last weekend. Being British, it’s quite uncomfortable to view the sculptures in the shadow of the Parthenon and see a plaster copy of the body of a horse between its original head and tail.
We must at least loan back the sculptures Elgin saved for posterity.
Chris Radford Jones
London SW3
SIR – If “flawless reproductions” can be made (Letters, November 29), then one possible solution to the dispute is for half of the original marbles to go to Greece and the others to remain, with those sent being replaced by fakes.
By rotating a few of them from time to time, both countries’ museums would retain their visitor attraction.
Ken Turrell
Norwich
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Letters: GPs ought to have known that virtual appointments put patients at risk
Plus: justice for Waspi women; mince pies for afters; Britain's broken roads; multilingual radio; traditional paella; and the Elgin Marbles