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It is unethical to check someone’s financial eligibility for treatment I do not believe that emergency department nurses should police a system for charging overseas visitors and migrants for medical treatment (News January 8). I also agree with emergency practitioner Jim Bethel that it is unethical to check people’s eligibility for treatment by their ability to pay for it. The government insists that no patient would be turned away in an emergency, but that is not the point. We should not be turning anyone away from emergency departments. If left untreated, today’s medical problem is likely to become tomorrow’s catastrophe. There is something distasteful about this government’s hounding of migrants in response to media scaremongering. Davina Parker, Wolverhampton

SENDING FOREIGN STAFF BACK WOULD BE THE ‘ECONOMICS OF MADNESS’ I am sick of hearing people say that there are too many immigrants in the UK, that they use our NHS for free and take our jobs and houses. What about foreign nurses and doctors in the NHS? Our health service could not run without them. One in 12 nurses in England has come from overseas. Do we really want to talk about sending them back to their respective countries? I think not. It would be the economics of madness, especially given the cuts in the numbers of nurse training places. If we were to send back to mainland Europe all the recent arrivals from the member states of the European Union (EU), it would rebound on us a hundredfold. We Brits have long taken it for granted that we can travel and settle anywhere in the EU. To give one example, there are more than one million people with British 32  january 15 :: vol 28 no 20 :: 2014

passports living in Spain. Where would they be expected to live if the Spanish government adopted a policy on migrants similar to that we are seeing in the UK? Maggie Yates, by email

MANY NURSING ERRORS ARE DOWN TO OVERWORK AND UNDERSTAFFING Four members of your readers panel were asked if unsafe staffing levels in hospitals should be classed as a ‘never event’ (reflections January 8). The panellists supported the introduction of national mandatory staffing levels, but were against unsafe staffing levels being reported as never events. Midwifery lecturer Sarah Esegbona-Adeigbe points out that cuts to administrative staff have resulted in more precious nursing time being taken up by paperwork. She says: ‘Add unsafe staffing to the list of never events, and some

clinical areas will be filing reports and conducting investigations constantly.’ We do not want the concept of never events to end up being watered down. The Department of Health’s list of such events has already been extended from eight to 25, but I do not see any watering down as a result of this. The reporting of never events now encompasses many areas directly linked to failings in basic nursing care, such as the severe scalding of patients and patients getting their head, arms or legs trapped in bed rails. Other new categories include wrongly prepared high-risk injectable medication, the maladministration of insulin and the misidentification of patients. Many of these errors that can cause serious harm to patients, or even kill them, can be attributed to the intolerable pressures of overwork caused by inadequate staffing levels and inappropriate skill mixes.


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Sending foreign staff back would be the 'economics of madness'.

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