Question time

Sir: Your leading article ‘Sense prevails’ (13 April) is a valuable précis of the Cass Review into NHS gender treatment. However, it also raises several questions. How are the actions of these individuals, groups and organisations different from those of others who have been found to have acted unprofessionally, causing harm to patients who were entitled to place trust for their health in them? Where was the ethical and executive management oversight within the NHS? What other unproven ‘treatments’ are being carried out under the ever-growing demands for more money to be allocated to the NHS? Finally, what sanctions are to be meted out – or will we be fobbed off with the perpetrators’ handbook: ‘Lessons have been learned’?

David Blackwell

Chesterfield

Shrinks rapped

Sir: In your leading article last week, you rightly note that ‘medical professionals should have been alerted’ to what was going on at the Tavistock Clinic. Quite so. The Royal College of Psychiatrists surely has a governance role here. Its silence has been deafening.

Noel Scott, retired consultant psychiatrist

Belfast

The doctor will see you now

Sir: I share some of Laurie Graham’s concerns (‘Cosmetic surgery’, 13 April) about the NHS. I live in North Wales, where the Betsi Cadwaladr University Health Board has been in and out of special measures. But my GP surgery has introduced a brilliant online triage system called ‘Klinik’, where one can type one’s requests or concerns in detail. It is so much better than Laurie Graham’s 8 a.m. ‘scrum’ or ringing a jammed switchboard. I have accessed Klinik three times in the past year and have always had a quick and appropriate response, two of which were face-to-face GP appointments within 24 hours.

As for communicating with the local hospital, I have had the best results when using email, but only once I know the email address of the person with whom I need to communicate. I have had to ask for those, but it is better than playing telephone tag to secure an appointment.

The internet is not the answer to everything, but if used imaginatively and wisely it should offer a few quick wins to a cash-strapped health service.

James Harris

Wrexham

Tale with a twist

Sir: As Olivia Potts speculates (6 April), the origin of the pretzel is attributed to Christian monks. The story goes that in the early 7th century, an Italian monk had some left-over bread dough that he was preparing for Lent. He rolled it into ropes and twisted them into the shape of arms crossed across the chest in prayer, before baking them. His fellow monks used the twisted bread as a pretiola or ‘little reward’ for children who came to church to learn their prayers.

Kay Bagon

Radlett, Herts

Culture gap

Sir: Mary Wakefield’s thoughtful conversation with Rob Henderson (‘Abuse of privilege’, 6 April) raises the important question of how we can change the culture to better champion children. How can we, for instance, bring back shame for fathers who abandon their families?

What is not mentioned is perhaps the ultimate example of a culture sidelining children: abortion. If kids growing up in institutions and foster homes have no power and visibility, how much more vulnerable are the unborn? But Henderson is on to something when he suggests ‘people are almost repelled by the weakness of children’. It’s a bleak diagnosis of a culture that portrays them as an economic inconvenience instead of marvelling at how such weakness can turn a parent’s life upside down in the most amazing ways.

Jon Wainwright

Cliburn, Cumbria

Peerless suggestion

Sir: Dot Wordsworth (6 April) raises the increasingly common solecism in the addressing of peers. It is not just the FT which makes use of the ‘Lord David Cameron’ format – the BBC is a regular offender. An oddity is that this incorrect form is rarely used in connection with peeresses. Ennobled women are much more generally referred to as ‘Baroness Thatcher’, or ‘Warsi’. Perhaps it might be an advantage to accord male peers with their peerage degree – most commonly Baron. Thus David Cameron might be referred to as ‘Baron Cameron’. If his given name were inserted it might be less offensive to protocol.

Joshua Garner

Wells, Somerset

Paying the price

Sir: I had not imagined The Spectator letters page to be a place so conducive to physical travail and/or financial hazard. Unfortunately, my better half – a Sussex girl, born and bred – saw Timothy Smith’s letter about a walking trip on the Downs (6 April). The resulting clamour to follow suit could only be diverted with the promise of a costly trip to the opera at Glyndebourne.

Tom Stubbs

Surbiton, Surrey

Good companions

Sir: After reading the common sense by Charles Moore (Notes, 13 April), I turned the page to read the superb poem by Ben Wilkinson, and burst into tears having just a few weeks ago said goodbye to my Jack Russell, Chester, who was nearly 15. This week I have taken a new four-legged companion, a five-month-old Patterdale cross. I keep feeling I have betrayed Chester, but everybody says: No, you gave him a good life – now move on with Jonno. Thank you for the poem, Ben.

Brian Gable

Hereford

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