Vol. 45 No. 8 · 13 April 2023

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Alice Spawls writes about the diminution and degradation of NHS services (LRB, 30 March). As a GP I meet patients almost daily who have been obliged to seek private treatment. They are often rueful about the cost, and say that they’d rather pay a little more in tax than spend tens of thousands of pounds of savings.

David Runciman, in the same issue, notes that mixed-payment, insurance-based health services such as those in France and Australia have better outcomes than the NHS, and thinks we should probably do more of what they do, i.e. make use of insurance companies to fund healthcare, rather than rely solely on general taxation. Runciman suggests that the NHS is too ‘sacrosanct’ for politicians to meddle with, but the truth is they meddle with it all the time. I’d argue that what is sacrosanct isn’t the service itself, but the principle of paying for it through general taxation rather than insurance, add-ons and top-up fees.

The solution to the NHS’s current problems is quite straightforward: fund it properly. If any political party wishes that funding to be supplied via insurance and add-on payments rather than taxation then so be it; they should put it in their manifesto and let us vote on it. That might make it ‘hard for politicians to get elected’, as Runciman puts it, but isn’t that the point of democracy? The NHS is in a dire state, worse than I’ve known it since the mid-1990s. If the government doesn’t want to fund the service to the standard that the electorate wants, then perhaps it’s time to make way for a group of MPs who will.

Gavin Francis

How to Plot an Abortion

Clair Wills is right, despite what Robert Harper says, that ‘you have to tell a story’ to get a legal abortion in the UK (Letters, 30 March). The 1967 Abortion Act lists specific legal grounds on which an abortion can be granted up to 23 weeks and six days into a pregnancy, and two doctors must sign a form saying these grounds are applicable in the specific case. The grounds include risk to the woman’s life, or to her physical or mental health; a serious foetal anomaly; or the pregnancy being the result of rape or incest. The woman’s social situation is taken into account: whether she is poor, has other small children, lacks a partner or family support, or is especially young. These things are ‘the story’. There are many doctors today who will sign for an abortion at the woman’s request, but the law must still be complied with and the ‘story’ indicated on the forms. Women are still being prosecuted in this country when they have abortions outside these rules. Doctors too are liable. I agree with Harper that the law needs changing. It dates back to 1861 and 1929, not just 1967 and 1990. Abortion is essential healthcare, accessed by a great many women at some point in their lifetimes. It is one of the safest medical procedures a woman may undergo. The criminalisation of abortion in this country and elsewhere, as well as the red tape women must deal with, should be abolished.

Marge Berer
International Campaign for Women’s Right to Safe Abortion

Clair Wills refers to the ensoulment of the foetus (LRB, 16 March). I would like to add another view. Our rabbi, speaking on this subject with our congregation, began by remarking: ‘In Jewish tradition, the foetus is not considered viable until it graduates from medical school.’

Mary E. Carter
Placitas, New Mexico


Barbara Everett writes that Emma Smith’s emphasis on the theme of migration in Twelfth Night is a ‘mistake’, based on a modish desire to ‘synchronise [the play] with the political issues of our own immediate moment’ (Letters, 30 March). It seems to me that it is Everett who is making the mistake by dismissing Smith’s discussion of this crucial aspect of the play.

The late Elizabethan era was profoundly influenced by debates around migration, driven partly by the arrival of thousands of immigrants from Europe fleeing persecution in the late 16th century (Shakespeare’s landlord was a French Huguenot). Migration and immigration suffuse Shakespeare’s plays, and there is now a terrific body of scholarship on this theme. Rather than seeing Twelfth Night as a rather abstract treatise on love and the ‘generative power within civilisation’, a more persuasive and even straightforward reading would focus on the ‘generative power’ brought by the migrant twins, disrupting the stultifying and rather childish state of Illyria with their own imported energies.

Of course, we all read Shakespeare through our own contemporary obsessions – it is no coincidence Twelfth Night is currently one of his most performed plays. But even sticking with the late Elizabethan context of Twelfth Night, Smith’s reading is far more than ‘presentism’.

John Mullen
London N4

Guano to Guns

Laleh Khalili writes about the Chagos Archipelago, which became part of the newly created British Indian Ocean Territory after the islands’ separation from Mauritius in 1965 (LRB, 16 February). The islands were ceded to Britain in 1814 after the defeat of Napoleon, so arguably the BIOT was not the ‘last colony’. That title I think belongs to the Phoenix Islands in the central Pacific. The story of their colonisation also features migration – but voluntary rather than forced.

The scheme was an initiative of Henry Maude, an administrator on various Pacific Islands from 1929 onwards and in the late 1940s resident commissioner of the Gilbert and Ellice Islands (he later had a distinguished career as a historian of the Pacific). The southern Gilbert Islands are small and have limited resources. In the early 20th century there was substantial population growth because the traditional checks on overpopulation – warfare, compulsory migration and infanticide – were barred by the colonial authorities and Christian churches, abortion was discouraged, and the efforts of the medical department had greatly reduced infant mortality. Maude hit on the idea of voluntary migration to nearby uninhabited islands (‘nearby’ is a relative term in the Pacific). In 1937, he sailed with delegates from the most overpopulated islands to the Phoenix Islands. They investigated eight islands, erecting a wooden flagstaff on each with a nailed-on Union Jack. Three atolls (Gardner, Hull and Sydney) were identified as having the potential to support a thousand people. After returning to their home islands, the delegates enthusiastically promoted the new lands and in 1938 a party of 61 pioneers set off there. Crossing the international dateline on the journey east they experienced two consecutive Sundays – a good omen for a devout people. The settlements on the atolls (renamed by the migrants as Nikomaroro, Orona and Manra) were carefully planned and resourced – they each had a post office, even – but it took only a few years to understand why the islands had been uninhabited. The settlers struggled with drought, supply problems and limited markets for copra, their only major product. The new colony could not sustain itself and in 1963 the British government evacuated the settlers to another new home in the Solomon Islands.

Tim Cundy
University of Auckland

Burning Questions

I enjoy a blazing hearth as much as anyone, so I read Fraser MacDonald’s piece on domestic fires with interest (LRB, 5 January). My father ran a bowling alley in Islip, on Long Island, from 1956 onwards, and we always had a supply of bowling pins, damaged beyond repair, to supplement the usual kindling and logs in our fireplace. A pin would take a few seconds to catch fire, but when it did, it put me in mind of napalm. An impressive sound, too. This was of course the extremely flammable coating. After a minute or so, the flame attenuated and the hardwood maple burned well and long, without smoke. I hate to think, though, of the gases and particulates produced in that open hearth, guarded only by a metal screen.

These were also the days when the kids of the neighbourhood danced, like fauns and satyrs, in the cloud of DDT sprayed from a truck that made the rounds to kill mosquitoes in summertime. (There was usually a beautiful late afternoon light that illuminated the cloud, inspiring us further.) Not a single grown-up appeared at the door to yell, ‘Are you kids out of your minds? Get in here! That stuff is poison!’

Allen Schill
Turin, Italy

On the Rocks

In her account of the links between the lighthouse and the arts, Rosemary Hill doesn’t mention the figure described by Daniel Defoe in his travelogue of Great Britain as the ‘famous Mr Winstanley’ (LRB, 16 February). This was the inventor and artist Henry Winstanley (1644-1703), who designed and built the first Eddystone lighthouse between 1692 and 1700. According to the Dictionary of National Biography, this structure of wood on a stone base was held together by iron and copper straps, and reached a height of 115 feet. According to Defoe, Winstanley was so confident of its strength that he ‘usually said he only desired to be in it when a Storm should happen’. He got his wish, happening to be supervising works on the lighthouse when the great storm of 1703 hit. Defoe writes ‘the first sight there Seaward that the People of Plymouth were presented with in the Morning after the Storm was the bare Eddystone, the Lighthouse being gone; in which Mr Winstanley, and all that were with him perish’d, and were never seen or heard of since.’

Robin Blake
London N1

Theirs and No One Else’s

‘The rhythm and rhetorical emphasis’ of the beginning of Beethoven’s Fifth Symphony, Nicholas Spice writes, is ‘far more effective’ with a conductor (LRB, 16 March). I wonder if he is familiar with Spira mirabilis. This band of young European musicians rehearse symphonic music intensively and lengthily together and then perform it, all without a conductor. I heard them play Beethoven, the Seventh rather than the Fifth, though scarcely less demanding. We don’t think that the four players of a Haydn quartet need a conductor, or the thirteen in Mozart’s Gran Partita. Is a conductorless symphony really so far-fetched?

Geoffrey Wheatcroft
St Martin de Belleville, France

On Missing the Point

William Farrell misunderstands several things (Letters, 30 March). First, I bought my Rolex long ago. Second, I have always had misgivings about sinister-sounding ‘masterplans’. The heroically revived Battersea Power Station is the destination-feature of a vast area of regeneration between Vauxhall and Chelsea Bridges on London’s South Bank which has, on the whole, developed piecemeal without the benefit of one. It is this free-market randomness that annoys conventionally mind­ed critics like Owen Hatherley and Iain Sinclair. Third, ‘masterplan’ is not syn­onym­ous with ‘regeneration’. I enthuse about the latter, but mistrust the former.

Stephen Bayley
Royal Fine Art Commission Trust, London SW11

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