'Our ideas help wreck other EU health services'

A citizens' revolt is brewing in western Cornwall: plans to downgrade the hospital emergency service in Penzance have just provoked the biggest street protest in the region for decades. Judith Cook of Newlyn wonders if new tax money will make a difference:

If we lose our accident and emergency department at West Cornwall hospital in Penzance, people at this end of the county will have to travel up to 40 miles to the nearest hospital, the Royal Cornwall in Truro. There is all-out opposition from all local councils, every single GP practice and the entire local population [at least 15,000 were at last week's demonstration in Penzance, police confirm].

What happens to a heart-attack patient in August when an ambulance has to fight its way to the patient, then 40 miles to hospital, up roads congested with traffic?

A few days after the big Penzance protest, a glossy brochure arrived in the post from our West of Cornwall primary healthcare trust.

The thrust of the trust's message is that the change has nothing to do with cost-cutting but is because critically ill people can be treated better in the larger Truro hospital than in our smaller one.

An expert quoted in the brochure explains that "the journey time has less effect on your chances of survival than having access to a full range of services". Local GPs do not agree with this.

The words of a second expert seem equally paradoxical, in view of problems also besetting the cardiac department at the Royal Cornwall: "There will be an increasing number of heart specialists visiting the hospital, and more specialist clinics locally." If all these heart specialists are waiting around, how come cardiac clinic appointments are being cancelled?

So, the prospect is that we shall be paying increased taxes for a cardiology service on its knees, and an A and E move that (according to a range of GPs writing to local papers) could put lives at risk.

A doctor, from east London, name withheld:

As far as my own work is concerned, I am clear that the negative coverage by the press of many health-related stories contributes significantly to my difficulties.

In the first place, it contributes to (even creates) the culture of mistrust and blame that leads to the practice of defensive medicine, which is widespread and on the increase. In this situation medical investigations and referrals may be motivated by a fear of litigation and complaint, and are not necessarily beneficial to patients. The potential for freeing up resources by reducing defensive practice is enormous.

Second, to have one's profession consistently portrayed in a predominantly negative light, is quite simply very demoralising, and produces feelings of anger and helplessness. Very little is reported about day-to-day good work.

Rather than offering a token such as Public voices, the time is overdue for the press to turn its spotlight of accusation and blame upon itself, and for a full public analysis of the role that negative reporting has played in the degradation of the health service.

During my working life I have been outspoken against professional privilege, and have worked in and supported radical initiatives aimed at embodying equality and empowering patients. I have worked in good faith for my patients over many years and have seen many hard working colleagues do the same. I am simply at a loss to know why journalists seem to dislike health workers so much. Now it simply makes me desperate to leave.

Christopher O'Hagan, from Derby, on France and us :

I cannot see the NHS in a million years getting anywhere near the efficient and courteous level of service I received in the small modern hospital at Mamers while on holidays north-western France.

The difference is not really about taxation, but about priorities and attitudes. If France spends 9.5% of GNP on health, and Britain just 5.5%, what are we wasting that 4% of our GNP on - nuclear weapons, attacking nations we don't like, crime generated by urban squalor and bankrupt drugs policies, the largest prison population in Europe? What?

Years of underinvestment in just about everything except MPs' pay, parliamentary accommodation and the Millennium Dome make transformation of public services an almost impossible task, exacerbated by a belief that "Britain is best". That stupid jingoistic belief got us into this mess; it took over 20 years for the general population to see problems which were apparent in the mid-70s.

Unfortunately, I hear that the hospital in Mamers is being wound down, and many services transferred to Alençon, 20 miles away.

Can someone bring representatives of the French system to Britain to show them the appalling consequences of trying too hard to make economies in public services?

Or will we rub our hands in glee that we eventually do become "world class" by promoting economic ideas that wreck the excellent public services of our EU neighbours?

The accounts excerpted here give just a small taste of the many we've received from NHS staff and patients, after last week's call for the experiences and the thoughts of those who work in the health system or use it.

Full versions can be read at guardian.co.uk/publicvoices

Public voices is a Guardian project dedicated to offering space to people in the hard-pressed public sector to write about their work, achievements, frustrations, and solutions. Please join in as an NHS employee or patient - or if you've worked or been treated in health services overseas.

Public voices will soon be looking at education: please get in touch at the addresses below if you have things to say. The first-hand stories of staff on the beleaguered railways can be read, and discussed, at guardian.co.uk/publicvoices/rail

Contributors should email public.voices@guardian.co.uk or write to Public voices, The Guardian, 119 Farringdon Road, London EC1R 3ER.