Sir, – Every morning I walk to work along Thomas Street in the Liberties – one of the oldest thoroughfares in this city, steeped in history, lined with the ghosts of merchants, rebels and ordinary Dubliners who built something worth being proud of. What greets me instead, day after day, is a dispiriting tableau of strewn rubbish, overflowing bins, stained pavements and the particular chaos that a colony of well-fed seagulls can visit upon last night’s takeaway bags. The birds, at least, are thriving.Dublin, in the glorious sunshine we have enjoyed of late, does not acquit itself well. Sunshine is merciless. It illuminates what darkness and winter rain are kind enough to conceal. And I say this with no pleasure: our city looks better at night. Sadly.I am embarrassed. As a taxpayer and as someone who genuinely loves this city, I am embarrassed. The US ambassador was not wrong when he suggested Dublin could do with a good power-wash. It stung to hear it. It stung because he was right.There is a well-established concept in urban sociology – the broken windows theory – which holds that visible neglect begets further neglect. When a street looks unloved, people treat it as unloved. When civic spaces signal that nobody cares, the message received is that nobody should. I see it every morning on Thomas Street. The people who live and work along that corridor are not lesser citizens. They deserve the same standard of urban care as any leafy southside avenue. The current state of affairs sends them a very different message.I want to be clear: the street cleaning crews who are out there in the early hours do their best, and I have nothing but respect for them. The problem is not effort; it is scale. The volume of rubbish being generated and left on our streets overwhelms what any crew can reasonably manage. More resources, more frequent cleaning, and genuine enforcement of littering laws are not optional luxuries. They are civic obligations.This year Ireland holds the presidency of the Council of the European Union. Delegations, diplomats and observers from across the Continent are passing through Dublin. What impression are we making? What does Thomas Street – what does any number of streets in this city – say about our standards, our ambitions, our self-respect as a nation? It is, I’m afraid, a national embarrassment.Dublin is a city of extraordinary character and warmth. Its people deserve better than to navigate filth on their morning commute. Do more. Please. – Yours, etc,RICHARD DEANE,Dublin 8.Private maternity careSir, – In his letter about the unintended consequences of the discontinuation of private practice and the loss of private income in maternity hospitals under Sláintecare, former master of the Rotunda Hospital Dr Sam Coulter-Smith paints a bleak picture – poorer services and loss of choice for all women and difficulties in attracting “the best and the brightest” to work in an underfunded system (Letters, June 24th). Knowing what was coming down the track over the past few years, obstetricians have continuously lobbied the government to make an exception for maternity hospitals/units to allow private practice to continue. Obstetricians, however, have not disclosed in detail the status quo they wish to preserve – beyond emphasising the importance of choice for women, and of private income for all hospitals, and of independence for voluntary hospitals. Having worked in eight different public hospitals in Ireland over 40 years (four of which provided maternity services), I never worked in a hospital in which private patients did not receive preferential treatment over public patients. This preferential treatment involved access to consultants, scans, clinic appointments, theatre lists, accommodation. While the level of preferential treatment varied between hospitals and between consultants, it was, however, systemic and considered normal, despite being intrinsically discriminatory. One obvious example of the difference between public and private practice in maternity hospitals/units relates to delivery.Having an obstetrician immediately available on-site is considered to be the optimal standard of care for private patients at delivery across all 19 maternity units in the State (so much so that money changes hands between some consultants to ensure this happens in the event of someone not being available).Surely, an obstetrician needs to be always available on-site for all women in case they are needed in emergency situations – as well as to directly supervise trainee doctors (particularly after hours)? Surely, every woman deserves the same level of reassurance and safety and consultant availability?In addition, there are differences in outcome related to social disadvantage; women who are socially disadvantaged are not private patients.As things stand there are not enough obstetricians in the system to support the full implementation of universal public-only maternity care. Even more consultants will be needed to provide 24/7 in-hospital consultant cover; the State Claims Agency, however, may be in a position to amplify the clinical (and financial) necessity for this to also happen.Rather than focusing on exemptions and loopholes to allow a discriminatory system to continue, obstetricians need to face up to reality and start demanding the Government tackle the challenges of resourcing a one-tier public maternity hospital system that gives women what they want: high-quality clinical care, choice, continuity, proper facilities. – Yours, etc,CHRIS FITZPATRICK,(Retired consultant obstetricianand gynaecologist and former master of the Coombe Hospital),Terenure,Dublin 6.Waiting times and abortionSir, – I welcome the extra scrutiny sought by Government TDs to remove the three-day waiting period for abortion services (“TDs seek extra scrutiny of Bill removing three-day wait for abortion over fear of backlash”, June 25th). As a GP who worked in this service from the beginning, I feel the minimum of three days to contemplate an abortion is essential. The majority of women I met came in various degrees of distress over an unwanted pregnancy. Their situation was confirmed – and if found to be within the 12-week limit to have the termination done medically, they were duly counselled on all options open to them. Most women at this point had already made up their minds to go ahead. But not all. Everybody was told that there was no urgency to initiate the procedure with medication.They were encouraged to use the three days to discuss their situation with their partner, a friend or sometimes a parent. They were given an appointment a minimum of three days later; either to start the procedure, or to have further chats about any doubts. A small minority would have changed their mind. I am of the opinion to have an abortion is the lesser of two evils, and should not be treated lightly. I think it is being treated lightly if this contemplating period is taken away. – Yours, etc, TRULS CHRISTIANSEN, Retired GP,Wicklow Town. Uniting IrelandSir, – Minister for Justice Jim O’Callaghan is reported as saying that “we cannot allow violence ... or the threat of violence” to dictate the future of Northern Ireland and the Republic (“Next Government must prepare for Irish unity, O’Callaghan tells SDLP conference in Belfast”, June 26th).He then goes on to say that we should “park” what he calls “the most difficult issues” such as flag and anthem.But are those not the kind of questions which, if unresolved, will make such a big contribution to the threat or actuality of violence? Festina lente towards a shared island, grasping nettles along the way. – Yours, etc,DAVID MCKENNA,Dublin 8.Reducing road deaths and speedSir, – While recent articles in your newspaper have highlighted how legislation, enforcement and safer roads all play an important role in reducing road deaths, the most important factor remains individual responsibility.Every driver chooses whether safety or speed comes first. No destination is worth risking a life to reach a few minutes earlier. – Yours, etc,JOHN MACFARLANE, Consultant in Rehabilitation Medicine,President of the Irish Association of Physical & Rehabilitation Medicine, Cork.Taking careSir, – I’ve had reason to use the public health system recently through Cork University Hospital and University Hospital Kerry. As it happens I’ve also had an outpatient appointment at a private hospital. Hand on heart give me the organised chaos of the public health system any day. The hardworking staff and medical personnel are invariably very helpful and friendly, and one feels in good, trustworthy hands.In contrast my experience at a shiny new private hospital wing was the complete opposite. Indifference left me with a bad taste afterwards.Money and the illusion of private care will never replace genuine human warmth and authenticity. – Yours, etc,TOM MCELLIGOTT,Listowel, Co Kerry.Better outcomes for childrenSir, – Jacqueline Roche is right to highlight the unacceptable outcomes experienced by too many children in care (Letters, June 25th). Every child deserves to be safe and supported, and accountability for achieving those outcomes is essential. At Empowering People in Care (Epic), we share that ambition of achieving better outcomes for children in care and young people leaving care. We also believe that Tusla must be accountable. Epic has over the past 20 years seen that where a child or young person has been systematically failed, questions often must be asked of Tusla. However, when we look at the issues in the care system that lead to children being failed, those questions must always be asked of government. The State’s responsibility to children in care extends well beyond Tusla. As the corporate parent, the government must ensure that care-experienced children and young people receive the support they need across housing, health, education and other public services. That means stronger cross-government collaboration, as well as sustained investment in the services – such as Tusla – responsible for keeping children safe. Protecting vulnerable children requires a whole-of-government response and a properly resourced Tusla is a critical part of that effort.An under-resourced and poorly funded child protection system cannot address the challenges the letter identifies, such as the shortages of foster carers and a lack of suitable placements. A lack of funding for Tusla will only make it harder to improve services and outcomes for care-experienced children and young people. Accountability and investment are not mutually exclusive. Children in care and young care-leavers deserve both. They deserve a system that is accountable, properly resourced and supported by joined-up thinking and service provision across government. We should not make the mistake of framing these as competing priorities. We need all of these elements in place if we are to fulfil our responsibilities to the children we have taken into our collective care. – Yours, etc,WAYNE STANLEY, Chief executive, Empowering People in Care,Dublin 7.Dublin Airport passenger capSir, – I see reports on social media that a group of mothers from North Dublin hand-delivered a giant letter to Minister for Transport Darragh O’Brien during the week calling on him not to remove the passenger cap at Dublin. The group, Children’s Rights Over Flights, is concerned about the effects increased flights will have on their children’s health. None of the mainstream media picked up the story, and I haven’t heard any response from the Minister. What I have heard all week is people saying that the hot weather we’re experiencing is due to climate change caused by fossil fuels. And that it is going to get hotter.It is surely blatantly obvious that rather than scrapping the cap at Dublin Airport, the Minister should be looking for ways to reduce the number of flights. – Yours, etc,ART Ó LAOGHAIRE,Bray, Co Wicklow.Israel and IrelandSir, – Last week’s report by the international commission of inquiry, confirming that the Israeli army has an approved policy of targeting and killing children, is not at all shocking at this stage; doctors and journalists who work in the region have been telling us this for years. But what is really shocking is how little impact this seems to have had in the news. And if ever there was further impetus for Ireland to include services in the Occupied Territories Bill, this should provide it. But in fact we know that won’t happen; official Ireland is terrified that this might spook American investment in the Irish economy. I am sure this prioritising of commercial prudence over ethical considerations will offer considerable comfort to those parents who have attended the funerals of their infants and children or who deal with the horrific injuries these youngsters have sustained at the hands of the IDF.In the meantime it will certainly focus the minds of voters who see this useless hand-wringing and inaction by our elected leaders. There are those of us who are sickened by the non-response of our Government to these appalling facts and we will not forget it. – Yours, etc,JOHN DUNNE,Enniscorthy, Co Wexford.Gimme a breakSir, – Does anyone watching the World Cup actually want an advert break inserted into each half and euphemistically called a “hydration break”? Football is a game of two halves. Not four quarters. This unforgivable tampering with the beautiful game has been cleverly engineered by Fifa to raise more revenue and to keep peripatetic American TV audiences happy. Call it what you will but it has nothing to do with water. – Yours, etc,ANTHONY MOONEY,Hove,England.