Friday 5 September 2014

I'll tell you what's wrong with the NHS

Twenty years ago it was accepted the NHS was a white elephant, a creaking dynosaur that was haemorraging tax payers money. Then Labour came into power and decided it would be run like a business, with managers, targets, budgets, marketing. Except it isn't a business, there are no sales, profits or accountability.

If it was run as a business most of the management would have been sacked. And the wards would be clean and nurses would look after patients first, not fiddling targets, completing endless charts and paperwork. HELLO it's not a business.

A great deal of cash was poured in it in the early Labour years, with businesses often footing the bill through invidious indirect tax hikes such as national insurance contributions. Unfortunately, much of this has gone on multi-tiered highly-paid management structures, ludicrous IT systems that didn't work, litigation, translators and a whole swathe of incompetent purchasing.

And why so many agency nurses? Nursing agencies are paid good rates much of which doesn't go to the nurses themselves, this is also the case in the care industry.

My mother worked as a nursing auxiliary in a mental hospital, the abuse she witnessed was shocking so she spoke up about it, a whistleblower if you like,  in consequence all the staff closed ranks and she was sent to Coventry. I'm very proud of her for speaking up, it takes a lot of guts to do what she did and not many have her courage.

What also needs addressing is the language barrier, many of the nursing and care staff I came across when my parents were unfortunate enough to be in hospital could barely speak English to me, so how they managed with older patients who may be hard of hearing doesn't bear thinking about.  Trying to find out information regarding tests, medication, home care package was often a pantomime of  talking slowly and very loudly with accompanying sign language. When your dealing with issues like medication and medical test results that's really frightening.

My impression was the staff don't care about old people, they can't make them well again so are viewed as bed-blockers and want them out asap regardless of whether the home-care package is in place or not - and often it wasn't.

And dirt was everywhere, cobwebs and dust. Blood and lots of it on the floor next to my father's bed which I pointed out to an orderly,  when no-one cleaned it I asked for a mop to do it myself.  This wasn't allowed of course. And don't get me started on the food, unappetising and unhealthy stooge.

On one visit to A & E my mother was left to wait for thirteen hours.  She was in a wheelchair, unable to walk and had dementia.

But at least a hospital is open to the public and everything can be seen. It's a different ball-game in a care home. I loathe care homes, but for a fortnight there was no option for Mum as Dad was  going into hospital for an operation and he was her carer.

I visited her every evening after work, at that time I worked very long hours often well into the evening so would go straight after.  The first night I was distraught to see her face dragged down one side, I called the assistant Matron to point it out asked whether Mum had had a stroke.  She gave her a cursory glance, barely looking and said no, she 'knew what a stroke was'.

The next day one of the residents told me Mum had a fall in the night. the home denied it  but it was obvious she was in pain so I rang my brother and asked what to do, after some agonising he said go with your gut reaction. So I did and called the ambulance myself as the home seemed very reluctant and acted in quite a belligerent manner toward me, not that I gave a toss.

So found myself in the bizarre situation of taking my father to hospital for an operation whilst simultananeously following Mum's ambulance. and somewhat surreally,  checking Mum in to A & E then running the entire length of the hospital to where Dad's ward was,  making sure he was ok as knew he was anxious about the anaesthetic, then running back again to A & E.

The waiting around was interminable,  she was on a trolley waiting to get an X-ray to assess any damage We waited and waited and waited,  eventually there was a queue of patients right down the corridor behind us.  Increasingly impatient, I walked round to the observation ward and saw dozens of staff standing around gossiping and laughing. I could feel my blood pressure starting to rise.

My mother was shivering with the chill of the air-conditioning, the chap on the next trolley - who'd just had a heart attack -  gave me his blanket to cover her and I started stripping off layers to keep her warm.  When there was still no sign of any staff, I told Mum to hold on and started running down the corridor with her on the trolley. Suddenly hospital staff appeared from all four corners with their hands raised in horror, 'you can't do that, it's not allowed, health and safety yadder yadder', it was hilarious but more to the point: it worked. She was seen immediately.

Life was becoming more like a farce in dealing with all aspects of the NHS. My father had several heart attacks and many angina attacks, on one occasion luckily I was in the house as the ambulance crew refused point blank to take him 'health and safety you understand' no I didn't understand: that's they're job.  So in desperation rang my brother who came over and helped Dad into the ambulance.

On another occasion I rang a cab for my mother who was also in a wheelchair, not only did he not make a fuss, he cheerfully lifted her in the wheelchair on his own. The difference in attitudes was a stark contrast, needless to say he got a huge tip.

Healthcare is talked of as free, but it's not. My father worked hard for fifty years and gave six years of his life fighting for his country so more than paid his dues.

Listening to the nurse at a case conference in the Cardiac ward, slowly talking to my father as if he were an idiot,  telling him to wait 20 minutes before dialling 999 when he had a chest pain in the middle of the night. I looked at her incredulously, vaguely saying something along the lines of 'you're fucking joking'. I'm quite sure the staff hated me and really can't say I was bothered, I was fighting for my parents so the dirty looks were often returned.

I could pass this off as just bad luck on my families part, except that my friends also had horrendous stories of malpractice and neglect that had resulted in the death of their loved ones, I wonder how many other stories there are of people just too grief-stricken to take it further.

Perhaps if staff were accountable for their actions and acts of neglect and malpractice that resulted in the death of a patient was treated as manslaughter with the corresponding prison sentence we might - at last - not be afraid to go to hospital

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