Saturday 19 February 2011

Second class treatment for the elderly has to stop

The report of the health service ombudsman showing that elderly people are being mistreated in hospital recently hit the headlines.
One patient who was transferred by ambulance to a care home arrived bruised, soaked in urine, dishevelled and wearing someone else's clothes. In another case, a man's life support system was switched off despite a request from his family to delay doing so for a short time.
Other cases told of a person denied a bath or shower for a number of weeks and another not given water.
While the report is shocking it should not come as any surprise. For a number of years now elderly people have complained about the second class treatment they routinely receive from the NHS.
A growing concern is just how frightened many elderly people are about going into hospital, not due to any illness but for fear of not coming out. The simple failure to feed and water people when in hospital can cause real problems, especially when ill.
There are already increasing reports of what could be called an informal policy of euthanasia operating across the land. This does not involve any direct intervention to kill people off but amounts to simple neglect to intervene and provide the support needed.
My own experiences with elderly parents have taught that whether dealing with health, social services or the care home sector there is need for a strong advocate looking out for the interests of loved ones. There is no doubt that elderly people who are regularly visited in hospital or care home, with a relative or friend looking out for their interests is less likely to be abused. Indeed, given the content of the ombudsman’s report one has to fear for the elderly person alone without support.
So why have things come to this sorry state? One problem put forward by some health professionals is the targets and box ticking mentality that has developed over recent years. The nurses are drawn between providing the care required and the need to reach targets. Maybe our hospitals have changed from centres of care to conveyor belts of process? There is no doubt a pressure to clear beds quickly.
The danger in the present climate is that any criticism of the sort to be found in the Ombudsman’s report will be seized upon by those in government as an excuse to privatise the NHS. However, the politicians really need to look a bit closer to home.
Many of the problems of the NHS and other public services emanate from the politicians. They do not seem to understand the processes of how things work. The constant setting of targets is something taken from the business world, yet successive governments have attempted to apply it across the public services from cutting cancer waiting lists to exam tables in schools.
The populist call is for more nurses and doctors, get rid of the managers and bureaucracy. The reality is that there needs to be logistical support to keep frontline staff in place and functioning.
What all of this indicates is a political class detached from reality in many cases and taking the populist drivel of the tabloid media as a basis for creating policy.
If a politician has come down the now well trodden path of researcher, political advisor, MP and then minister, what experience do they have of running anything?
This inexperience in how things work has caused many of the problems of our public services today.
The reality is that there are no doubt too many managers and bureaucrats in some services. There could be change and reform but dare anyone think the unthinkable that actually some things might have worked better the way they were before all the interference began.
The education and health system of the past may have needed changes but it did not need to be butchered by ideologically driven market obsessed governments.
The report of the health ombudsman should give serious pause for thought. There no doubt needs to be change but prior to action being taken the question needs to be asked as to how we reached this sorry state in the first place.
What has happened to so empty the NHS of the caring, dedicated culture that has been its hallmark since inception? How do we get it back? Perhaps it is time to take rather more notice of those working in our public services, rather than continually devalue them by seeking to measure and cost everything they do. Certainly the ombudsman’s report is a sad reflection on a service that has lost its way.

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