NHS:The perfect storm..

[Anna B]

Very worrying programme on TV tonight; 'Panorama - NHS: The Perfect Storm,' about the future of the NHS. This was a report from Liverpool on the battle to transform the health service. Basically it was saying that it can't continue in its present form and needed a radical overhaul.

 

No surprises there then, but the things it was planning were very dubious indeed. For example it was planning fewer hospitals and less beds, with the money saved diverted into 'care in the community.'

 

Yes, well, we've heard that one before when they closed down the mental Hospitals, and look how that turned out... Those who would once have been in a place of safety are now trying to survive on their own outside, in a world they cannot cope with.

 

I think most of the burden of this will fall on the elderly who are the biggest group admitted to hospital by virtue of their failing health. Care at home is already patchy and inadequate and tends to be the lowest priority in the general scheme of things. These days it seems they can't kick people out of hospital fast enough, sometimes with disastrous results.

 

I'd be interested to hear what other people thought of this programme, and if they have any better ideas for reforming the NHS.

[Eric Arthur]

If you'd ever visited a mental hospital like Middlewood you'd know that they were used a dumping grounds for people that we preferred not to experience. The principle of care in the community is superior to institutional facilities and residential care is still available for the most needy.

 

The same principle goes for every area of care that doesn't need intensive supervision. The elderly in particular are much better off as a member of the wider community than god's waiting room and heaven forbid that families might even take responsibility for their elders or sick.

 

How it is implemented is tricky though. It starts with us all making an effort instead of expecting the state to do it all. What are you doing?

[Anna B]

Actually I used to work at Middlewood hospital in the 1970s and some of the care was very good. I worked in occupational therapy and know something about the level of support some people need, and I certainly don't see that in the community.

 

As you say, there is still residential support for the most needy, but there is a huge gap in care in the community for those with serious, chronic, but less pressing illnesses. Indeed they make up a large proportion of those who are now being harrassed into work and sanctioned when they can't cope, especially since the closing down of places like remploy.

 

Care in the Community might be superior to the big institutions when it works, but too often it simply doesn't. And in many cases is simply non-existent. They may not be 'dumped' in an institution, they are dumped in an uncaring world instead.

 

As for the elderly, yes they are certainly better off as part of a wider community, but when they are ill they need to be in hospital. And, as is so often the case, when you are bed / housebound, unable to go out, with no visitors bar the rushed 15 minute a day care worker (which, can I remind people, the OAP has to pay for,) what kind of 'community' is that?

Edited July 14, 2015 by Anna B

[Flexo]

I'd be interested to hear what other people thought of this programme, and if they have any better ideas for reforming the NHS.

 

Panorama is tabloid TV. Whenever they have covered a topic I know a lot about, I've been left angry at their sensationalist misreporting and ignorance of the facts.

[Eric Arthur]

Actually I used to work at Middlewood hospital in the 1970s and some of the care was very good. I worked in occupational therapy and know something about the level of support some people need, and I certainly don't see that in the community.

 

As you say, there is still residential support for the most needy, but there is a huge gap in care in the community for those with serious, chronic, but less pressing illnesses. Indeed they make up a large proportion of those who are now being harrassed into work and sanctioned when they can't cope, especially since the closing down of places like remploy.

 

Care in the Community might be superior to the big institutions when it works, but too often it simply doesn't. And in many cases is simply non-existent. They may not be 'dumped' in an institution, they are dumped in an uncaring world instead.

 

As for the elderly, yes they are certainly better off as part of a wider community, but when they are ill they need to be in hospital. And, as is so often the case, when you are bed / housebound, unable to go out, with no visitors bar the rushed 15 minute a day care worker (which, can I remind people, the OAP has to pay for,) what kind of 'community' is that?

 

It looks like we agree that care in the community is better than institutions like the NHS except in the most needy circumstances.

 

I also agree with you that community care could always be better just like anything and everything could be better.

 

Where we differ is that you seem to think that "community" is a state funded care worker.

 

Do you think that we should take more personal responsibility for our family before expecting the state to intervene? How about changing benefits and tax breaks so that people who look after their relatives (maybe by using that extra bedroom that is attracting bedroom tax) benefit more than those who don't look after their relatives?

[alchresearch]

No surprises there then, but the things it was planning were very dubious indeed.

 

I didn't watch it but as it was Panorama, assumed it would be the usual scaremongering and portraying people's beliefs and opinions as fact. Its been a long time since it was a respected programme.

 

A few weeks ago they did a programme on GMOs, which came under fire for being inaccurate:

 

http://gmwatch.org/news/latest-news/16221-what-bbc-s-panorama-got-wrong-on-gmos

 

And an older one:

 

BBC's Panorama stalks the wrong man in programme about... stalking

http://www.dailymail.co.uk/news/article-1351869/BBCs-Panorama-stalks-wrong-man-programme--stalking.html

[Anna B]

It looks like we agree that care in the community is better than institutions like the NHS except in the most needy circumstances.

 

I also agree with you that community care could always be better just like anything and everything could be better.

 

Where we differ is that you seem to think that "community" is a state funded care worker.

 

Do you think that we should take more personal responsibility for our family before expecting the state to intervene? How about changing benefits and tax breaks so that people who look after their relatives (maybe by using that extra bedroom that is attracting bedroom tax) benefit more than those who don't look after their relatives?

I know what you are getting at - community means all of us, but times have changed dramatically. Now nearly everyone who can, works all day, and has less time for volunteering. Neighbours are out all day and often aren't even known. Lunch clubs and social centres are closing down, or the transport isn't available to get them there. Even so, we should all do more, much more.

 

Caring for an elderly relative at home is the ideal solution, but isn't always possible for a number of valid reasons. Also sacrificing a wage for a carer's allowance, (£60 per week, paid for by reducing the relative's benefit) can leave people in serious long term financial difficulties, (including their own pension prospects.) Considering care home fees are £500 + per week you would think some of that could be diverted towards 'care at home.'

 

I think all these things need looking at at government level. Old people have contributed for a lifetime, and many still have much to offer in terms of wisdom and the long view. I think they need to be valued, and regarded with a great deal more respect. Unfortunately, seeing them as 'a problem to be solved,' means they are diminished in some people's eyes, and can be treated very badly in society.

[jfish1936]

My aunt was an inmate at Middlewood, and we visited regularly.

I contrast the care she received, and the facilities available to her, with what I saw of similar people before I retired, to whom the phrase " lack of care in the community " could be applied.

I have seen people with severe behaviour problems, resulting in police being called, but there's no room for them in a "mental hospital". Of course, this is really the fault of their relatives, who should be happy to find a room for someone who screams foul abuse at those who pass in the street, or who are convinced that someone on the other side of the street is laughing at them, so go over and hit them.

True, this is Australia; but the same thinking was applied as in UK: "mental hospitals"/"asylums"/"supervised residential care" come expensive; close them down, and let's hear pious platitudes about (usually other people's) family providing care.