Friday, April 15, 2016

The value of the 'elderly'?


Over the last few weeks, I have been able to study the National Health Service at close quarter.
Any time I have used it, I may have been a patient but I always fully cogniscent… never ill,  always able to speak for myself and say when something wasn’t going right
Over the last few weeks I think I have experienced the best and the worst.

On July 5th 1948 the NHS is born. Health secretary Aneurin Bevan opened the  Park Hospital in Manchester  as the first  NHS hospital. For the first time all medical disciplines; doctors, nurses, pharmacists, opticians and dentists were all together under one organisation to provide free health care for everybody.

And this is exactly what it does and we should be very proud of it. The fact it can never, ever have enough money to do everything it would wish to do is obvious. It is busy, a little grubby, always understaffed, underpaid and seems to run in a state of general confusion.

The confusion was such a state that when my dad was doing OK, but not marvellous I did think about going privately and getting him a room in the local private hospital- which with no insurance, might have cost a small mortgage. He was waiting for an MRI scan, before they could move on with the next  treatment protocol. Days passed, into a week, still lying in the bed, still no scan. Radiology kept phoning, then the appt would be nabbed by some poor person more needy. Like the young man in the other ward, just had a severe stroke at the age of 35.

My dad is 80, and hasn’t had a stroke, so he could wait.

So I thought about getting him scanned privately and turning up with the results. Two CAT scans and a Doppler had shown up nothing, so it was a ticking box job. They didn’t expect to find anything. Others had priority.

Then last Tuesday night when it all went desperately wrong, the majesty of the NHS went swiftly into action. State of the art equipment, minute by minute care and his life was saved. And he is still here to tell the tale. A bit garbled maybe, but still here.

If he had been at the private hospital, they would have had to have taken him to the local NHS A & E ( ER) by ambulance… and he would have been back where he started.

A 2010 report from the commonwealth fund said the UK health system was the most impressive overall,  compared with ten other countries - Australia, Canada, France, Germany, Netherlands, New Zealand, Norway, Sweden, Switzerland and the US. It rated good in all categories. And I don’t doubt that for one minute except quality of the coffee, the tea….  The public toilets can be a bit dodgy and you do have to run the gauntlet of the banned smokers who hang about secret little pockets of the grounds like lepers.

And our local hospital is built at the top of the hill. The car park is at the bottom.
Tough is you have emphysema.
But the communication is bad between patient’s families and doctors. Bound by complicated and often non sensical confidentiality issues, plus a ton load of paperwork, it can be really hard. Why explain the issue to the patient, who is too ill to understand or too confused to take it in, then not tell the family who has been sitting over the need for the last three days.  The law might be something, good clinical practice has to bend sometimes to be humane.

But that did get my thinking. Nicola Sturgeon has her own hobby horse 'named person scheme', ie every child will have a  state representative to look after their wellbeing.

Every child.

Every child in Scotland.

Talk about big brother is watching us. It is one of the most stupid things I have ever heard.

Yes there are many children in danger in Scotland and they need more protection than that they are getting at the moment. Equally there are many, who have two  parents who care  for them and nurture them as parents should, no third party intervention needed.  The act is to bring in  state guardians to monitor what children want and need.

 You might have to read that sentence again..

And children, by any definition have parents somewhere, maybe they should actually look after their own kids.

But what of the elderly, rotting in hospital day after day with no family to visit them, no family to  ask them what they had for their tea and was it recognisable. Nobody to speak for them when things maybe aren’t going as well as they should be, to take their pjs home and bring them back nicely ironed. Or take them for a wee wheely in their chair out into the hospital garden to have a wee bit of sunshine. I respectfully suggest that Miss Sturgeon maybe looks at  her plans again  and maybe thinks of another way to spend the money put aside  for the named person scheme.

What about a named person scheme for the  over 65's with no family in a twenty mile radius?

 But she won’t as old people  are not good vote catchers, are they?

 There is nobody there to take them out of the hospital to vote or send out their postal vote for them.
As a society we just don't respect or value our elders enough. And Nicola is not helping. Shame on her.

Caro Ramsay  14/ 04/ 2016


  1. Sounds like a scary story about your dad. I hope he he doing okay now.
    Medical services are such a mixed bag. In South Africa, if you can afford it, you go to a private hospital most of which are pretty good. Most can't. The state hospitals are very variable to put it politely. And not free but cheap.
    The government has been mulling over a plan to supply free basic health care. I support that in principle, but many people are convinced that the state won't be able to manage it in practice. I don't have any idea what the answer is for a country like South Africa.

  2. I agree totally, Caro. Having someone designated to speak for elderly patients who have no close family would be a great idea. I don't believe that EVERY child in Scotland really needs their own representative.

    I've seen elderly people fail to be fed in hospital because of their mental health issues. They are confused and frightened because they don't recognise the nurse who fed them this morning, or last night. They need a little more time spending on them, which the nursing staff don't have to spare, so they get missed out, or forgotten.

    Yes, the NHS is brilliant in an emergency, as with your dad, but how many of those emergency situations could be avoided if services weren't so backed up and overloaded all the time?

  3. As one who is approaching the vicinity of elderly I can see the need for advocacy for certain segments of the population. Vulnerable children and adults could well be served. I don't know if our social work segment is adequately staffed to do so.

  4. Barbara and I, too, hope your Dad is now doing well. As you know, I am a big fan of how the NHS handles emergency situations, and sad to hear how the routine falls short. In Greece, there is free medical care for those who qualify, but those who can afford it generally opt for private hospitals. In the US...well, where to begin.

  5. Thank you all for your thoughts. The grim reaper had a wee knock at Dad's door on Tuesday, and was repelled. Today the old yin was sitting up in bed and counting his Malteasers. And he has just been inducted into some UK Cycling Hall of fame. My dad has something in common with Bradley Wiggins!
    The wizened old chap in the corner never gets a visitor, never gets a nice cup of tea from the cafe ( my mum gives him one out dad's flask), never has somebody to remind him that he does/does not like sprouts/mince/ rhubarb when it comes to menu choices.
    I suppose it's a writer's thing but I do find myself looking at him and filling in a back story. He will be in a novel one day. As a hero!

  6. Oh, so good to hear your father survived the crisis. And a salute to the NHS.

    In the U.S., care is very uneven depending on whether one has health insurance, private or Medicare. People on Medicaid are not accepted by many doctors. Even with Medicare, not all doctors accept it. And now some doctors do not accept any insurance, private or public and one has to pay up front.

    When I broke my ankle a few years ago, friends worked hard to find a doctor to do the surgery and accept Medicare. Other doctors wanted to be paid a small ransom.

    And the 33 million who still have no medical insurance because 19 conservative state governments have denied Medicaid expansion go without it.

    Health care is the leading cause of bankruptcy here.

    So, cheers to the NHS. I hope it continues to save lives. It is impressive. I wish we had it here.

  7. Caro, I am so glad your father finally got the care he needed and he is still with you. I wish you many beautiful times together in the years to come. I looked after my dad in his final years. Regarding the privacy laws, we have one called HIPPA. I cannot tell you how many times I had plead with hospital and doctor's office personnel to tell me his condition NOW and not after I FEDEXed them an original notarized copy of the Health Care Proxy he had signed for me. I had a set set speech that began, "Put yourself in my place. Your beloved parent is 92 and your are trying to help him....