Hospital services under threat

Hospital services under threat

Map of hospitals which are in danger of losing their trauma centres.


Hospital limits number of patients seen in A & E

Hospital limits number of patients seen in A & E

From BBC News:

“The number of patients admitted to an east London hospital A&E unit is to be capped at busy times to improve care.

The Care Quality Commission (CQC) said the A&E department at Queen’s Hospital, Romford, was providing patients with “unacceptably poor care”.

It comes after inspectors found some A&E patients had to wait up to 11 hours before being transferred to a ward.”

This appalling decision is the result of so many patients visiting Accident and Emergency Departments and while this decision has been made by a hospital in Romford, it could apply to any hospital within the UK.

There have been many calls for patients to visit their own GPs rather than attending hospital but still patients pour into A&E departments in their droves. Why?

One reason must be that the out of hours GP service is so derisory. Patients are visited by doctors who speak little English or who just do not care. I have had the misfortune of needing to call the out-of-hours service on a Friday evening only to be told that I should see my GP on Monday. The next day I collapsed, an ambulance took me straight to hospital and surgeons performed an operation on the Sunday. My family could have saved me time and much agony by calling for an ambulance in the first instance.

It seems that some practising GPs sign on as out-of-hours locums because they can gain a significant amount of extra pay. I know of one GP who chose to give up his practice because he could take home more as an out-of-hours locum. Now, GPs are hardly paid a pittance; they are highly paid yet do no work at nights or at weekends, unless they have signed up for an out-of-hours service.

Sure, doctors train for many years and are expected to make life and death decisions but in my experience UK doctors can miss simple diagnoses that American doctors dare not because they would be sued for millions of dollars. Yet in the UK, the government is continually attempting to further restrict compensation payments rather than improve patient care.

The result of this incompetence on the part of successive governments is that hospital A&E departments are bearing the brunt and will be further forced to restrict the numbers of patients seen. Somehow, I cannot imagine Margaret Thatcher allowing a situation like this to continue. Much as I disliked Thatcher’s policies, she handbagged doctors and forced them to ensure the service to patients improved considerably. It has since deteriorated badly. We no longer have any politicians capable of performing a similar feat. Conviction politics has died and we are left with mediocre tinkerers. And we are all the poorer for it.

Disabled Pensioners and Disability Living Allowance

Older people find it difficult to get out and about at the best of times and for disabled older people it’s far worse.

The Government is stopping the payments of Disability Living Allowance to pensioners which means they will be unable to lease cars from Motability. Many disabled pensioners cannot use public transport because it is too difficult for them to get to a bus stop or train station or they suffer so much pain they cannot abide being tossed about on hard seats or sit comfortably when the vehicles are thrown about. Having a leased car for many disabled pensioners is therefore essential.

Removing disability payments from disabled pensioners means their social isolation will be made far worse than for pensioners that are not disabled. Now, it has been established by many research projects that social isolation can lead to an early death.

What we must ask ourselves is: is the removal of disability benefits from disabled pensioners because the Government has not thought about the consequences, does not care or is it a deliberate policy on the part of the Government to ensure that disabled pensioners die earlier?

If it is deliberate … there is a name for causing the deaths of those who are disabled or do not fit the social model a government is developing.

It is called eugenics.

My Father’s War

War does incredible damage to individuals, even those who appear on the surface to be unaffected.

I remember standing at a window with my father as we watched a Remembrance Day parade. He was crying. I asked him why he didn’t take part but he just shrugged. For some reason I remember a phrase from around the same time: “Sorry to rain on your parade but …”. Whether I had seen an advert or a programme on the television I cannot remember. I also remember a young girl and something about the Burma Star Association. Maybe, in retrospect, I am remembering a combination of various images and news items , the origins lost in time. I cannot say.

My father served in India and then in Japan with the occupation forces. In Japan he was based in Kure. He had photos of Hiroshima and seemed to have been involved with the clean-up of the city but he talked little about his service. I also know he was in REME and worked on generators. I remember there were also photographs of him and his mates, seemingly happy and laughing about something or other, at Angel Falls in India. What I wasn’t sure about was why he cried quite so hard during the Remembrance Day parade. Didn’t every soldier who survived fighting the enemy end up occupying a foreign country?

Whether the images were of different programmes or adverts or not I seem to remember that the image of the young girl and the phrase “Sorry to rain on your parade” had something to do with the way troops returning from the Far East were treated. My father returned in 1947 sporting a shattered ankle. He mentioned that one of his most vivid memories of the summer of 1947 was that you could recognise returnees from the Far East because they wore greatcoats while everyone else was dressed in very light clothes because the summer that year was so hot.

His most vivid memory, however, was being treated as an embarrassment. Most people in Britain had been through the European war and wanted to forget it. They wanted to enjoy the peace. Life for ordinary people was changing quickly; a new Labour government was talking about introducing a National Health Service and other major developments in social security. No wonder nobody was particularly interested in returning soldiers. It must have been even worse for prisoners of war who suffered under the Japanese. The public had seen the horrors of the Holocaust on their cinema screens and the horrors seemed to have inured them to suffering. Soldiers and prisoners returning from the Far East were a sight too far. But, for so many soldiers like my father, the memory of being ignored was heartbreaking.

For me, there was something else I did not understand. My father was an assistant in a grocery shop in Kent yet hadn’t been called up to serve in the army until the latter half of 1944. Why? I desperately wanted to know. I knew my mother had been in Air Raid Precautions but I knew nothing of my father’s role. Had he been a spiv, making money on the black market? It didn’t seem likely, knowing my father. There was something else, though. Talking to him now and again revealed the odd comment that suggested an incredible knowledge of unarmed combat, killing techniques and explosives training far beyond the training given to soldiers joining REME. Further attempts to pierce his silence, however, apart from those odd mentions during unguarded moments, revealed nothing.

I had to wait until after he had died before I was able to find out more. Among the few items left after his death were a number of diaries, some written during the years 1939 to 1944. Some of them seemed to have been written in a code. It took a long time to decipher. There were references to meeting ARPs and the Fire Service. References I found most strange mentioned regular meetings with the Chief Constable. Why would a grocery assistant need to meet the Chief Constable on a regular basis? Curious. I had no inkling of what the diary entries might mean until I saw a television programme years later. It concerned groups of trained killers known as Churchill’s Auxiliary. The role of Churchill’s Auxiliary was to act as a resistance should the Germans invade. The auxiliary was disbanded in mid 1944, after the D Day invasion.

Suddenly, it all made sense. The unarmed combat, the secrecy, the refusal to take part in parades. I remember him saying something along the lines of: they aren’t interested in saying to people that war is awful and harms people; they were, he said, saying: look at me, I served my country, aren’t I wonderful.

He suffered many health problems in later life. His leg was amputated when his shattered ankle, a constant physical reminder of his army service became gangrenous. I remember hearing that he was referred to a psychiatrist because of mental problems. He left, supposedly for the appointment, but returned so quickly it was obvious he hadn’t kept it. He must have been either afraid what he might reveal or, more likely, afraid of what he might do if his old memories were drawn out of him.

My father’s experiences left me in no doubt that it doesn’t matter how much people suffer, as long as they are part of a large group or population which has suffered the same experiences they can eventually cope with the trauma. The smaller the group or more dispersed the population, the harder it is for them. Maybe, had he just served in Japan, he could have coped. His earlier war experience together with his Far East service, his feelings of rejection and being sworn to secrecy about the Auxiliary left him isolated and prone to mental torture no one should ever have to endure. The smaller the war or the less people affected by it, the more severe the mental trauma. It’s no wonder soldiers returning from wars like those in Iraq and Afghanistan suffer so much post traumatic stress disorder. Wars are instigated by politicians and public opinion. Soldiers, sailors and airmen are not there because they want to be. We should have learned by now to respect and understand returning soldiers whether they appear normal or not. It is a disgrace that they are still too often left to cope alone.

Child Abuse

A new database of children’s hospital visits is to be set up to identify possible child abuse cases. What I would like to know is: will a record be kept of abuse carried out by doctors and nurses?

My concern is not theoretical but based on experience. I had a profoundly brain damaged daughter, Susan. She was the second born of twins. My wife and I were told soon after the birth that she had suffered brain damage cause by the cord being wrapped around her neck. However, our GP at the time wasn’t satisfied with the explanation and we began a judicial review. It turned out that the explanation was a lie; the damage was caused by an injection of a drug to contract my wife’s womb and expel the afterbirth being given by a doctor who did not check her first. Susan was crushed by the sudden contraction. Despite evidence to the contrary, no doctor would agree negligence was a factor. In fact, one ‘expert’ said he had no intention of ruining a young doctor’s career because of an accident. It didn’t matter that a child’s life had been destroyed; for doctors, their careers are more important than a child’s life.

Susan suffered many problems. A recurring theme was severe pain caused by tendons not growing at the same rate as bone growth. She had many operations to cut her tendons. In one instance, at Buckland Hospital, Dover, the surgeon decided an operation was not necessary and instructed a nurse to press down on Susan’s leg. On her return home, Susan wouldn’t stop screaming. We took her back to the hospital where it was found that her femur had been broken by the pressure applied by the nurse. Our complaint resulted in an apology but it was clear the nurse would have been blamed yet she was merely carrying out instructions given to her by a consultant. We took the complaint no further because we didn’t want to see a relatively innocent nurse sacked for a decision caused by an uncaring and pompous consultant. This is the way doctors wriggle out of responsibility. Would a database have recorded the abuse suffered by my daughter? I doubt it.

Susan eventually went into a Home for severely disabled. She died while being fed by a nurse. We later found out that she was the fourth child to die in similar circumstances. The Home was closed and the abuse hushed up. Would those events have been recorded? Again, I somehow doubt it.

How many parents will be blamed for the actions of doctors and nurses? I dread to think.

Supporting local businesses in Deal, Kent

Most of my Christmas presents have been bought online this year. However, while staring at the screen I thought: I really should do more to support my local town centre shops. Why that thought should have popped into my head I have no idea but it seemed a good one.

I have a number of health issues that cause me problems, especially when going out. The worst of them is Rheumatoid Autoimmune Disease. It used to be called Rheumatoid Arthritis but the name has changed recently. My hands are turning outwards, fingers are bent and even with medication they are painful so a trip into town isn’t a decision made lightly. But, I thought, yes, it is important to support local businesses so off I went.

I have a little car with a few adaptations which make driving easy, so that is no problem. I’d be housebound without the support of Motability, mind. Finding a parking space is usually not a problem as Dover District Council has provided disabled parking bays. I must admit to being somewhat peeved when I see people park in disabled bays then jump out of their cars and hurry into the town. I would love to be able to hurry but, well, that’s life, isn’t it?

Anyway, I hobbled my slow way into the town centre. One of the presents I needed was a pair of quality jeans promised to a relative. I made my way to Marks and Spencers but the jeans were in such a muddle it was too painful to lift them to see the sizes clearly. All the staff were busy so I gave up and left the store. There used to be a menswear shop in the town, John’s Menswear, where staff were always pleased to help but that has gone now, like so many of the little shops.

I also needed some women’s toiletries so I made my way into Superdrug. Searching the rows of toiletries and so-called perfumes, I was approached by a member of staff who asked: ‘Do you need any help?’ I declined, saying that I was just looking, thanks. She then hung around and I felt as if I was being watched in case I stole something. Maybe she felt she was there for me if I did need help but that wasn’t the impression I got. Mind you, I hadn’t been completely honest. My thoughts when she asked if she could help went something along the lines of: I could get far better products online paying not much more than the rubbish you have available here.

So, another failure. Next I called at a small, local shop. I didn’t notice the name. I found what I wanted and as I went to pay tried engaging the member of staff in polite conversation. The disinterest was as apparent as the mobile phone she had been speaking into before I went to the till. I shall not be going there again.

What a contrast I found when I went into a small shop called Lynda’s. Many years ago it was called Lynda’s Drug Store and I still know it by that name. The staff were polite and helpful and chatted away in a very friendly manner. They quickly found what I wanted. It’s a great pleasure to do business in a shop like that.

Next I called into Poundland, a truly horrifying experience. The queue was long and there were no seats. After an interminable length of time, I gave up, put the product back on its shelf and left without buying anything.

By this time I was exhausted, cold, in pain and felt thoroughly deflated. Only my visit to Lynda’s gave me any hope, but not enough. I shall not be returning to Deal town centre in the near future and definitely not for shopping. Why should I when I can get everything I need from the comfort of home, the majority of products arriving within a day or two at the most. Local town centres? You can keep them.

No planning Permission for New Hospital in Dover?


East Kent Hospitals University NHS Foundation Trust says it is planning to build a new hospital on the site of Dover’s present Buckland Hospital and claims the new hospital will cost £21,000,000. However, according to Dover District Council leader Paul Watkins the Trust has not yet applied for planning permission. What is going on? My attempts to find out raised more questions than they answered.

As well as being leader of Dover District Council, Paul Watkins is a member of the newly-formed Health and Wellbeing Committee, which will be run by, or has close links to, Dover District Council. To further complicate matters, there is also a South Kent Coast Clinical Commissioning Group. Trying to find information on how the roles of these various organisations interlink or overlap, or do not, seems depressingly difficult.

According to the Department of Health, the reorganisation will liberate the NHS leading to increased democratic legitimacy in the NHS. Yet the Health and Wellbeing Committee appears to have no democratic element at all as members are appointed and are not voted into office. This seems to have led to a committee dominated by ruling Conservative group councillors with no representation from representatives of other political parties. More and more interesting.

Now according to the South Kent Coast Clinical Commissioning Group, their role is to:

1. Prevent people from dying prematurely.

2. Enhance quality of life for people with long-term conditions

3. Help people to recover following episodes of ill health or after injury

4. Ensure that people have a positive experience of care

5. Treat and care for people in a safe environment and protect them from avoidable harm

and in addition to these

6. Tackle health inequalities.

OK, so these are the aims of the South Kent Coast Clinical Commissioning Group. What, then, are the aims of the Health and Wellbeing Committee? Not a lot, it appears. In fact, it will be wound up in 2013 and become the Health and Wellbeing Board. Confused? You are not the only one.

So if I do not know the role of the Committee, and it seems to late to matter now, what will be the role of the Board? According to Parliament’s Publications Website the role of the Board will be:

“Health and wellbeing boards will be the forum for local authorities, the NHS, local Healthwatch(?), communities and wider partners, to share system leadership of both health and care services and population health.

The Act mandates the statutory minimum membership for health and wellbeing boards to include at least one local elected member, a CCG representative, the local directors of adult social services, public health and children’s services, and a representative from the local Healthwatch organisation. The NHS CB must also participate when invited to do so.

They will develop a joint understanding of local needs through Joint Strategic Needs Assessments (JSNAs); a shared set of priorities and a strategy to address these in Joint Health and Wellbeing Strategies (JHWSs). JSNAs and JHWSs will form the basis of NHS and local authorities’ own commissioning plans, across health, social care, public health and children’s services. The Government recently concluded a short public consultation on draft statutory guidance on JSNAs and JHWSs. A formal response to this consultation will be published by the end of the year.

Health and wellbeing boards will have duties to encourage integrated working between commissioners of services across health, social care, public health and children’s services. This complements duties on CCGs and the NHS CB to promote integration. They will consider how the collective resources of the NHS and local government can combine to improve outcomes, for example through Community Budgets.

By involving local councillors and representatives of people using services through local Healthwatch, and through wider engagement with local communities, health and wellbeing boards will strengthen local democratic legitimacy of health services and increase the influence of local people.”

So, to complicate matters further, a NHS Commissioning Board will have statutory responsibilities for the South Kent Coast Clinical Commissioning Group. There will also be a group overseeing NHS provision for the public and its name will be Healthwatch. It will:

“… be the new consumer champion for both health and social care, and Local Healthwatch will feed local people’s views and concerns about local health and social care services into the system.”

Have you heard of Healthwatch? I hadn’t. Yet it’s supposed to be the service users’ champion.

I took a look at the membership of the respective groups, committees and boards. On the board of the South Kent Coast Clinical Commissioning Group are: Dr. Joe Chaudhuri and Mr Chris MacKenny.

On the Health and Wellbeing Committee are: Dr Joe Chaudhuri and Chris Mackenny. In addition I found Cllr Paul Watkins and Karen Benbow.

Among the Council of Governors of the East Kent Hospitals University NHS Foundation Trust is Karen Benbow.

And as I had confirmed before, the Leader of Dover District Council is Cllr Paul Watkins.

With the same people appearing on the same committees, boards and groups, wouldn’t you think that information regarding the work of one would be relayed to members of the others? Yet Cllr Paul Watkins, as Leader of Dover District Council, announced to the press that the East Kent Hospitals University NHS Foundation Trust had not contacted the Council’s planning officers over the building of the new hospital. Surely he must have known what the East Kent Hospitals University NHS Foundation Trust was planning through his contacts in other groups, committees and boards he serves on. Couldn’t he have had a quiet word with his friends on the other boards, groups and committees rather than appearing to slap down the East Kent Hospitals University NHS Foundation Trust in the press and potentially cause more confusion for the public? Keeps his name in the public domain, I suppose.

Or maybe other members of boards, groups and committees are not friends but potential competitors?

When do roles overlap and when must they be kept separate and private? How can so few individuals have seats on so many boards and groups? I thought this reorganisation was supposed to make the NHS more accountable and democratic? Sorry, but it seems far more complicated, less democratic and open to accusations of corruption and cronyism. Not that I’m accusing present members of being corrupt but the potential is there.

And where in all this bureaucracy and red tape do ordinary people, the users of the services, come? Do people actually matter any more? And, most importantly, how is all this reorganisation supposed to keep our NHS as a public service and keep it from becoming a money-making machine for private companies?

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