The Health Service – Once Again

Argus title : We must speak out over NHS

Party leaders are squaring up to each other over Britain’s Health Services. Cameron claims the Conservative Party’s commitment to the NHS is absolute. Brown cites record Labour investment in health and remind us of the appalling record of previous Conservative governments.

Such Olympian squabbling cuts very little ice with ordinary people. So does the information that the Treasury has very nearly matched European spending on health. The difficulty, as we are all coming to realise, is how the government has spent the money.

Enormous sums have been expended on increasing the salaries of already well paid GPs and consultants. When negotiating contracts, the government allowed GPs to award their own salaries, saying they “run their own businesses”. As a consequence, GP salaries have increased by 30%, while at the same time out of hours services have decreased.

Vast sums have been squandered on developing a complex national computer system which many clinicians fear may work. Meanwhile, expenditure on patient care has been mercilessly squeezed.

The damage to standards is obvious to those who use the NHS. All too often patients and their families don’t know what to do about bad experiences. Some are too distressed to take action. Others are too loyal to complain. Though appalled by the incompetence, poor management and callous indifference that they encounter, they recognise the deep commitment and selfless professionalism of many NHS staff. So they say nothing.

However, people are beginning to speak out. The Argus recently reported the experience of 2 elderly patients whose dentures were lost while they were receiving inpatient treatment at the Royal Sussex County Hospital (RSCH). These complaints were not petty. They were inconvenienced and humiliated, their recovery put at risk because their capacity to eat was compromised.

Joan Gwynne-Smith’s son said that when he first mentioned the loss of his 86 year old mother’s dentures to staff they appeared uninterested and “shrugged their shoulders as if to say what do you want me to do about it?”

Though the hospital has now said that it will reimburse the cost Mrs Gwynne-Smith’s new dentures, when Mike Wilson contacted the Argus to report that his mother Mary Wilson had also lost her dentures in the same ward, the hospital showed signs of irritation. A Trust spokesperson said “the Trust is not always responsible for loss of personal property”. She said the Trust recommends the use of denture pots but that Mrs Wilson “chose to wrap them in tissue” adding “it is likely they were mistaken for an item of rubbish”.

It does not appear to have occurred to either nurses or administrators that confused elderly people may have difficulty understanding or remembering a request to use denture pots or that sick people with limited mobility may experience difficulty in reaching them.

It is predictable that modest elderly patients would wish to wrap dentures in tissue rather than have them on display. It surely should not be beyond the capacity of any properly trained and supervised cleaner to ensure that they are not thrown away.

My husband reminded me that during his mother’s last illness at Worthing General Hospital, her glasses and cups of tea were regularly placed out of reached on the paralysed side of her body. My husband would buy her orange juice, which she liked, only to find it had been neatly placed in a locker which was also out of reach.

Some of my late father’s experiences in the RSCH and Brighton General Hospital were similar to those of Mrs Gwynne-Smith. In the course of two or three admissions he lost 3 pairs of pyjamas and two pairs of spectacles. The staff were as casual about his loss as those who dealt with her, commenting that items “must have got caught up in the bedding”.

A sympathetic nurse told us not to bring in my father’s own pyjamas, but to let him wear hospital issue. Reluctantly we did so, but at the cost of his dignity, because they rarely fitted and often gaped.

There was never any suggestion the hospital might compensate him for the inconvenience or expense of replacing his glasses. In fact, there was just a hint that a demented old man didn’t really need them. Staff seemed indifferent to the fact that he was blind in one eye and completely disorientated without them.

Carelessness with patients’ property worked both ways. I recall my father being given a zimmer frame which belonged to another patient though it was clearly marked with his name. Its frail owner looked distressed, but didn’t protest. I made sure it was returned to its owner, with thanks, but had I not been there that frame would have remained by my father’s bed.

On another occasion, which I have already described in this column, I had to retrieve my father’s dressing gown and slippers from a distressed fellow patient. They were drenched in urine, but there was no apology from staff.

The neglect of elderly patients has been a scandal in this country for years, but now at least, is beginning to be publicised. The 2005 Panorama programme which exposed neglectful and abusive behaviour at the RSCH marked a sea change, triggering a steady stream of disclosures about poor treatment in hospitals and care homes around the country.

Two factors have led to change. The first is that baby boomers now in their fifties, unlike their parents, are not accustomed to making do and putting up with things. Many are used to respect, relative affluence and at least some freedom and independence. Their experience of their parents’ care has exposed the full horror of conditions which may await them in their own old age.

The second major change is that as health services are squeezed they are beginning to offer an equally bad service to younger people. There was front-page coverage when a young soldier who had returned wounded from Iraq was treated in an ordinary NHS hospital and left for hours with an overflowing colostomy bag, despite requests to empty it. His mother reported numerous failures in basic nursing standards.

Opposition politicians used this incident to condemn the decision to close military hospitals, inexplicably failing to acknowledge that the report had highlighted lapses of NHS care which would have been scandalous whoever the patient might have been. What was noteworthy about this was not just that the patient was a soldier, but that he was young.

My husband is in his forties. Up until 6 months ago, he was in excellent health. In fact, he took pride in refusing even aspirin if he felt unwell. Now, however, things are different. Following treatment for a misdiagnosed minor ailment he has had 4 operations requiring general anaesthetic, with two urgent admissions to hospital and months of pain relief, including at times morphine and other addictive medication.

His experience has been a scandal and people have said I should use this column to write about it. I may do so, but I have little hope it will do much good. Panorama dealt a far more public blow to local health services than I ever could and yet when its producers carried out a review of the original programme they could offer little reassurance that improvement had taken place.

Nothing I wrote about my father’s poor treatment, which was far worse than I have described in this article, issued in any apology or even expression of concern by health officials. With hindsight, I wish the family had made formal complaints about my father’s treatment and sought compensation on his behalf.

We didn’t complain because we were exhausted – and because we were loyal to the NHS. We were fooled. Tory and Labour “reforms” mean that a truly national health service no longer exists. Trusts operate in competition with each other, in thrall to private companies and unelected quangos and manipulated by politicians, bureaucrats and affluent health professionals.

Services may be free at the point of delivery, but are being so ruthlessly squeezed that, despite widespread loyalty to the NHS, those who can afford it will eventually be forced into the private sector. The poor and the old will be left with the dregs of an NHS which was once the envy of the world.

The families of Mrs Gwynne-Smith and Mrs Wilson have given a lead. So long as health trusts remain deaf to criticism and cannot be persuaded or shamed into good practice, patients and their families should have no compunction about making formal complaints – and demanding compensation.

The simple truth is that when institutions are ruled by money, we do best to hit them hardest where it hurts most – their pockets.