Why the NHS needs to change...

[CogitoErgoSometimes]

Basic care denied to elderly patients

Yet another story about the NHS failing to provide basic care to patients. The NHS, like the curates egg, is only 'good in parts' and given that it costs so much and given that we are meant to be a modern society that is an appalling state of affairs. What good is free healthcare if it means you are condemned to suffer malnutrition, lie in your own filth or need a doctor to prescribe water to you so that you're sure of getting a bloody drink?

There is a lot of knee-jerk 'hands off' opposition to the NHS reforms but how can anyone honestly defend a system that allows such laziness, complacency and neglect?

[Lifeissweet]

I have had a lot of treatment from the NHS over the last 5 years and my DS is regularly in their care. I have to say that I am so proud that we have this Service in our country and have always received professional, thorough and efficient care. All that despite the political messing and stupid bureaucracy that makes patient care so much harder than it needs to be.

I don't like people bad mouthing the NHS. I don't recognise the 'laziness, complacency and neglect' you speak of.

[Prolesworth]

This report on failures of care for elderly people is horrific, of course and something must be done about this immediately. But it is totally wrong to use this to condemn the entire system, and it's even more wrong to think that privatisation will improve matters. It won't.

[Jinx1906]

Cogito, totally agree. Unfortunately there seem to be a lot of people who believe the low standards of care are normal and that all these horror stories are fabricated. I guess the fact that success rates for some cancers and heart disease are much lower then in a lot of other European countries are probably all lies too. As well as denying people who have paid there NI all of their life medication because they are not worth it etc..

[CogitoErgoSometimes]

I believe that this is the tip of the iceberg - and this is based on some quite horrendous examples of shoddy treatment experienced by my own (small) family and circle of friends.. There are many people, like lifeissweet that get good treatment but, as there is no feedback system to judge satisfaction with the service, many others are let down and it goes completely unnoticed. I know people that are terrified to go back to hospital after their experiences but who would rather forget all about it than register a complaint.

It is not bad-mouthing to insist on a better standard of care or to point out that a system where there is no choice and no alternatives may have other flaws. The NHS should not be a sacred cow.

[glasnost]

Yeah it should be a CASH COW, right?

But what would I know being an American? (This is irony at the accusation from OP that I'm, apparently, American. Based on nothing at all. If her political nous is anything like her wild aspersions on where fellow posters come from there's really no need to go on.)

[CogitoErgoSometimes]

Who said anything about cash? Obviously in the US it's all cash-based, as you know given that you're from those parts But if your elderly mother went to stay in a hotel that didn't clean the rooms, change the sheets or have running water, you'd check her out and check her into another one. A fundamental flaw in the hospital system is that you can't do that simple thing. You're stuck.

[glasnost]

Maybe the NHS needs MORE money pumped into it? The answer isn't privatising it by stealth. If the gov can always scrimp 'n' save to finance aggressions against countries guilty of having resources we need why can't it do so for the NHS?

It's curious, isn't it, all these media stories about the supposedly dire state of the NHS right when the gov needs to convince the sheeple that the NHS needs privatising. Is there, perchance, a link?

[RunnerHasbeen]

Needing to change and needing to have the proposed changes are completely different arguments. The changes to social care and council funding forcing the elderly to stay in hospitals, for example, can only make this situation worse - so it doesn't appear that any of the proposed changes have actually got any evidence or real motivations of this sort behind them. It is also hard not to relate the private nursing home scandals to this story and the proposed changes.

This report suggests the problems are: a lack of leadership, poor attitude among staff and a lack of resources. I cannot see any evidence at all that the reforms would even attempt to tackle these problems. You may get a profit driven leader but the staff are more likely to be poorly paid and there won't be extra money on resources.

I have always had very good NHS care, however I do not think the current hospital model was designed for long term social care and should not be doing that job - so would welcome changes in that regard.

[niceguy2]

This is a subject close to my heart at the moment because my gran is quite ill in hospital at the moment.

What's been most upsetting is the general apathy coming from the nurses. I know my gran is one of many patients and it's just a day in the office for them but obviously to us it's a big deal.

And I do believe trained nurses should be able to update charts in a timely manner. Other nurses should be able to read said charts and there shouldn't be confusion over the basics such as whether or not she's had a urine test and whether or not she fell out of bed.

I hear all the time that nurses are overworked and they need more staff but judging by the amount of nurses on my gran's ward, they simply needed to work more and chat less. There were always a gaggle of nurses yabbering away at the desk but rarely was there one actually on the ward itself.

I really hope this is not representative of the NHS in general because if it is, chucking more money at the problem simply won't fix anything.

[CogitoErgoSometimes]

Yes it is a problem of leadership and I would argue that it's also a problem of motivation. The satisfaction of a job well done is clearly not motivation enough for the 1 in 5 hospitals highlighted in the report and so patients are trapped in the sitution with no choice, no alternative and what sounds like no comebacks. Why should it be down to relatives like niceguy2 or myself getting awkward or an independent study to get hospitals to care?

No, the study probably isn't coincidental. But there are plenty of expert voices in the NHS saying 'it's all perfectly fine just as it is' and we need some balance.

[Prolesworth]

I dunno, the people I know who work in the NHS do not say it's fine as it is, but they certainly don't think that the government's proposals are a good thing either. One of the problems is the culture of chronic insecurity that's been created by constant reforms and restructuring exercises. It's both wasteful and extremely bad for morale.

[CogitoErgoSometimes]

The cultural problem that leads to elderly patients being neglected is not 'insecurity'...

[Prolesworth]

I didn't say it was, but if a service is not properly resourced and morale is low (for whatever reason, including the chronic change culture) then standards of care are more likely to suffer, aren't they. The point is, the government's reform proposal won't remedy these problems. They won't save money or stop waste and they won't improve standards of care.

[Teetik]

Laziness, complacency and neglect. Very strong words.
Christ, you have completely missed the part about the ethos of free healthcare at point of use improving a nation.
You are being utterly dim if you think this lot of con-artists will do anything to sort out the shameful treatment of old people.
What WILL happen is an improvement is certain kinds of provision, but more and more failures in the departments that don't respond to market forces easily. More and more people will find healthcare harder to access. If you are one of them in years to come, think back on your naive, trusting self.

[GreenMonkies]

Speaking as someone who has worked for the NHS for over a decade I can tell you that laziness isn't the problem. It's gross under-staffing and shockingly low morale. We are worked like dogs, underpaid and rarely thanked, despite the fact that we are, 99% of the time saving lives. There is no such thing as perfect. No system will ever have zero failures.

The NHS needs fewer paper-pushers and massive investment. Staffing levels are dangerously low, and mistakes are made due to lack of time and ridiculous expectations.

You're welcome.

[Tianc]

I think the large number of complaints about shockingly bad care in private, commercial old people's homes kind of knocks on the head the idea that poor care for the elderly is either an NHS problem or a state-funding problem.

A friend working in a private care home was about to whistleblow on her employer for stuff that makes that BBC report look like 5 star care ? but was pre-empted by the family of one of the patients calling the police.

[Tianc]

knocks on the head the idea that poor care for the elderly is either an NHS problem or a state-funding problem caused by the structure or funding of the NHS.

Obviously it does happen in the NHS too.

[CogitoErgoSometimes]

What do you mean 'don't respond to market forces'? The number of elderly people in the UK is increasing and therefore there is a big potential 'market' (to use your word) in related services. The NHS does not seem to be geared for the change this is already having on health requirements. I don't understand the point about free healthcare at point of use either. Nowhere has it been put forward that this will cease to be the case. What I object to is the notion that 'free' means 'shut up and think yourself lucky'...

As for strong words. What words would you use to describe the attitude of a hospital that leaves their patients in the state described in the study?

[glasnost]

Well said Greenmonkies! You can wager your sane, true voice will be drowned out by ideologically driven anti NHS types who just loathe anything public. As you said the NHS needs massive investment. Period.

Pity noone followed up on my point that all these horror stories are circulating in the rightwing media (ie ALL of it including the awful BBC) just when the gov's about to privatise it. This is propaganda of the worst kind and worthy of Pravda, quite frankly.

I'm not sure I agree OP is "naive" or "trusting" Teetik. What's Cogito's agenda here? Why start this thread at this time? WHO ARE YOU Cogito?

[CogitoErgoSometimes]

Agenda? This is a politics board, the NHS reforms are a current political issue and this story is therefore relevant. You glasnost were urging us all to contact peers this week and petition them to block the reforms... that's action of a rather more ideological nature than a simple discussion, I think you'll find. WHO AM I? No-one special really. Just someone that has lost one too many people to the supposedly wonderful NHS and gets very angry that nothing seems to get better.

At least when private nursing homes are found to be behaving in a cruel or neglectful fashion they can be closed down, the staff prosecuted and the residents moved. The poor patients in the hospitals highlighted in the report will doubtless have to stay exactly where they are and accept the usual rubbish that 'we have learned lessions'....

[GreenMonkies]

" What words would you use to describe the attitude of a hospital that leaves their patients in the state described in the study?"

Here's some: Understaffed. Over worked. Underpaid. Unappreciated. Working to guidelines set down by management graduates who have no idea what it's like to work on a ward or treatment/diagnostic clinical area.

I get home from work every day exhausted, I earn less than £10k a year, my salary has been frozen and my pension is being eroded. Every day we are pushed to work faster, look after more patients. Sometimes "compassion fatigue" is the only way to cope with protocols that make you treat patients in a conveyer-belt style.

No one is saying it's ok. The NHS is dying on it's feet. Stream-lining and targets just kill it quicker.

[glasnost]

Nothing gets better because the NHS is chronically under funded and hyper managerialised. Yep? Geddit? Why don't you support injecting more money into it instead of privatising it? I'm sure you support all the wars the UK's needlessly, cynically involved in which cost shedloads of cash the public purse cannot afford.

[glasnost]

Brava Greenmonkies! People like you are the true voice of Britain and should be bloody listened to.

[AWimbaWay]

Can I draw peoples attention to this petition for those that haven't seen it and might like to sign.

[CogitoErgoSometimes]

I haven't said I either support or that I'm against the reforms. I have said that the NHS needs to change for the better. We've had over a decade now where vast amounts of extra cash have been funnelled into the service. There has to be more to it than money and what I categorically do not accept is that 'underfunding' explains why a sick old lady in a hospital bed can't get something as humane and basic as someone to bring her a drink of water.