The Welfare State We're In, The website of the book by James Bartholomew
December 02, 2010
This is the kind of failure of the NHS that is hard to measure

It is because this failure is hard to measure that it does not get to the top of our politics-driven National Health Service. I am referring to the treatment of the elderly.

You can put a number on a waiting list. You can measure the number of people who survive different kinds of cancers for five years. You can measure how long people wait in Accident and Emergency. But you can't easily measure the number of elderly people who are not helped to eat and drink or the number who are left to lie for hours in their own urine. Perhaps, though, it would be possible to measure how many are lying on hard beds when they should be on air-filled mattresses to reduce the risk of bed sores?

All this is relevant today because the Daily Mail and Radio 5 Live, among others, have given plenty of attention to a report by the Patients' Association about the treatment of the elderly.

Here is a typical example that has been brought forward:

Last November, the grandmother was admitted to Queen’s Hospital in Romford, Essex, with chronic heart failure after the care home where she had lived for a year became worried about her after a fall.

Mrs Dowsett, a local government consultant, brought her mother home-made food.

But although it was placed in front of her, other patients said staff did not help her to eat or drink.

The call alarm buzzer was also repeatedly left out of her reach.

One day, after using a bedpan, she was left calling for help and ‘in a very uncomfortable position — like a turtle on its back’, said Mrs Dowsett, who had twice to go and tell a nurse before anyone went to help her mother on the ‘understaffed’ ward.

Requests for painkillers were refused.

On another occasion she arrived to find her mother ‘looking like she was dead but still alive, screaming in pain, ­incoherent, clinging to the bed in a foetal position’.

Her mother also developed bedsores, which went undetected for days.

She was discharged on December 3, readmitted to hospital 16 days later and died on December 21 from a heart attack.

An investigation was launched after a complaint by the care home about the bedsores.

A report by the safeguarding adults team found that on the ‘balance of probability’ there was ‘neglect’. It also found her diet and nutrition should have been properly monitored.

The report added that the police were contacted for their stance and they advised ‘it would be a criminal matter if it was an individual who had the sole care of the patient. As it appeared this was the failing of the institution as a whole, they advised that the institution should investigate their own failings.’

That was the Daily Mail report. It is in full here.

And here is how the article begins:

Tens of thousands of elderly people are suffering appalling care at the hands of the NHS every year – pushing complaints to a record high.

For the first time last year, more than 100,000 patients and relatives were forced to issue complaints after being let down by the Health Service.

Hundreds of thousands more won’t have bothered to complain because they have so little faith that the NHS will listen.

Must do better: Complaints about the treatment of elderly patients within the NHS have soared

The Daily Mail is today backing a campaign by leading charity, the Patients Association, for an overhaul of the complaints system to make it completely independent – and end the scandal which sees people forced to complain to the hospitals against which they have a grievance.

And we are backing their appeal to raise £100,000 to boost their helpline which helps angry NHS patients submit complaints and has become inundated in recent years.

I am glad to see the Patients' Association getting so much coverage for this important story. It is good that the British public is increasingly getting to grips with the unwelcome reality that the NHS has major failings. My only slight regret is that the conclusion reached by the Patients' Association is that we should 'call Matron. I have heard this cry for at least the past two decades, probably more. Newspapers and politicians take up the cry but it never seems to result in a real change. And meanwhile there is a failure to face up to the truth that the problem is systemic. The problem is the nature of the NHS - a top-down monolith with all the same sorts of malfunctions and waste that normally exist in state monopolies.

We need to change the system. The OECD lists six different types of healthcare system (see previous entry). Judging by the results we have experienced in Britain, almost any of the others would be preferable. The government should commission an enquiry using people of all political persuasions to look at systems around the world and find the one that would best suit our needs.

At present, many of us have bitter experience of how badly the NHS has treated elderly people that we love. This must change.

Posted by James Bartholomew • Indexed in NHS

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