And a rider, to my previous post...

I had meant to link it to this excellent article by Dr Max Pemberton who writes a column in the Daily Telegraph, which I think sums up the problems at the heart of the NHS.

http://www.telegraph.co.uk/health/8526344/Finger-on-the-Pulse-Max-Pemberton.html

I am in favour of reform, and it is not all about cost cutting. Some of the things I talked about in my blog post can be done without spending money. For a start, patient b who was sent home from hospital before Christmas would have possibly saved the NHS a considerable amount of money if the patient had been kept there till better, and not wasted two ambulances coming out needlessly. I agree with Max Pemberton that the business model is a flawed one. (I have similar feelings about education). I have always worked in the commercial sector and while aghast occasionally at some of the ways the public sector seems to work, I don't think business and health are a happy mix. A wealthy nation is also a healthy and educated nation. If we keep people well and educate them properly, business can flourish. That shouldn't mean an open cheque book, but neither should it mean health and education are shoe horned into adopting business practices that don't make any sense and don't promote the needs of the patients/pupils.

I am also deeply aware that the majority of the staff working in the NHS are overworked, often underpaid and dedicated to what they do. But to give you one small example of where things are going wrong, let me tell you this story, which happened to us only last week.

Mil has recently needed to go to hospital on a regular basis for blood transfusions. Last week we were told she had to be ready for 8am (entailing a carer coming in at 7 to help her get ready), as she needed to be in the hospital by 9am for a blood test prior to having the transfusion. I would have taken her, but had the school run to do. I was slightly anxious about how the transport people would cope with her, so I dropped the kids off and got back to her flat at 8.45 to discover no sign of the transport. They eventually turned up at 9.45 and seemed surprised to learn they needed to push mil onto the ambulance in her wheelchair (this is a private company outsourced by the hospital, NOT the brilliant ambulance crews we have met on several occasions). The person pushing her seemed never to have used a wheelchair before and kept getting it stuck over the threshold of her doorway. We eventually arrived at the hospital at 10 am, so it was 12.30 before mil could have any blood (it takes time to make the blood up). She required two units of blood, which take 2 hours per unit. The earliest was getting away was 4.30pm. I had to shoot off for the school run so bil stayed with her. He reported that transport turned up at 3.40, twenty minutes before they were booked, and the attitude pretty much was if she doesn't go now, she doesn't get a lift home. Apparently if you are booked one way, you have to be booked the other, so bil wasn't allowed to do it himself. The result was she didn't have the second bag of blood. HOW can it be that transport dictate the treatment patients receive? This is a clear case of the tale wagging the dog.

On a more positive note the staff at the haemotology unit where she is being seen are uniformly excellent, but they agree with me that dragging an 86 year old, very infirm lady in in this manner once a week is not ideal. Nobody it appears is looking at the whole picture. And I am sure this is not unique to mil's situation.

I am reminded somehow of a powerful piece of thundering rhetoric in one of my favourite Dicken's novels, Bleak House. When the road sweeper, Jo dies in poverty, in shocking circumstances and Dickens launches into a rant about the inherent wrongness of his death.

Dead, your Majesty. Dead, my lords and gentlemen. Dead, right reverends and wrong reverends of every order. Dead, men and women, born with heavenly compassion in your hearts. And dying thus around us every day.

I think, if Dickens were alive today, he'd be tempted to say the same about the elderly dying in our hospitals, don't you?