I do not know anyone in a care home or having any family members pending, but I've always wondered why care home fees are so high.  Perhaps this report by the CHPI explains why, and whilst the findings do not come as a surprise to me,  I still think it is outrageous and calls for a formal enquiry.  The vulnerable shouldn't be a money-spinner.

https://chpi.org.uk/papers/reports/plugging-the-leaks-in-the-uk-care-home-industry/

4 hours ago, hightail said:

In the main 'they' are among the poorest and most disadvantaged.  The report even acknowledges that price rises will affect them disproprotionately.  They have been the most easily persuaded that there will be a magical surplus of quality social housing because it's the immigrants who have it all now.  They are those who are convinced all jobs will become well paid in comfortable conditions.  They are those who believe we only pay in to the EU and get nothing back.  They are those who thought they had nothing to lose by voting leave and will be hardest hit.

Well, 'they' freely made their choice.  Why can't you respect that?

6 hours ago, fletch70 said:

If you read the site of the report it is not a worst case scenario at all 

 

It would appear from media reports the people who most want a no deal Brexit are either those who will be able to make money from it i.e the very wealthy or will play the markets, and at the other end of the scale, the poorest who follow the likes of Stephen Yaxley Lennon although Tommy Robinson does sound so much less elite now doesn't it.The report says the poorest will suffer the most from rising food and oil prices. 

 

As for Boris appearing to be a criminal, I said appeared and we would have to wait for the supreme court to rule on that. If they do rule he acted unlawfully then the weight of the law should be brought down upon him -BUT I do believe in the rule of law which was why I said we would have to wait. So you see I was not saying we should do anything until the rule of law has been allowed to play out so maybe you could actually read what I said before jumping in. By the way, it was a long while before 1939 that Hitler did away with democracy and the rule of law in Germany.

 

As for what you claim is democracy- during the campaign almost no one said leaving without a deal would even be an option or if they did they were in the minority. Comments like remaining in the single market, keeping the customs union, the easiest deal in history all spring to mind. As such people who voted leave had many different versions of leave in their mind. Equally people who voted remain also had different visions. 

 

If you want democracy - this is where we need the second referendum with the stark choices laid on the table . Leave with the deal negotiated, the most up to date would be May's deal , or remain. If a different deal comes up then that should be included. Alternatively you could have a single transferable vote of deal, no deal or remain . My suspicion s that deal would win being the second most popular although I may be surprised.

 

So you see- you completely misunderstood what I wrote, maybe you should have taken time to read it.

 

For he record, I believe that leaving in any form is a national disaster, in fact hiding the referendum as it was was a very poor decision. 

 

We live in a representative FPTP democracy which again in my opinion is a poor version of democracy ; the systems used for MSP's or indeed the 'German' system provides a combination of representation and stability 

My, haven't I poked the hornets nest.

As no country has ever left the EU, with or without a deal, this is just speculation.  We do not know what will happen.  It may be what you choose to believe and there are others who obviously choose to believe otherwise.   Currently this messy divorce from the EU is political.  It seems to me like trying to separate from an abusive partner who wants to ensure it's as difficult at possible to stop other 'partners' thinking they can do the same.  If we ever leave the EU it will become all about the economics. 

You said in your earlier post 

Quote

I have to say as well, those who seem to be wanting a no deal Brexit are the very people who will suffer the most.

Again, you are speculating, but if that's their view, accept and respect it. Or would you prefer them to be sent to re-education camps so that they can all think the right way....like you?

I repeat what I said in a previous post that the question on the ballot paper was leave or remain and whether it should be thus went unchallenged by those that could. 

I believe the leaflet that Cameron sent round to every house suggested that it could take 10 years to get a deal with the EU, so a no deal must have been out there.  The government at the time were very pro-remain and armageddon was preached at every opportunity.  I think you are under-estimating the electorate not to have considered the possibilities.  You clearly think (you called the no-dealers imbeciles in an earlier post) that everyone who has a different opinion to you is stupid.  I bet you are fun guy to be around.

How about we all accept the outcome of the 2016 referendum and move on (please).  In ten years time, maybe we can have another one to see whether people want to rejoin.

6 hours ago, Jase1982 said:

 

To be fair, there was thirty years worth of work put into preventing any major issues with Y2K.  People always use Y2K as an example but are ignorant of the "things" carried out in the background for years.  People prepared, yet you wouldn't ever see a headline in a newspaper proclaiming the success of very dedicated individuals.  There has been zero preparation for Brexit.

 

Democracy should be inclusive though?  If you use the comparison to the Nazi's; they gained democratic power through creating crisis (although it's debatable whether they were directly responsible for the Reichstag, they still took the opportunity and blamed the communists) and then told the people that they were the saviour, so that more people would vote for them.  I'd argue that under these circumstances the crisis scenario is Brexit, and it's concerning how many people at the Euro elections blindly voted for the Brexit party.  Fascism is about obtaining power through one form or another; be that political or violent. 

 

Democracy shouldn't in my opinion be about going down one road regardless of the views or opinions of a large number of people who are still involved in the democratic process (at least we hope, if your versions of democracy is to be followed).  If a successful argument had been made for Brexit, and a clear strategy put in place MP's would have voted it through by now.  We're where we are because MP's know there's no better deal than being in the EU, and the government has been taken over.

 

Y2K.  Thirty years worth of work?  Where do you get this information from?  The first time I can see it even mentioned is 1985.  I had relatives working in the IT industry back in the day and they say there was no plan for Y2K until maybe 1995.  

In a binary choice, there will be a winner and a loser.  Everyone knew that beforehand and yet no objections seem to have been raised by those who were in a position to do so...because they were so sure (wrongly) of the outcome.  The crisis is caused by one side not accepting the result.  It's arrogant to accuse people of 'blindly' voting for a party, just because you disagree with that choice.  

In your interpretation of fascism, (about obtaining power through one form or another), we could accuse Corbyn and co of doing just that.

Maybe we should go back to the days when only the rich landowners and nobility were able to be MPs, appointed by the queen. Take away the vote from the working man and god help us that we should allow womens' suffrage!  Then we wouldn't have to bother about the opinions of large numbers of people in the democratic process.  How happy we would be.

You say there has been zero planning for Brexit.  How do you know this?  Do you have a spy in the Cabinet and in every business and house in the country?  Is Amazon Echo leaking reports that I am stocking up on tinned tomatoes and toilet rolls?

Neither side is listening to the other.  A contingent in this parliament has hobbled any negoiating power with the EU from day one.  They do not want to leave the EU at any cost.  The ERG do not want to stay in the EU at any cost.  So we remain in this fugue state and it's not good for anyone. 

You may have faith in our current MPs.  I do not. 

16 hours ago, fletch70 said:

I have only scanned it but from what I see, only an imbecile would think no deal is a good idea. Mind you, so many people are not aware of the facts and the likes of the Daily Mail and express will not help them make informed decisions. 

 

It it really is quite sickening

 

I have to say as well, those who seem to be wanting a no deal Brexit are the very people who will suffer the most. 

 

The stress of this is is having an adverse effect on many people’s lives. Boris Johnson also appears to be a criminal although we will have to wait for the Supreme Court . Of course if they uphold the Scottish ruling I guess they will be the next to go, followed by a fire in Westminster. Anyone got a brown shirt? 

Well, the report is a worse case scenario.  Wasn't Y2K a similar example.  Planes did not drop from the sky.  The world kept spinning.

Who are 'those people' who want a no deal Brexit who will suffer most? If you are not amongst them, why are you so overwrought?  

Does appearing to be a criminal make you guilty?  Is that the kind of system you would like in this country?  Hang someone just because he looks a wrong'un?  Bypass the law, the courts and the evidence? Very Germany 1939.   Neville Chamberlain apparently thought Hitler 'appeared' to be an honourable chap that would stick to the deal brokered.  We all know how that turned out.  

However you voted, it is right to respect the outcome of the referendum.  That is not fascism; that is democracy.

I hope you get your brown shirt; the colour should suit you.
 

The USA (and other countries) spend more of their GDP on healthcare than the UK. Who wants a system like theirs?

I'd like to know where the cash is being spent and practical and imaginative ways to save money, rather than just throwing more and more money at the problem.

Missmermaid, as far as your letter is concerned, yes, send one to the practice. However, unless all the staff are sneaking in the back door like rock stars, they are fully aware of what is happening. I'd involve the local MP and newspaper too.

You are in the trade TAI. Would you just step over the bodies or would you think of ways to resolve the problem? Say it was your mum or your nana stuck out in the rain?

Would you not spend some time finding out why these people feel they have to wait outside before the surgery opens? Cannot get through on the 'phone, the telephone numbers are premium rate, have no access to the internet or don't know how to use it?

The 'cake' has always been too small, but I would expect those in certain positions to at least look at ways of ensuring everyone has equal access.

Yes, I can see why mothers would want to save cash.

I'm still not convinced that the first hour would not work well as a walk-in in some circumstances. My GP practice has 13 doctors, so a few could carry on with the standard appointment system.

I'm a rare visitor to my GP, but I have suffered the torture of the eternally engaged tone when trying to ring for an appointment. If there was an option for a walk-in with the understanding that I may not be seen, but would be able to make a later appointment at the desk or try my luck another day, I'd take it. What's important is setting the patient expectation and giving them options.

This is not doing away with the appointment system - it would still operate as normal the rest of the day - it's modifying it to suit the patient need.

I've seen a chart (Health and Social Care Information Centre) which shows that, in England at least, (full-time) GP numbers increased year on year from 2004-2009, fell very slightly in the next 3 years, but has since returned to 2009 levels.

However, the number of GPs per 100,000 population is lower than 2009. The population is growing faster than the number of GPs. Probably faster than any other country in the EU.

All other countries in the UK spend more per head on health than England. Although Wales has shown the greatest decrease over the years, it's still higher than England. Health spending, however, continues to grow. So more money, just less to go around.

I thought Mariner51's suggestion of the first hour being a walk-in surgery was a good one. Can anyone suggest why this would not work? Those that couldn't be seen, could queue up at the desk to make a 'proper' appointment or take their chances the next day.

Only one question remains, do you get many people with lice in your surgery TAI?

Yes. (For both vitamin D, and iron).

 

For the initial “working out is there a problem”, Vitamin D levels would have had to be specifically requested (it isn’t a “routine test”), while iron deficiency would be hinted at by a particular type of anaemia.

 

That anaemia would be detectable on a routine ‘full blood count’ (which would show a “microcytic anaemia”, which they would then look further into, iron deficiency being the most common cause of one subset of microcytic anaemia).

They wouldn’t actually monitor “iron levels” (by measuring the amount of iron) though, using a surrogate marker (ferritin) instead.

This is a Pulse article on Vit D from 2013.

http://www.pulsetoday.co.uk/clinical/more-clinical-areas/musculoskeletal/vitamin-d-testing-guidance-to-prompt-sea-change-for-gps/1/20002686.article?PageNo=2&SortOrder=dateadded&PageSize=10#comments

And they monitor the levels through blood tests?

Bazzas, I didn't think you were disagreeing with me and I wouldn't have any issue if you did. Absolutely, I would not want any person having to make a choice between food or pain-relief. It is only the English who still have to pay for prescriptions.

I'm guessing (and only guessing) that the OP may have a vitamin D deficiency. GPs will test for vitamin D (which is, as you know, really a hormone) in some cases and not necessarily on the patient's instigation and may suggest the patient purchase their own supplements if found to be deficient (according to the current guidelines) - unless, of course, they are quite obviously suffering from rickets. This approach may change as more research is done and we learn more about the vitamin's role in disease prevention.

The thing is our 'national' health service varies from town to town, surgery to surgery and GP to GP.

Sorry, I made an assumption. I meant that it was significant to a person, like the OP, who is on benefits, (but also to pensioners, students etc), who would normally be entitled to free prescriptions. Their budgets would now have to pay for medicines they previously got for nothing. And, yes, I think that would be significant for some.

A person who did have to pay for prescriptions should be savvy enough to work out what is cheaper over the counter, although I'm still confused why people continue to pay for branded ibuprofen, when supermarket-own is just as effective.

I understand that medicine prices vary according to what they are. To have a system that varies the cost of the prescription dependent on that factor would probably be more expensive to administrate than maintaining the status quo.

I can't help but think there's a bigger question lurking in the background here.

I did read that the NHS is withdrawing prescriptions for certain items, paracetamol, nit shampoo, omega 3 etc. Presumably this is because the items are generally thought to be cheap over the counter, are not considered necessary for general health or where the efficacy is questionable. However, for people on low-incomes like the OP, where every penny counts, the impact may be significant.

We can only assume that the deficiency that the OP is suffering is considered by the GP (at this time at least) not likely to be contributing to any current health issue.

The OP should be able to challenge the GP's decision and the surgery shouldn't be placing obstacles in their way to prevent this, by falsely stating that there is a charge to view, not allowing a GP appointment to discuss, or forcing them down the SAR route.

If you check the ICO website, you will find that it is free to view your records (following a SAR), but they may charge for copies. I would just take a photo.

It seems not all GPs are the same. I asked the receptionist for a printout of my blood results for my records. They were printed off and given to me there an then.

Me too!

If I was a on the judgement panel, it would hinge on how the direct debit came to be cancelled.

I didn't think MF's comments were sanctimonious.

We are all guilty at times of blaming third-parties,

when we should be taking responsibility ourselves (I am no exception).

We should be able to voice our opinions,

(within certain bounds),

even if others do not like them,

as they can make us stop and assess our thoughts and actions.

BTW,

what is a Royalties Account Holder,

or a Gold or Platinum one for that matter?

I may be talking nonsense, since I am not familiar with the prescription certificate system, but how difficult would it be and how much more expensive to have a card, rather like a bank card, that has an expiry date built in and which could be checked by the pharmacist before dispensing? Better still, an app, which would be more cost effective in the long-term.

Legally, it may be that the onus is on the patient to check that the certificate is in order, but I can see that it would be an easy mistake to make in this hectic world.

If this does turn out to be true (that is the manipulation of the waiting times was intentional) what should be the punishment?

Do Hospitals generally use different software to manage waiting lists? Are other hospitals having the same problems?

Is it true that shorter waiting lists attract bonuses and for whom?

Can we really afford to do away with targets? It is one way we, the general public, can gauge the health of our hospitals - although, in truth, we don't get much choice when it comes to treatment.

Being found out misleading or lying is, to me, far greater a cause for concern than simply telling the truth, however bad. Once trust is lost, it is rarely regained.

Nigel1804,

It is terrible to lose a parent at any time and can only be compounded when you believe poor or neglectful care has been a contributory factor. I understand your mum was unable to communicate, but it shouldn't be too much too hope that a care home employs staff who are trained and watchful of those most vulnerable.

Under the Access to Medical Records Act 1990, I thought the care home had 21-40 days to respond to a request (I used this when I applied for my relative's records, although it was from a hospital not a care home). If the care home management (it should not matter that this specific care home has closed) do not do this or are unhelpful, I would contact the ICO for advice.

Silverfox is right, even with a solicitor, the road is long and bumpy. There will be times when you want to scream, tear your hair out and cry. Is the solicitor no-win, no fee? The law is fickle, even with all evidence on your side, there is no guarantee that you will win the fight.

So are you saying the home that mistreated your mum closed down, but the company that operated it are still in business and presumably operating other establishments?

Complaining can be an utterly draining business.

Yesterday, the Times carried two medical articles on two different pages, without any linking comment.

 

1. The first was headlined ‘ Doctors who trained abroad ”far more likely to be incompetent” ‘

 

Sources and some statistics were, of course, cited, and those included the GMC’s own records. Irish-trained, twice as likely, apparently. Bangladesh-trained, 13 times more likely, it is suggested.

 

2. The second article was entitled ‘Medical schools turn down 770 straight-A applicants’. It went on to explain that there is ‘a shortage of doctors in the NHS’, and:

 

“The government says it must restrict places because it takes £230,000 to fully train each doctor. Last year the NHS was forced to hire thousands of foreign doctors to fill jobs.’

 

 

 

 

I, too, have frequently read articles that foreign doctors are more likely to be dragged in front of the GMC for medical errors.

I believe the government announced last year that it will be training more doctors and that there is a suggestion that they will be compelled to work for the NHS for a minimum of 5 years. We'll see how that pans out.

However, the other side to foreign doctors (and nurses) magnetically attracted to working in the UK is that their own countries, who perhaps have spent equal amounts in training them, lose their much needed skill, especially from the poorer countries.

Oh, and Ford, I think it very unlikely that people who voted for Brexit believed that the money saved would go to the NHS. That's just political flimflam. The strategy is that if they repeat something often enough it becomes true.

They cannot hold your dad in hospital without his permission: It's not a prison. (They cannot throw you out either, although I have read of instances of elderly, vulnerable patients being discharged in the middle of the night). However, caring for a sick relative must be intense, physically and emotionally and the burden would fall on your mum, who you say is also unwell. You don't want her to end up in hospital too.

The system for (safely) discharging patients really does need to be slicker. The wheels - whether it's the social workers and care packages or medicine dispensing - seem to turn so slowly.

I was listening to Inside Health the other day and they mentioned that everyday medicines like anti-histamines, painkillers and nit treatment may no longer be available on prescription. I assume people go to the doctors for such things because they are entitled to free prescriptions, although the cost of the process of issuing that prescription, (including the doctor's time), to the NHS must be many times more than purchase over-the-counter at the pharmacist.

I would echo Bazzas excellent post.

If you do meet, I would strongly advise you to record the meeting. Regardless of how many of you are present (on your side), it can be difficult to recall conversations. To be honest, I wouldn't ask permission, (in case of resistance and antipathy) but record covertly. Written notes are never the same.

In the meantime, obtain as much data as possible (from the care home who should have records regardless of whether they are closed and the hospital), using the Data Protection Act. If some records have been 'lost,' let them admit that in writing.

As painful and as difficult as the process is, (and there may be many times when you want to pull your hair out or give up) it's important to take action - to seek justice for your mum and to prevent others suffering the same fate.

Good luck and let us know how you get on.

Very interesting Think About It and I echo others comments on your excellent post.

It is estimated that the UK population has increased by over 4 million in the last ten years, clearly not evenly distributed. It can only get worse.

I’m not surprised councils drag their heels in providing home care or seeking care homes placements. Every day they delay, they save money . Would it help if all social care were funded by the NHS, removing the responsibility and money from local government?

I would agree with you that some people rush to their GP at the mere hint of malady and not even because they are require a sick certificate. Do you operate a triage system, as they do in A&E?

One thing I am confused about is the BMA’s proposal to allow GPs to charge private patients for minor surgery like mole removal in their spare time. It rather makes a mockery of their continual insistence that there are too few (overworked) GPs. Are they hoping that the lure of money will encourage more doctors to become GPs?