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mr_mastiff

Your Views on NHS care.

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Over the last few months a number of forum members have asked for advice concerning the poor care of their relatives. Whilst they have been given advice on how to deal with the issues concerning their relatives treatment it as become obvious that a place is required for people to make comments generally about their experiences of the NHS.

 

Are there issues you would like to raise about the NHS nationally or locally then please feel free to post them here.

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Firstly, I should say that I don't know anyone in a care home, but I have heard and read reports on a number of distressing cases over the last few years.

 

I would be terrified if I had a relative who needed to go into care. I do not think we can trust any of the the regulatory bodies in this country, be they in health or otherwise. As you say, this particular care home received a 'good' in their last review by the CQC in 2010. It would be foolish to believe that all the problems that they were eventually closed down for only occurred during the last year.

 

The question that I always ask myself is why did it take so long? How many relatives complained about the poor care in the lead-up to the exposure? If they were suspcicious but failed to raise their concerns, why was that? Fear?

 

I cannot help but wonder if they were in the same position as me when my relatives were in hospital and I could see the incompetence, the apathy, the inertia, the bloody-mindedness and cruelty, but however many times I complained, to whomever, in whatever medium - verbal or written - nothing changed. Where else was I to go?!

 

A member (they always change the manager or the organisation's name when things are going badly as if that will make a difference!) of the CQC, was speaking on the radio the other day and said - probably as the previous incumbent said - all the right things, but, as they say, words are cheap. Those in the higher echelons of this organisation (and so many others) seem to be a plucked from a very shallow and small pool of cronies. It's incestuous and means we don't get the best person for the job.

 

She wants to encourage 'mystery shoppers' and to involve people who have experienced care homes through their loved-ones. All well and good, but I want to see a complaints system in place that responds in a timely manner (there is nothing timely about the CQC) to concerns and that is independent of the care home/hospital/GP.

 

Another point that was raised was the calibre of the care home staff. Low pay - perhaps - doesn't attract the best staff and training is poor.

 

However, does low pay and lack of training justify treating a fellow human-being - a very vulnerable one at that - so cruelly? Other members of staff, unless they were wandering around with blinkers, would have known what was going on.

 

Of course we should value people who do this kind of work more highly, but behaviour like this is inexcusable.

 

In the Winterbourne View scandal the hero of the hour (now I think working for the CQC) was one male careworker, Terry Bryan, who having failed to have his concerns listened to by the management and the CQC, finally went to the media. He deserves a medal for his selfless perseverance.

 

During a debate on the radio, one caller (who I think was involved in the profession) said that the inspectors should not go in heavy-handed and demoralise the staff. I have no time for this kind of namby-pambyism. If you are doing a good job, your conscience is clear, there is nothing to be demoralised about.

 

I know this is a pet theme of mine, but there does seem little accountability in the healthcare sector. Honest mistakes aside, hang 'em (the guilty) and hang 'em high would be my motto.

 

And lastly, the question of the high cost individuals (or the councils) pay for care home places. I am reminded that people like Duncan Banantyne and Shrien Dewani (the man who is awaiting extradition for allegedly arranging the murder of his wife in South Africa) have become rich through owning these establishments. I believe in a free enconomy but exploiting the weakest in our society makes me more than a little queasy.

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About 18 months ago, dad had some abdominal pain and went to his GP, who sent him to A&E. That was about 11am. He was seen by a junior doctor around 1pm and not seen by anyone. After waiting another 5 hours, he decided he'd had enough and was coming home and going back the next day at 8am. He finally got admitted at 7pm.

 

That was a normal weekday too. (ie, not Bank Holiday, weekend, around Christmas / New Year, etc)

 

My parents were lied to about my health as a child. My mum claimed (I vaguely remember this too) that I'd wake up of a morning having just vomited for no apparent reason. According to the doctors who saw me, there was nothing wrong and my parents were being paranoid. Around this time, I was also complaining of headaches.

 

Anyway, I saw a neurologist last year over some stuff and he said "did you know that you had epilepsy as a child?" Mum then explained that it was brushed off and she was made to feel like she was being paranoid.

 

Those of you who have seen my current thread in here, will also know that I'm having a lot of trouble - got a diagnosis, having a lot of trouble and am getting nowhere.

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Sali, It is very true that words are cheap. When I worked within the NHS I admitted a number of patient onto the ward from care homes (two of which have now been closed) and it was obvious that these poor individuals had not been cared for. I could give a long list of what I would call neglect. I went to my manager about my concerns and he was fully supportive. There just seems to be a point were as it went further up the management level any action would be at at crawl.

 

The whole system of regulation requires firm policing. What I mean by that is that before they can even open a care home they must prove that good care will be given. All staff must be trained and independent supervision allowed 365 days a year. All inspections would be without warning and inspection reports available to the public.

 

Any home where neglect was found, the owner and management would be criminally responsible and a mandatory minimum prison sentence given.

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Nystagmite

I think it is pretty much conclusive that the last government's deal with GPs has stretched A&E to breaking point. I, too, have sat with a poorly relative for hours and hours (after triage) awaiting to be treated or admitted.

 

I think doctors in the past have often been guilty of treating patients and their families like ignorant rustics, too stupid to understand their illness or its implications. Whilst a residue of that still exists, I think it's on the wane. The internet, for many of us, (searching for information), has been both powerful and empowering.

 

Mr Mastiff

Couldn't agree more. We need regulatory bodies who act swiftly, decisively and fairly - but we don't have them. Their absence has led to a massive breakdown in trust - of the NHS, of the police, of politicians, of the BBC, of banking and on and on. Once trust is lost it is very hard to regain and I cannot see anything constructive being done to counter the decline. Denial and cover up always seem to be the first defence.

 

In another thread we discussed wastage in the NHS. As a former nurse what do you think of the news today of the suggested 3 billion lost treating foreign nationals - either in money not reclaimed by the NHS from another EU country or by health tourism? Fact or fiction in your view?

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Sali there is a definite problem, I have personal experience of treating foreign nationals. Who could not pay. After about £240,000 of treatment they were told no more, their own Government would not cover the cost, where they came from did not have this specialist treatment and so it stopped. Next day in the paper the Hospital was branded racist there was a political storm from local MP,s media etc. So we started again until months later it was sorted out at a bargain price.

 

I could give you more examples, the main problem is the NHS have the rules in place but when you try to enforce them it becomes a moral political argument where you are dammed if you do and dammed is you dont. The only way I think is compulsory health insurance that must be produced before entry or when applying for a visa.

 

Even then there are still many moral and ethical considerations about how far it go with treatment, where do we get the extra beds from etc etc etc.

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We obviously think the same way on this subject.

 

Raise justifiable concerns in this country on immigration and you are likely to be branded xenophobic or racist - which has become a more heinous crime than murder!

 

How would you ensure that the compulsory health insurance provided adequate cover for the visitor during their trip? Insurance companies - moreso if they are abroad - are notoriously difficult to recover money from. There's always some caveat or other to wriggle out of payment. Would the NHS pursue the debtor? Would it even be cost effective to do so?

 

Also, how to recoup money from countries where visitors do not require a visa - such as the EU? It's easier for the NHS in terms of time and money just to claim the person is local.

 

I would suggest the NI number is used to prove eligibility, but there would be administrative overheads and people on the front-line would have to be prepared to be hard-hearted turning people away.

 

The only real way is for the NHS NOT to be free at the point of use - except for A&E - and no goverment would dare to go down that path...although they'll probably manage it by stealth eventually.

 

Another one of my bugbears is translation costs and forms printed in hundreds of different languages. Millions of pounds (and this would creep into billions if you included local authorities) are used not for visitors but people who have lived here years.

 

These are the things I think of when I hear of an elderly patient left lying on a trolley in pain through lack of beds or a person being denied life-extending drugs because of insufficient funds.

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Sali, It is not a matter of race. It is a matter of resources and what is fair and just.

 

There is already a system in place for EU visitors which needs adjustment both ways for it to be successful.

 

I would suggest the only UK companies would be allowed to sell insurance to visitors or oversea companies which wish to sell insurance would need to place a large bond with nhs before being allowed to sell so that they could not hide behind international law to get out of payment.

 

I have worked in America and they are very successful in recovering costs and being cost effective why should we have a problem.

 

As for turning turning people away I believe there would be a large number of both legal and ethical issues to be addressed before you could even consider that an option.

 

There are so many issues that need addressing but in order to make change the Disease of Political Correctness must be treated and stamped out before any change can be made. Resources must be prioritised to care for the patient in the bed and nothing else and lastly people have got to start demanding change, the system will collapse if we do nothing.

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Umm, another (too) highly paid unaccountable (to the public) NHS executive appointed to replace the last (too) highly paid unaccountable (to the public) one. This government is rather fond of appointing people from abroad into senior posts. Perhaps they don't want people who are sullied by the system, although I see he has worked for the NHS before.

 

I'm guessing you are concerned that he is an American with an American's view on healthcare. You say you've worked there - do you prefer our system or theirs? I've always thought that their system is rather good because they are extra thorough - But ONLY if you can afford to pay.

 

I heard about the children's vitamin supplement proposal on the radio. It's said that rickets, once common in the Victorian era, is on the rise - perhaps through sunscreens and kids not playing out so much, although I think it's probably more complex than that. In an age where we are almost force-fed healthy eating advice and information is available at the touch of a keyboard, it's astounding that some parents are not ensuring their children eat a healthy-ish diet, however fussy they are.

 

Although science has enabled a man to go to the moon, we still don't actually know absolutely the effect that some vitamins, or lack of them, have on our current or long-term health.

 

There will be a day when non-invasive technology will be able to measure and calculate our vitamin/mineral/hormone levels on a daily basis. This accumulated data over many years will enable science to better understand their impact. For example, vitamin d (which I know is a hormone) is now thought by some to be a cancer preventative.

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I do not fear the american system it as many excellent components and if you cherry picked the good part from both the American and British systems you could have a truly superb NHS.

 

It would take a mind change in attitude and expectations from the British public but it could work. The american system does not allow waste if you miss an appointment you pay for it you do not get a letter offering you another one free of charge.

 

Above all you are responsible for your actions in America meaning you will be sacked and just not moved sideways until the dust settles.

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Instead of just chucking vitamins at parents, I do think education is needed.

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Instead of just chucking vitamins at parents, I do think education is needed.

 

Totally agree, a good diet is important but a spokesman on the BBC news suggested that the decline in family incomes is beginning to play a role in the health of our children.

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I feel the NHS are too slow/reluctant to prescribe medication nowadays.

 

They have gone from one extreme to the other. Years ago, they prescribed too much, now they are reluctant to prescribe anything.

There is no happy middle ground.

 

I blame this on cost (practice managers watching the budget like hawks?) and the fact that too many younger GP's follow current guidelines like 'sheep' and don't (aren't allowed to?) use their own initiative anymore.

 

There again - it could be the 'suing culture' we have now that is making them err too much on the side of caution.

If they prescribe something and you die - they are worried about blame?:???: Who knows.

 

 

When requesting medication for a problem, they will often fob you off with:-

 

''I can't prescribe you that'':-

 

a) ''It can be addictive'' (NHS speak for '' it's too expensive'')

b) ''It can cause cancer'' (NHS speak for ''it's too expensive'')

c) '' Have you tried relaxation methods? (''ditto)

 

My all time favorite is : ''Have you tried anti-histamines?''

 

It amazes me.

If you take a Dog to the vet in this country - the vet will see it is sick and will prescribe the necessary medication. A vet will not let an animal suffer.

And yet - people are very often only given help when all other (cheaper?) options have been exhausted.

 

That's the downside of the NHS .

 

There are good things about it as well - For example, I think they do a great job (considering the huge influx/strain that has been put on it, especially with NHS tourism/influx of immigration), when there is only so much in the pot.

And I think that most nurses do a great job - I had a recent stay in hospital and the nurses worked their socks off!

 

It's mainly the NHS GP Practices that I am unimpressed with.

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I feel the NHS are too slow/reluctant to prescribe medication nowadays.

 

In my experience, they're too quick to give out medication. Have met at least one GP who said he wants to investigate first.

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Yes, we need a revolution led by someone with the moral authority of Oliver Cromwell, (his speech to Parliament is depressingly true of the current mob), the tenacity and stubbornness of Boudica and the anarchic soul of Beppe Grillo...but that's just a dream.

 

I am disappointed with the government-commissioned inquiry outcome. I don't believe any of the recommendations will have much impact or improve the service.

 

I disagree that the complaints system is confusing. In England the first contact for a formal complaint would initially be PALS. However, many of us who have gone this route quickly discover just how useless they are and so direct our complaints directly to the CEO. Still, whomever you complain to, it makes no difference. Their object is to either ignore, deny or cover-up. We need a body we can turn to who will investigate swiftly and competently. Take the complaints system out of the hands of hospital. Let's have real transparency.

 

Today we hear that whistleblowers (I applaud them and hope they are protected) have exposed the practice of falsifying data on targets for cancer patients. Seemingly the hospital - Colchester - had carried out their own investigations in Feb 2012 and, surprise, surprise, found the claims to be unfounded. Now we know differently.

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After reading the report below I feel worried for anyone having a baby at the present time. I would love to read the risk assessment made by the insurance company!

 

http://www.bbc.co.uk/news/health-24856772

 

Is it the high level of damages that they are worried about OR the service that bad and falling apart that £700 per birth is considered reasonable?

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Well, the way insurance (supposedly) works is the higher the risk, the higher the cost. Margaret Hodge may regard this cost as 'absolutely scandalous,' but she needs to examine the reasons behind it. It is possible that the NHS is being taken for a mug by the insurer. Afterall, they (the insurance companies) rip individuals off on renewals when they don't shop around. I've never thought of the administrators in the NHS as the sharpest of knives when it comes to business.

 

Undoubtedly negligence claims against the NHS are rising. Falling standards or people becoming more aware of their rights and ability to take action? I heard that a couple of maternity nurses put a newborn baby in the stationery cupboard. OK, the door was left open, but what possessed them to think that this was a professional or responsible action? Thankfully, the child was fine.

 

Interested to know what you think of the new law to jail nurses found guilty of gross negligence.

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Hi Sali, I am a little unsure! What is gross negligence until I read the fine print then I am unwilling to comment. There are many people looking after each individual patient from shift to shift and as I read it at the present time it will be hard to see it working! There are already numerous laws which should cover negligence if they do not provide the answer then I cannot see another law making any difference?

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As I understand it gross negligence is any action that causes harm or death. I take your point that it would be difficult to link this to one particular medic, with changing shifts, but it would not be impossible. If there are indeed already laws which protect patients they are not being used often enough in my opinion. We have only two nurses who have faced disciplinary after the mid-staffs horror - and that took years. Why?

 

My own relative, whilst in hospital, told me a nurse had been 'rough' with her. She was not somebody who would overplay a situation. She had bruises on her face and when I tried to go and talk to the nurses (when I could actually find any) they were just not interested. This followed a catalogue of shocking care. I wish now I had called the police, but it just didn't occur to me at the time. It should have been possible through written records to identify the likely culprit. I will never forgive or forget. Knowing that (unknown) nurse is still probably employed - and at the same hospital - very likely to re-offend, (maybe already has), chills my heart.

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" A catalogue of shocking care." Indeed.

 

Here's a link to the full National Patients' Association report published today, excerpts from which have been receiving some media attention.

 

Not for the faint-hearted:-

 

http://www.patients-association.com/Portals/0/Patient%20Stories%202013.pdf

 

The laws are there: they just aren't enforced - and no government dares give patients and their families the power to enforce them directly.

Edited by nolegion

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It annoys me how so much money is wasted on perscriptions and medication which is never used. In hospitals when they use one tablet from a blister pack for one patient, they have to bin the rest and cannot give it to another patient.

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