In the days after my grandmother’s (or Nan as I called her) funeral on Monday, I have naturally been thinking about the very different places we had visited her during her illness. In stays of varying lengths, she was resident at North Devon District Hospital, a Nursing Home, NDDH, North Devon Hospice and finally the same Home again.
The treatment and care she received at NDDH and the Hospice was second to none. The dedication, compassion, attentiveness and professionalism of all the staff there was outstanding, and me and my family are eternally grateful to them for this. Her (terminal) condition improved slightly at these places, and more importantly so did her comfort and mental well-being.
Unfortunately, the same cannot be said for the Nursing Home. I have no complaint with the hard work and good intentions of most of the staff there, in particular a few of the carers who were very helpful and competent. However, the stark truth is that the vast majority of those who work there (and the turnover is quite high) are simply not up to what is a demanding job, physically and mentally. Most of the staff there lacked the skills and experience so clearly evident at the Hospital and the Hospice. Basic things such as the dispensing of drugs and lifting of residents were not done properly. Matters of personal dignity were not dealt with appropriately. Complaints were responded to by some staff by a degree of vindictiveness.
In addition, staffing levels were very low, resulting in the staff there being rushed off their feet, and simply not able to cope with the needs of a variety of highly dependent elderly people. One carer, who subsequently left, said that the owners of the Home had brought lots of agency staff in when an inspection was due, allowing it to pass. The same carer said that she had complained to the management, and the regulator (the Commission for Social Care Inspection), but had been met with a brick wall.
When my mother complained, she was met with a similar reaction, including a particularly callous and high-handed response from a doctor, who perhaps loses some of his objectivity by certain ties to the Home.
What is the answer? Why was the care at the Hospital and Hospice exemplery, and lacking at the Home? Well, the only reason I can think is that the Hospital and Hospice are run as public services, with monies received ploughed into patient care (and in the case of the Hospice, further fundraising efforts). The result is high staffing levels with little turnover, well motivated and trained carers (including not just clinical staff but everyone involved, who all make a difference) and particularly in the case of the Hospice, an environment which calms and reassures.
Unfortunately in the case of the Nursing Home, funds that could be used to advance care are diverted to make considerable money for the owners. The trend in public services at the moment seems to be towards further privatisation. This is simply money taken out of the pockets of patients, of students, of rail and bus passengers and put into the pockets of well off individuals.
Despite our fears, my Nan had a peaceful, painless death, in company. It is my hope that we can make how we care for the most vulnerable– including the mentally ill as well as the elderly and dying – the gold standard for how our society is judged. Are we civilised enough to make this a priority high enough to take out of the hands of profiteering sharks, and into the custodianship of institutions like NDDH and the Hospice? I hope so for all our sakes, most of us will get old and ill one day.
Article by JL of North Devon Socialist Party
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3 comments:
I couldn't agree more with this.
Three of my grandparents spent years in various nursing and residential homes, almost all of which suffered from the problems you describe here.
For me, this is one of the most compelling arguments for socialism, the standard of care currently available for most elderly people. It would surely not be difficult to improve greatly.
I agree also with much of the article, but I would add a note of caution in that experience of the NHS is not always quite as good as the experience JL had.
Waiting in a freezing and run down Hospital watching my Father die as the boiler broke down yet again was not pleasant, and whilst the staff were fantastic, the staffing levels were not great and the Hospital was underfunded.
Staff shortages at the Maternity unit in Tiverton have caused two children in the past few years to be born with severe disabilities caused by oxygen starvation at birth, and the units is still understaffed, in spite of assurances given only recently after one case went to court for compensation.
Of course, there is very little state provision left now for geriatric care, resedential homes are virtually nonexistant and nursing homes almost extinct. The one specialist unit in Exeter at Whipton Hospital recently had a string of complaints of abuse and neglect due to understaffing.
Whilst Private Care Homes are generally poor and inadequate, the NHS and local authorities can no longer offer a real alternative, and even when they do, they too suffer from underfunding, understaffing and the resulting poor treatment of patients.
We need a properly funded NHS with a consistantly high level of Nursing Care & Resedential Care solutions within it, leading to an abolition of private provision. This can only be provided under a socialist society.
Steve - I agree that in this respect my Nan was lucky, she was on a well staffed and equipped ward, possibly not representative of all the wards at NDDH or at other hospitals.
Underfunding is still chronic, mainly because so much money is wasted through overpriced pharmaceuticals, administering the internal market, PFI and other private sector profiteering, and the extensive use of (non-medical) consultants.
The skill and dedication of NHS staff is a testament to the spirit of public service that leads people to work for the NHS, and also the regulations and standards that come from having an NHS, and are not generally present in private hospitals.
Something which I didn't mention in the original article was my continuing disgust that such an important institution as the North Devon Hospice is entirely dependent on charitable donations. The same applies for the Children's Hospice and Devon Air Ambulance. There's plenty of money for greedy bankers, but not for lifesaving or providing joy and comfort at the end of lives long and short.
Thank you both for your comments, I think the whole situation really highlights the point that you both make, that we can only be a really civilised and decent society once we have got rid of the dehumanising, amoral and corrupt system of capitalism, and replaced it with democratic socialism.
JL
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