A personal view of private care homes

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

Decontamination threat - averted!

The tide of privatisation and marketisation has been halted in Devon, with the news that Northern Devon Healthcare Trust will not be contracting out it's Sterile Supplies work to private company Decon Sciences. This means that the proposal, which was once supported by 10 trusts in Devon, Dorset and Somerset, is now dead.

The health union UNISON ran an excellent campaign, and gathered support from the public as well as healthcare workers. The idea of a postcard sending campaign to the Chief Executive clearly worked. The clinical risks of the venture were spelt out forcefully, and ultimately worked to force the Trust's hand.

In order to try and force it through, the Government promised £1 million to each Trust if they took part. The growing unpopularity of privatisation meant that even with this giant bribe, the move didn't go ahead. The Trusts must now link together to campaign to get this cash, which is obviously available, to fund overstretched services.

While the proposal has been defeated, it is clear that there is still some uncertainty, and the Trust has said that in the 'middle-term' other options might be explored. They didn't state what the 'middle-term' meant, but it may well be that an attempt will be made again to privatise a service provided by NHS staff. We celebrate this victory, but are aware that there may be more battles to come.

Decontamination threat update - NDDH Trust decides to delay decision

In response to the many postcards sent to the Trust Chief Executive and the criticisms of the scheme by health unions, clinicians and professional bodies, the North Devon Healthcare Trust has decided to delay a decision on whether to outsource sterile services to private company Decon Sciences until September.

It has become clear to the Trust that there are serious deficiencies with the plan to privatise the services, including financial considerations on top of the health, practical and environmental problems previously outlined by Devon Socialist Party, and by UNISON and professional bodies such as the Royal College of Surgeons.

Six options are now being investigated by the Trust:

1. Do nothing;
2. On-site at NDDH;
3. Collaborate with a smaller number of Trusts to create an NHS-provided service;
4. Collaborate with a smaller number of Trusts with an outsourced provider;
5. Investigate a partnership with private healthcare providers such as BUPA;
6. Create a local NHS service, provided off-site.

Devon Socialist Party would favour options 1 and 2, which appear to be the same but differently worded. The current service is very effective. The Healthcare Commission's 2007 Report on North Devon District Hospital noted that "medical devices which can be re-used were properly cleaned in well-run decontamination facilities." There is no clinical rationale for outsoucing the services. Additionally, the distance of a Taunton facility could cause supply problems. The need for Decon Sciences to turn a profit could lead to the cutting of corners, as has happened elsewhere when Sterile Supplies services have been contracted out.

Sterile Supplies needs to be LOCAL.
Sterile Supplies services need to be done by the NHS.

Please continue to send postcards, letters and emails to Trust Chief Executive Jac Kelly.

Support our GP surgeries!

With the Government's plans for private companies taking over the running of NHS trusts in the limelight, it seems only right to highlight a campaign being run by local GPs and health centres up and down the country with the British Medical Association (BMA).

The campaign is opposing the replacement of local, family GP surgeries with large commercially-run and impersonal 'polyclinics'. The BMA, the Royal College of General Practitioners and GPs fear the new polyclinics could have a detrimental impact on the healthcare of millions, and in rural areas with poor public transport provision like Devon the impact could be even worse than in urban areas.


The campaign has a petition at: www.supportyoursurgery.org.uk

The RCGP has produced a more detailed factsheet analysing the Government's proposals here.

Needless to say, we support the campaign fully, and advocate an NHS run in the interests of patients, not private sector profiteers. This means private sector involvment in the NHS must end, and PFI projects and debts cancelled. Health services should be provided locally, with an expansion in the number of doctors and nurses. Improved NHS provision should be funded by savings provided by the nationalisation of the pharmaceutical and medical supplies industry, whose gigantic profits come at the expense of patients and taxpayers.

Most importantly, we need to replace a system which breeds inequality, poverty, illness and stress and replace it with a system, socialism, which will promote better health through drastically reducing inequality, reducing working hours and pressures at work, and improving people's lives, living conditions and environment.

North Devon District Hospital - Decontamination Threat

In NHS hospitals Sterile Supplies departments fulfil a vital function by making sure that surgeons have everything they need during operations, including thoroughly sterilised equipment. Last year the Government falsely claimed (based on distorted interpreatations of relevant information) that these departments weren't meeting the standards of service expected of them.

Of course, you can decide for yourself whether this was deliberate or not, but the New Labour Government's obsession with privatisation seems to override any other consideration. After all, it wouldn't be the first time that they'd eased the path for private healthcare parasites to make good money out of the NHS.

Traditionally, and with good reason, NHS Sterile Supplies Departments are based in hospitals near to where they are needed, operating theatres for example. Now, the Department for Health has plans to replace these services with regional 'super-centres' run by the private sector. In the South West this would be in Taunton.

In April Northern Devon Healthcare Trust board will decide whether to accept the 'in-house' tender from North Devon District Hospital's Sterile Supplies Department or the one from the private sector company in Taunton - Decon Sciences. If the Trust Board accepts the outside tender the contract will be for 20 years. The contract may also include penalty clauses which would hit the Trust with a large amount of money to pay if they decide to pull out of the contract. Even if there are penalty clauses if Decon Sciences don't deliver an acceptable service 20 years is still an enormous commitment, especially if the standard of service isn't up to scratch..

With the existing services, the safety of patients is paramount. In the hands of private companies profit is the main motive, so the danger is always there that the company may cut corners to save money (and so make more money).

The British Orthopaedic Association has expressed its firm opposition to these developments. They are concerned with the threat these changes pose to the quality of care they can give to patients. For surgery, it is essential that sterilised equipment is readily available. If it isn't, there's a danger that the start of an operation will be delayed or unnecessary equipment won't be available if something unexpected happens. Either of these might mean the operation not being as successful as it would normally be. There is also a danger that infection rates might rise.

This isn't just scaremongering. One of these 'super-centres' opened in Birmingham last year. In the 6 months up to September 2007 there were 3,400 decontamination 'clinical incidents'. These included mislabelled, damaged, mixed up and badly packaged instruments. One Birmingham-based consultant pointed out that in one instance they had to open up 7 sets of surgical instruments before they got the properly sterilised ones they needed.

In the case of North Devon, there's an even bigger problem - the hospital is in Barnstaple, the supplier is in Taunton! The danger of greater delays in therefore greatly increased, along with the possibility of the items being contaminated in transit.

As socialists we are particularly concerned about the welfare of the staff at the centre of this storm - through no fault of their own. What protection would they have if Decon got the contract? Well, they get the glorious opportunity to work for Decon Sciences, i.e. move to Taunton or have to commute there. If they decide to stay with North Devon Trust they'll be given other employment, but how suitable or acceptable this might be to them is open to question. Considering there doesn't seem to be any problem with the past standards of service provided by these Sterile Supplies staff, all this must be doubly upsetting and annoying for them.

Whatever the cost might be to keep the existing service at North Devon District Hospital, at least it would mean that the department remained conveniently on-site and under the control of the local Trust. Some other facts also need to be taken into account. What effect would the proposed change have on the welfare of future patients in North Devon needing surgery of some kind? The risk of something going wrong just because instruments aren't properly sterilised or available when needed - is the hospital Trust Board prepared to face the possible consequences? Also, not all of (our!) public money paid to Decon Sciences would just be for services provided - a certain percentage would be given to them just to line the pockets of their shareholders.

Despite pressure from the Government to accept this, these changes aren't inevitable. Plans in Oxford were successfully opposed. Closer to home, the Royal Devon and Exeter Hospital Trust has declined to use the Taunton 'super-centre'. The Northern Devon Healthcare Trust Board isn't going to make its final decision until early April so there's still time to turn back from going down this potentially serious, risky and dangerous path.

UNISON branch officials in North Devon have been working with the hospital's Sterile Supplies staff to fight these plans. But they need more support. You can help by doing one or more of the following -

- Get your trade union branch to send messages of support to Northern Devon UNISON Healthcare branch. Pauline Brennan is the branch secretary. She can be reached at Level 3, North Devon District Hospital, Raleigh Park, Barnstaple, EX31 4JB or by email at northdevonhealth@hotmail.co.uk.

- Express your opposition to these plans by writing to or emailing the local MP Nick Harvey, your councillors, the Hospital Trust Chief Executive (Mrs Jac Kelly, North Devon District Hospital, Raleigh Park, Barnstaple, EX31 4JB) and your own GP.

Also please write to the North Devon Journal and North Devon Gazette.

NHS demo and anti-BNP protest

In response to the Exeter University Debating Society's reckless calling of a debate on the question of whether the BNP should be allowed a platform on campus (a position we strongly disagree with as the presence of fascists, which the hard-core BNP members undoubtedly are, leads to intimidation and violence against groups such as ethnic minorities and homosexuals, and also gives the impression that the BNP are a legitimate political party which only lends them credibility), Devon Socialist Party, and other groups such as Exeter Socialist Students, Exeter Socialists and Devon NUT, organised a protest outside the debating chamber.

The debate was won (if not on strength of argument but because the right wingers who see having fascists on campus as a 'cracking wheeze' dominate the Debating Society turned out in force) by those proposing the BNP be allowed on campus to spread their poison and cause safety issues for large numbers of students. They will now undoubtedly try to invite someone like BNP Fuhrer Nick Griffin down to speak, something which will be resisted by all anti-fascist campaigners. As last Friday, the Socialist Party and Socialist Students (who organised the protest last week) will be at the forefront.

On the Saturday, Socialist Party and Socialist Students members travelled from Exeter to London to go on the march to defend the NHS. It would be fair to say that the four main things you could always see on the demonstration were people, banners for the health union UNISON, banners for the general union Unite and Socialist Party members, placards, banners or papers.

The rally held at the end of the demo was kept deliberately non-political by the UNISON leadership, who seem determined to remain several centimetres up the Prime Ministers unmentionable. In UNISON they bitterly oppose any attempt to question the donation of millions of pounds of UNISON members money to the New Labour government that is kicking them in the teeth and the NHS in the direction of private sector fat cats.

We say - Break the link with New Labour - don't fund those who kick us in the teeth
- Support the Campaign for a New Workers Party and candidates standing on anti-cuts and save the NHS platforms
- Link up the local NHS campaigns to form a fighting national 'Save our NHS' campaign free from the obstructions of the likes of UNISON leader Dave Prentis

Save our NHS national demo - free bus places left

On Saturday 3rd November there will be a national 'Save our NHS' demonstration in central London. Socialist Party members will be out in force as always, arguing not just that the NHS is an essential serve, but that the privatisation and introduction of markets and competition needs to be stopped and reversed.

The NHS needs to be a public funded and democratically run organisation to be a success. Cuts and siphoning off money to the wallets of rich shareholders of PFI and private health companies removes money from front line services and results in overstretched staff, fewer services and the rise of the superbugs MRSA and C. difficile.

The demonstration, organised by the health union UNISON, starts at 11am at Temple Place, Victoria Embankment. UNISON in Exeter and Barnstaple are running buses to (and from) the demo. There are still free seats left on the buses, which leave Exeter at 7am and Barnstaple at 5.30am (from the Square). If you are interested in getting the Exeter bus, please contact Jim at maj_mij@hotmail.co.uk. If you are interested in getting the Barnstaple bus, please contact Sue Harte on 01271 322353 or unisonhealthndevon@hotmail.co.uk .

It is still time to drive out the profiteers and save the NHS! Please make it to the demonstration if you can!

Exeter CNWP meeting on 19th April

Over 30 people attended a meeting on the Campaign for a New Workers' Party at the Exeter Community Centre last Thursday. Speaking at the event was Tony Mulhearn of the Liverpool 47, John Stone, Plymouth branch secretary of the TGWU (personal capacity) and Jim Lowe from the Exeter Save our NHS campaign.

After speeches, which included a wide ranging analysis from Tony on the nature and degeneration of the Labour Party and a reflection on the successes of the socialist Liverpool council and betrayals of the Labour Party leadership, there was a vigorous debate on the nature of the Labour Party, is a new workers' party needed, how can we campaign for one and what form it might take.

The meeting allowed us to launch the CNWP in Exeter and Devon, and gives us something on which to build.