Sunday, 28 February 2016

James Delingpole suffers a life-threatening embolism - and thinks he may have discovered why the NHS is at breaking point

The pulmonary embolism was the result of falling off a horse. The journalist spent four days in hospital on morphine as a result. The staff were all wonderful, but his recovery wasn't helped by a senile old man in the bed opposite (literally) flinging shit around in the middle of the night, keeping everyone awake for hours, and soaking up a huge amount of staff time. Delingpole has written about the experience in this week's Spectator in an article entitled "What I learned while nearly dying", subtitled: "My NHS experience, with a life-threatening problem, was an encouraging one – apart from the other patients":
"I saw this happening a lot: old people who’d been admitted for acute problems (e.g. cutting their feet on some glass) very quickly becoming long-term cases as, in hospital, they let down their guard, gave up on their last vestiges of self-sufficiency, and succumbed to a series of subsidiary problems — constipation so bad that it threatened to require surgery, say; or injuries sustained from falls while trying to get up, confused, in the night. 
This is what is meant by ‘bed-blockers’. They were only expected to stay a couple of nights; instead they become semi-permanent because the NHS, being in the business of caring, cannot bring itself to chuck out people who aren’t sufficiently fit and well."
Delingpole makes it clear that he's not calling for frail old people without acute conditions to be thrown out on the street. But it seems obvious that they shouldn't be treated in hospitals designed for the acutely sick or seriously injured- i.e. patients who are likely to recover thanks to the the treatment they receive and will leave hospital as soon as they're able to, or who will die within a few days and require relief from pain and distress, and whom it would be cruel to move elsewhere. But evidently not obvious enough for anyone to ever come up with a solution, because this has been going on, to my certain knowledge, for over half a century. My wife's only hospital stay (apart from when she gave birth) was at the age of seven, when she ended up as the only child in a mixed-sex geriatric ward. A terrifying experience, I'd have thought.

When I had two separate week-long stays in hospital thirty-odd years ago - utterly exhausted, scared, in the worst pain I'd ever experienced in my life, and starving and horribly thirsty because I was on "nil by mouth" -  I found myself on both occasions in a large mixed-sex ward where at least half the "patients" were senile bed blockers who didn't seem to have anything specifically wrong with them - at least, nothing that the medical staff could do anything to improve. They were just very old, and suffering the nightmare of dementia. They never seemed to have any visitors, so there didn't appear to be anywhere for them to be discharged to where they'd be looked after. As in Delingpole's case, they seemed to spend most of the day drifting quietly in and out of consciousness, and then come to life around midnight, when they'd start trying to get out of bed, or soil themselves, or start shouting incomprehensibly - or all three. Given that any chance of dozing in the evening had already been disturbed by patients in the doorless communal television room watching soap operas and comedy programmes ON FULL BLAST, I did begin to wonder if we'd all been unwittingly enrolled in some bizarre experiment designed to discover the best ways of making sick people even sicker. I have never been so glad to escape from anywhere - I even lied about how well I was feeling in order to secure my release.

I'd sort of imagined (I don't know why) that those days had gone. Delingpole's article suggests they very much haven't. How many Health secretaries and ministers have there been since my wife's awful childhood experience? How many NHS heads? How many civil servants and assorted "experts" have pored over this fundamental problem? Is the lack of an answer the fault of the automatic recourse by conscienceless politicians and newspaper editors to the "XX days to save your NHS" lie? And don't tell me it's a problem with underfunding. That's too easy. I suspect the real problem is a lack of courage amongst those who run the health service, a fear of Daily Mirror or BBC News headlines accusing politicians and administrators of heartlessness or of trying to "privatise the NHS" or whatever.

Answers on a postcard to Jeremy Hunt, please.

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