Recent days
have seen stories in the media about horror in the hospitals as the drive to
the financial margins has created tighter treatment margins with crises when
the margins are reached and exceeded.
This is an
edited item from 25 October 2010, "Bed Blocking For Dummies" and
originated in a piece from 2005. Bed Blocking was exciting the BBC and other
media because of the spending review.
Quote:
In the last
dozen years the pre-conditions for serious problems have been in place but have
gone critical only a couple of times, mercifully avoiding the worst. Whatever planning may have been done in the
past there have been some significant developments quite recently so the
figures have been going the wrong way.
This means that critical phases will occur more often. Just when the tipping point might occur into
chaos, or collapse or catastrophe is an open question.
Quote from the
earlier item:
WHEN DID YOU
LAST SEE YOUR GRANNY?
The ambulance arrived
in the early hours of the morning, a routine event; recently there were four
visits by paramedics and ambulances in one day.
The reason is not mobs of drunken yobs beating out each other’s brains
or local addicts overdosing, it is a quiet, well behaved, ordinary and indeed
gentle group of neighbours who fall or have a medical crisis.
The problem is
their longevity and its consequences. The carers come and go from 6 a.m. to
midnight, and so do the medical and emergency services. Nationally, the number
of call-outs for the ambulance services has increased sharply in the last
decade; this is one reason for the added demands.
The wider
problems in the NHS have compounded the problems. Ladies who once rivaled each other in their fashion
sense and men in competitive sports now try to cap each other’s trolley horror
and medical disaster stories.
They are many
and various, one who visited her Family Doctor for a routine prescription
discovered that the local hospital had declared her to be deceased and all her
medical records had been deleted from the relevant NHS systems; so the undead
stalk the land.
A desperately
sick man died quietly on his trolley after a 72 hour wait. Treatment that is nearly too late, or long
delayed, complicates long-term recovery, and when attention is given for the
immediate issue they are packed off home as quickly as possible to manage and
recover as best they can. Some soon return to the hospital, often as an
emergency case. Where have all the
convalescent facilities of former decades gone?
The bungled
attempt to regulate residential homes more closely by New Labour, that caused
so much personal damage and distress, wiped out a huge number of temporary and
permanent beds and accommodation for the elderly infirm when the owners decided
to take the money and run as property prices rocketed.
In the
meantime the major erosion of the income of the old by stealth taxes through
the machinery of local government and national finance means they are less able
to care for themselves. The effects of
other regulations, Health and Safety and Euro inspired instructions and
admonitions have added to costs and prices.
In all the
planning for new housing demanded by the government, intended to be in the
hands of the forthcoming Regional Governors and their development directorates,
the bit that is missing is what to do about the old.
The vagaries
of the housing market add to the complexity of the problem, as do the serious
dangers of boom and bust. In boom, there is a tendency to hang on for the best
possible price, and that is always a little too long. In bust, the old who cannot cope also cannot
sell their homes in the new situation.
Because of
what has happened already it is possible that one way or another over the last
few years the number of ordinary houses and properties effectively removed from
the market and occupied by single old people needing daily care is more than
the numbers of new properties demanded by New Labour as vital for “new needs”.
A lot of these
“new needs” arise from the expansion of the holdings of second and third homes
and the buy-to-let sector fueled by cheap credit. The people who benefit from this surge in
property buying are subsidised, probably, through the tax and benefits system
far more than the struggling pensioners, and the ones who benefit from the ramp
include almost all of the current political and media elite.
We know that
the slow disintegration of the pensions system since 1997, part of the assault
by Brown and New Labour on the Lower Middle Class, the “peasants” as they
engagingly call them, will create intricate problems in the decades to
come.
More pressing for
the immediate future is a disaster about to happen; one serious pandemic of
influenza could be enough. Although the
government may well put it down to a necessary conjunction of statistical
trends relating to demographic factors inherent in the age structure of the
population, the electorate may take the view that the state has a
responsibility.
Given the
state of the A&E and geriatric facilities in most hospitals, the serious
and growing problems in community medicine and general practice, the tipping
points from pressure to crisis and from crisis to disaster are perilously close
to daily experience.
The only
considerations that will worry the government, of course, are the poll ratings
amongst those able to vote, the question of how the young voter will react, and
the serious worry that the sudden availability of up to a hundred thousand
houses could crash the property market in the run up to the next general
election.
In the
meantime we give almost all our attention and thoughts to the media excitements
of the day. In the night, the ambulances come and go, and the carers wake long
before the dawn.
Unquote first.
Christmas is
coming.
Unquote second.
What will
happen at the end of this year?