I was saved from thrashing around looking for a solution to a problem when on the
news came the perfect subject. The NHS!
This evening came the problem that can be close to many patients hearts. Patient
transport! This can be a godsend to the elderly, those needing regular treatment
and in fact those who hospitals keep saying are taking up beds they need. The downside
is that appointments need to be kept to avoid wasting valuable doctor/nurse and equipment
facilities. Those on dialysis or radio therapy have to attend at set times every
day or two. Both affect all ages and many patients can find relatives to provide
transport on a regular basis - but not always.
A few examples may help you understand the difficulty from my very small circle of
My mother had kidney failure several years ago but was lucky, it only took the doctors
about 2 years to link the symptoms with the cause so ended up having to travel about
15 miles to the local renal unit 4 or 5 days a week. Fortunately my step father was
able to drive her there and back. Now he would have no chance as not allowed to drive.
A friend is about to undergo 45 daily radio-therapy sessions every day at his local
cancer unit which is about 30 miles by car, don’t even think about public transport!
Naturally, when the possibility was mooted, his wife intended to take him back and
forth, only she broke her wrist 5 weeks ago and only just out of plaster so driving
is out of the question. The hospital sympathised and suggested a taxi as they could
offer nothing else.
That will teach me to tell them about my experiences up here earlier this year.
In my case, I only had 37 sessions and I can get a bus to within 15 minutes walk
of the Royal (little knowing just how debilitating the treatment can be). The first
week was fine but the staff realised how I was getting there when the bus was late
one day (you need to get there very close to appointment time) and there is a group
of volunteer drivers using funding from the local football club able to help out
which really was a godsend. Everyday relying on a friend (I’d only been here less
than a year) or neighbours every day is pushing it a bit. As it turned out it was
normally just one day a week when I had to rely on a bus and walk. Some patients
(frequently those of a certain age or living on their own used the hospital transport
service which was extremely variable for some reason even to the extent they would
forget to call for patients or even take them home. One lady was waiting until go
8pm before she summoned up enough courage to ask what had happened. The hospital
arranged for and paid for a taxi - not clever for someone elderly and poorly.
I hope by now you are just wondering where I’m going with this. How about the current
way for trying to say money by contracting out services. My experience suggests that
the expected savings never materialise and the cost savings result in good profits
for the contractors (why would they do it otherwise?) And the service provided is
not as expected. Usual excuse is ‘it’s not in the contract’ or even better, ‘teething
troubles’ (current excuse from the new patient transport contract holder) and of
course, the hospital (or whatever) has no control of the service provider. This extends
all over including actually keeping prisoners in jail for example.
In early November 2017, the ‘local’ hospital near to where I used to live actually
admits it takes 40 to 45 minutes for most patients to get there (having ‘downgraded’
two hospitals saying that new access roads will be built (when asked by whom, they
went quiet at a public meeting earlier this century apart from saying that ‘the blues
and twos will get through’. The latest idea is that the main hospital will only be
for A&E and the others will be upgraded (returned to proper hospitals) to deal with
everything else. Also said earlier this century!!
As with most hospital trusts all this happens following public consultation which
simply results in them simply doing what they intended in the first place. Hospital
management is well known for using revolving doors as things go wrong. It happens
everywhere and the solution is in government hands. Dear Mrs Thatcher even went as
far as appointing a man with a ‘proven’ track record in turning large organisations
around. I think it was about a year when he reported back saying it was an impossible
task due to the complexity of the largest employer in the country with it’s many
and disjointed tasks.
This, in part, is why many functions have been devolved to ‘service providers’ following
the proven dogma that the private sector is always more efficient than the public
sector in the view of the conservatives (frequently proved wrong the second politics
gets involved). It be fair, our NHS is the envy of the world in spite of it’s shortcomings.
So, is there a way to make our NHS run like clockwork and keep everyone happy? The
quick answer is no way without simply starting again. See, simple, although we may
kill a few in the process so someone has to stand back and reassess the situation.
May I suggest that attitudes of management needs to changed as the meetings I have
had suggested that their priority is medical care without thinking how that care
is delivered. One CE actually told me that buildings and maintenance had nothing
to do with providing health care which naturally turned into where did that attitude
stop? Ambulances, car parks, patients etc. It has to be considered as a whole service
in the same way that any well run business does- you may need to think about that.
I will, back soon!