©2017 Norman Cutting

Webmaster - Norman Cutting (normcall@uk2.net)

The NHS


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 relatives/friends.

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 change as not allowed to drive. A friend is about to undergo 45 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 few 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 other 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!


continued

Back to Norms home page and back to the main home page