Tag Archives: NHS



R.I.P.  Democracy in the UK

R.I.P.  Caring about things other than money





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A letter to Santa

Dear Santa

It’s years or even decades since I wrote to you, so I wonder whether I might ask for the following presents.  The presents aren’t for me, but if you could manage the lot, that really would be the best present of all time.

Perhaps your Reindeer could deliver one each while you sit back and have a well-earned rest.  There’s some debate as to whether or not all of your reindeer are female or castrated.   Male reindeer lose their antlers in winter, don’t they, but as long as they can all draw on a few skills that are so sadly lacking in some of the people they’ll be visiting the gender of your reindeer matters not a jot!  Care, charity, compassion, concern and consideration are but a few of the senses absent from the recipients of the gifts you’re about to deliver.

Dasher’s reputed to be your speediest reindeer, so we’ll keep Dasher until last!  And I’ve rearranged some of the others, so that they have a bit of variety from their usual line-up.  Similar to the way in which many of our political leaders with their supposedly caring minds have been rearranged recently.

Comet and Cupid have got to be the first down the chimney, hand-in-hand, delivering to a very Happy Couple, David and Nick, who were drawn together by another Cupid.   After a whirlwind romance, they succumbed to temptation and tied the knot.  David and Nick deserve all they get.

Comet will forgive me, I hope, for calling on one extra-terrestrial frozen mass that travels around the sun in an elliptical orbit to deliver to another body with a frozen mass but also in orbit.  Historically, comets have been considered to be bad omens.  Cupid will understand the need to accompany Comet.

Could David and Nick have two presents each, please?

For David, a pair of fluffy slippers.  A fairly traditional old-fashioned present, but his feet must be so very tired after wearing hobnailed boots for months on end now.  He’s trampled over ground that’s been compacted with care over the years as it provided a solid base for many people.  The young, the old, the poor and the sick have all suffered recently as they’ve had no choice but to watch everything they believed in by way of support mechanisms being dismantled at breakneck speed.   David’s second present could be a pair of headphones, or perhaps a couple of ear trumpets, or any device that could amplify sound and enhance the power of those two little receivers on either side of his head.  At the moment he’s either unable to hear, or unwilling to listen, to the voice of the people.

Nick will probably be found lying down in a darkened room, waiting for his next mission to be announced.  He’s feeling weary, from all that orbiting around his sun-god.  So, for Nick a hot-water bottle to warm his frozen heart as he orbits.  And some heavy-duty suspenders because the oomph has gone out of his braces.  He’s been dangled, swung and swayed for far too long now, and if his elastic snaps, then his orbit could be so great that he’ll never find a way down to earth again.  That may not be a bad thing though.

Prancer brings to Vince a mirror, a compass and a magnetic tutu.  The mirror may remind Vince of who he is and what he once believed in, let alone what he once promised; the compass will direct him towards the right path.  The magnetic tutu will allow him to leap and pirouette to his heart’s content, but will always bring him back to earth with a bump and a strong reminder of the way in which he has chosen to manipulate his position.

Dancer arrives gracefully in the Cabinet Room at 10 Downing Street, where the whole cabinet seem to be rehearsing for Strictly Come Dancing, all dancing to the tune of the Happy Couple.  Dancer’s gift will be the last-published edition of the Oxford English Dictionary.  The words that have come from the mouths of the cabinet have shocked many of us recently – and they haven’t finished yet – so this present from you will enable them to learn some acceptable words, rather than the vulgarities they’ve grown accustomed to.

Hopefully they’ll see how rude they’ve been, using words like scum, sinners, scroungers, spongers and so on.  They never used such words before the General Election to describe the people who voted in that election, so perhaps power brings with it a mouth filled with obscenities.

All the Secretaries of State would welcome a bottle of mouthwash too, if you could arrange that one, Santa.

And if you could also run to a copy of Derek Fraser’s ‘The Evolution of the British Welfare State’, and a copy of Charles Webster’s ‘The National Health Service: A Political History’ then the Cabinet could be kept occupied and out of mischief for a good while reading up on what they’re all trying to demolish and finding out why they should tread carefully.

Donner and Blitzen can work as a twosome.  The thunder and lightning they deliver to the House of Commons will be deafening and startling.  It will shake awake that sleepy band of so-called representatives of the people.  To each MP a pair of kid gloves made of the softest leather you can find, plus a feather duster.  The gloves are to be secured permanently to their hands so that they will be gentle and thoughtful whenever they debate and vote on issues that affect the real people, even though they may not impact on the lives of this strange bunch of representatives that has landed from outer space.

As for the feather dusters, I’ll leave it to Donner and Blitzen to place them where they see fit.  Any orifice will suffice as long as the purpose and function of a feather duster remains intact.  To dust away the cobwebs, but not to demolish spiders in the process.   They protect fine china.  That’s what we ask our MPs to do too.

Vixen has a detour to make, I’m afraid, to the Care Quality Commission (CQC) to deliver as large a quantity of magnifying glasses as possible.  The CQC has been very short-sighted for years now, failing to care enough about the quality of care it has allowed to be registered and delivered to people in need of care and support.   The magnifying glasses will enable the CQC to inspect at very close range all those self-assessments from care providers all over the country that will be in need of scrutiny from now on.  And perhaps the few inspectors that may remain after the latest shake-up will each be able to take a magnifying glass with them when they go on unannounced inspection visits.  They could all do with an appointment with an optician too.

Now to Dasher, your right-hand reindeer.  Dasher will have had a rest while the others were all working hard, so Dasher will speed you all to Buckingham Palace.  Don’t worry, it’ll be empty as the usual tenants will all be elsewhere.  Waiting for you there will be every single resident from every single care home in the land, plus every single older person who can’t afford to heat their own home this winter, plus every single child from every family that is soon to be made homeless and forced to move further afield plus their mums and dads of course, plus every single disabled person who is soon to face the most stringent inspection of their personhood in order to retain the support they need, plus a few more good people who will soon be battered and bruised by the bunch of heartless thugs we call the government.

Rudolph is the youngest new arrival to your fleet, so perhaps Rudolph could do a Rudy, a front somersault with 1½ twists and keep you all entertained.  Turn the heat up, eat the cupboards bare, have a great party.   Stay as long as you wish.

Oh, I nearly forgot: while you are having a rest, Santa, loads of presents will be delivered to the Palace.  Well, we arranged to re-route all the presents that were destined to go elsewhere  to the undeserving powerful heartless decision-makers, to the fat-cats, to the wheeler-dealers, to the tax avoiders, and so on.  And we re-directed the bankers’ bonuses too, so you won’t run out of anything at all as you celebrate.

Many thanks in advance, Santa!

Seasonal Greetings to you all.


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Care and progress? – Or ideology gone too far?

Plymouth – July 2010

THREE council-run residential homes could be closed as the city changes the way it looks after elderly and vulnerable people.

And a respite unit for people with learning disabilities also faces closure if the city council Cabinet agrees at its meeting next Tuesday.

The changes will come as part of a wider strategy to modernise care services.

The council has already moved older people out of a number of out-dated residential centres and into new extra care schemes where they can be helped to live with more independence.

Fife – October 2010-10

As public spending cuts begin to bite, councillors will be asked to consider three cost-saving options when the social work and health committee meet on Tuesday (19th October).

One of these includes closing all local authority residential care homes with residents moving to another care home of their choice in the private or not for profit sector.

Fife – October 2010 update

While councillors agreed on Tuesday to reject a plan which would have seen all 10 of its care homes closed and residents transferred to places in the private and voluntary sector, question marks remain over seven of the homes after the council agreed to consult with a view to “replacing existing provision as and when suitable alternative provision becomes available.”

Llanelli – October 2010

A new row is brewing over controversial plans to close two Llanelli care homes.

Union chiefs have complained to the Assembly Government  over the public consultation exercise being carried out on Caemaen and St Paul’s care homes

Carmarthenshire Council denies Unison’s claims the exercise is “unfair and inadequate”.

The union says the consultation document includes options to close both homes and privatise residential care home services.

Suffolk – October 2010

The council is to look at all 16 homes that it operates across the county – and has come up with three options for the future:

Option 1 – Closing the homes and buying in services from the private sector.

Option 2 – Selling off all the homes as going concerns.

Option 3 – Closing six homes and trying to sell off the remaining 10.

Isle of Wight – October 2010

Also proposed in the far-reaching consultation are plans to scrap free home care for the over 80s and increase charges for services, including meals on wheels, home care and day centre sessions — plans which have sparked concern among carers.
Frances Wright, chairman of the Isle of Wight branch of Carers UK, said: “All these charges will add up. It’s not just money — people are worried about paying for services but they are also worried services will disappear.”
A report commissioned by healthcare watchdog, the IW LINk, suggested further plans to cut support services for all but the most vulnerable people could prove to be a false economy. It found money spent on preventative social care services resulted in long-term savings for the council and other agencies, such as the NHS.

This week’s Comprehensive Spending Review has caused Nigel Edwards, Acting Chief Executive of the NHS Confederation, to warn in a letter to The Daily Telegraph that hospital beds in England may fill up with the elderly and vulnerable because of cuts to local authority social care funding.  “Hospital beds will be blocked for those who badly need care because the support services the elderly require after discharge will not be available.”

= = = = = = = = = = = = = = = = = = = =

Once upon a time – not a bedtime story, this one! – elderly and vulnerable people were spending longer than necessary in nasty, horrible, depressing, run-down Victorian long-stay hospitals.  Many were fairly averagely normal (whatever that means) when they arrived; some were just seen as a danger to the public, so were lifted and incarcerated.  Before long they became institutionalised to such an extent that a return to normal life in the community wasn’t on the cards.   Even young unmarried women who had become pregnant were forcibly held in some of these appalling institutions – and they never recovered from the experience.

Then, as the Welfare State gained strength, and as society gradually improved its attitudes towards the needy, the vulnerable, and those with disabilities, there was a plan to close these places down, once and for all.   From the 1960s, Care in the Community became the buzzword.  Then slowly,  all people were to have the same human right to a life with dignity, regardless of  their age, gender, race, colour … and so on.  Goodbye to institutions, asylums, long-stay hospitals.  Hello to care.  Or so we thought.

Here we are now, with the biggest onslaught about to take place on our public services, our welfare state, with the sick, the vulnerable, the elderly and the poor all about to become victims of a brutal ideology gone too far. Without a mandate from the Great British people for such draconian measures.  I want nothing to do with that kind of Big Society.

We found a way to care in the community.  Is there no place for care in the big society?

At the memorial service for PC Toms, on Monday 18 October 2010, David Cameron quoted “evil thrives when good men do nothing” – and as I watched a clip on TV News of him saying that, I wondered to myself whether the (then undeclared) Comprehensive Spending Review would bring a similar thought to our minds.

They don’t care, do they?

So we will have to show them that we care.

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Intermittent connections in the world of dementia and care

There is what is known as a ‘major Service Outage’ in my part of the UK, and many of us are struggling with creepingly slow broadband connections – all are up the creek without a paddle for the foreseeable future, and no amount of troubleshooting has so far been able to sort us all out.  I’m told I have an intermittent connection, but no boffin has so far been able to create the constant connection that I need.  And as those strangely disconnected moments turned into hours, then days and now weeks, we have all been driven to distraction.  So, many micro filters have been changed, routers powered down and powered up, settings have all been checked, lines tested … and so on.  The systems have all had a thorough MOT.

But the brain behind the broadband can’t send the right signals to the right place at the right time for a meaningful, reliable and constant connection to be established.

Just like dementia.

When the brain’s working properly all those little electrical impulses work their way along the nerves to and from parts of your body and parts of your brain.  The neurotransmitters help those signals to jump across the gaps between the nerve cells.  And language, movement, problem solving and memory all work according to plan, according to the blueprint.  The connections remain constant.

But, with Alzheimer’s disease, the brain shrinks as the number of nerve cells in the brain reduces.  You can’t grow new nerve cells, so as more and more cells die away, the problems of dementia increase.  The neurotransmitters are reduced too so they can’t send the same signals.  The intermittent connections begin to surface.

The brain needs a good supply of blood – via blood vessels – for it to function, but if the vascular system in the brain becomes damaged, because of diabetes, high blood pressure or heart problems perhaps, or a stroke, the blood can’t reach the brain cells, so they eventually die.  And then along comes Vascular Dementia to wreak havoc.  More intermittent connections surface.

It’s 100 years since Alois Alzheimer first described Alzheimer’s.  Very little of Alzheimer’s teachings had to be revised and, though 100 years older today, they have not been corrected or amended but only confirmed.  Alois Alzheimer was apparently an optimist.

Dementia is the word we use to describe the symptoms that occur when the brain is damaged by disease, the most common being Alzheimer’s Disease.  Vascular Dementia is the second most common form of dementia.

Dementia is degenerative, and the speed of decline varies. A person will become repetitive both in speech and movement, will look in a mirror and fail to recognise their own image, will also fail to recognise their own family and friends, will lose the ability to carry out everyday tasks (the so-called activities of daily living or ADLs), will often become verbally and/or physically aggressive, will become agitated, may suffer hallucinations and delusions, will gradually suffer severe memory loss, will often lose their speech entirely and in the latter stages they will lose the ability to swallow, the ability to move, the ability to breathe.

Dementia leads to death.  There is no cure.

For some unexplained reason, Dementia is  seen at present as a problem requiring social care rather than health care.  And that is where the intermittent connections in the world of dementia and care really begin to show themselves.

Paul Burstow, Care Services Minister and Liberal Democrat MP, had a crack at local authorities for jumping the gun and making cuts in care support ahead of next month’s public spending review.  He also told Community Care that “Every local authority has a responsibility to do its best to make efficiencies and protect the frontline – there are better ways they can do this than salami-slicing and slash and burn.”    I can only agree with him when it comes to salami-slicing – if only because I can think of a few salamis that I’d like to slice, all currently involved in the care industry and in the dementia care industry.

Mr Burstow is also upset by the low uptake of personal budgets.

The Princess Royal Trust for Carers published the results of its survey of 800 carers, who care unpaid for a sick and disabled family member, and found that over half (53%) of all carers who work earn less than £10,000 a year, with three-fifths (60%) having to spend all of their savings to support the person they care for. 89% say that they are financially worse off as a result of caring and, consequently, almost two-fifths (39%) fear they will lose their home.  Broke and broken: Carers battle poverty and depression.

Read these Quotes from Carers – the intermittent connections in the world of care are clear to see.

Today, Stephen Dorrell – the new Chairman of the House of Commons health committee – has urged politicians to face up to the way in which vulnerable elderly people are being forced to pay for medical care, health care, all because of the redrawing of the boundaries between health care and social care, without proper debate or scrutiny.

The debate surrounding NHS Continuing Healthcare – which is healthcare fully funded by the NHS, in any ‘setting’ so in hospital, in a care home, in one’s own home, in a caravan or even on a double-decker bus (privately owned, of course!) – is something that most people never need to come into close contact with, unless and until they or their relatives are old, and/or with health needs.  And especially, unless and until they develop dementia.  Then, for some strange reason, the connections of the professionals suddenly resemble our broadband problems: fully funded, but fully intermittent.

Many people are denied the human right to return from hospital to their home, by healthcare professionals and by social services.  They’re told they need ‘nursing care’ 24/7 in a care home.  They are then offered by the NHS £100 towards the cost of that nursing care, the Nursing Care Contribution.  But they are then also forced to pay £3500 per month or more for residential care, often shabby and sordid residential care.

All because they have health needs that are such that they can no longer live an independent life.  Residential care is the choice of last resort for so many people, because they can no longer be cared for at home.  And that applies especially to those with dementia.

They are often forced to sell their own homes – or rather their family is forced to sell the home, because by this time, the person needing 24/7 care is in no position to do so themselves – to pay the extraordinary costs of residential care.  Extraordinary costs, because nobody is ever given a breakdown of that cost, but it’s not normally a fair charge.  The quality of care provided is rubbish in many care homes, with enormously inflated charges, enormously inflated pre-admission promises of care, enormously low-paid workers, mostly immigrant workers, enormously low standards of training, especially dementia training.  But enormous profits for the care home industry.  (see the CQC announcement today today about some of the sordid care homes and agencies it has forced to close.  Many  other sordid care homes and agencies have survived the CQC axe – but only just, and only thanks to some very closely woven and constant connections.  There’s little chance of their connections becoming intermittent.)

The hoops and hurdles that have to be faced by those who challenge the decision-making process (also known as the National Framework for NHS Continuing Healthcare) are so complex and complicated that the so-called professionals can’t even work their way through them all.  And then the family members who find the inner strength to challenge it all are forced to spend years, and years and years being humiliated by the Primary Care Trust (PCT) and Social Services (SS).  It comes to resemble a game without rules, like Snakes & Ladders with venom-filled snakes hissing and spitting at the poor souls who try to climb the rungless ladders.

Except that there are rules.  There are legally binding rules that should not be broken.  But they are being wilfully broken, by the NHS, the PCTs, and the SS.  Aided and abetted by governments, one after the other.  They are all in it together, to paraphrase David Cameron.

“We are clear about what we must do … in a way that protects the poorest and the most vulnerable in our society, in a way that unites our country rather than divides it, and in a way that demonstrates that we are all in this together. Prime Minister David Cameron’s speech on the economy, Milton Keynes, 7 June 2010,

Dementia is an extraordinary disorder of the brain, a disease of the brain, a most devastating illness, for which there is no cure.  People die of and with dementia.  But dementia is not being acknowledged as a disease, an illness, a destructive force, removing from a previously capable and competent human being each and every single quality that defines a human being.

We as a civilised country ought by now to have found a way to create the constant, reliable connection between needs and service provision.  Dementia care still suffers from a ‘major service outage’ of a kind that paralyses those with dementia and their family members caring for and about them.

I am sick and tired of reading, hearing and watching our government, our ministers, our politicians, our healthcare professionals, our social care professionals and so on, all cry out in shock horror about the problems of caring for the elderly that we are facing, but they continue to do nothing to correct the ills of their ill-defined system.  Actions speak louder than words.  If we really are all in this together, then we should not be so lily-livered about sharing the responsibility for it together, via taxation.   All that is required is for the connection to be made, between health needs and care.  Between dementia and care.

After all, tomorrow it could be any one of us – even you – with dementia and needing care.

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Filed under abuse, Alzheimer's, care, care fees, care homes, dementia, dementia care, law, liability, Local Authority, NHS, NHS Continuing Healthcare, politics, professional responsibility, social work

Coalition plans for the NHS

A few comments on the Lib-Dem-Con plans for the NHS~:

from Liberal Conspiracy concerned about the dismantling of the NHS – me too!

from askcliff concerned about Andrew Lansley’s possible hidden agenda – no, Cliff Hagen, I don’t think you are scaremongering;

and, yes, How very odd, Mr Lansley – from Tax Research UK.

David Cameron is apparently terrified, as a parent, by the lack of good state schools, especially in Westminster –  well, David, why not try the Pimlico Academy – courtesy of John and Caroline Nash, of course, c/o Care UK again.  Wait a minute?  Wasn’t Westminster the scene of Shirley Porter’s creations of a suit of clothes to suit the Tories?  Yes, course it was!!!  That turned out to resemble the Emperor’s New Clothes …. unfit for viewing by the uninvited, but eventually all was revealed.  What a thought!!!

Nick Clegg, I’ve said it before and I’ll say it again: I’m disappointed.

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Treasury sends back Lansley plan to give GPs control of £80bn

Thank you, Treasury!  Thank you, for sending back Andrew Lansley’s plan to give GPs control of £80bn.

“Lansley’s white paper, the biggest shake-up for a decade, was due to be out next week but the timetable has slipped after Treasury officials said there was not enough provision for making GPs accountable to the public, given they would control 80% of the £100bn NHS budget.”

“The white paper got bounced back because there was no way the Treasury could sign up to a proposal which handed £80bn of public money to 35,000 GPs who are basically unaccountable private businesses,” said one official.”

Otherwise it could be the thin end of a wedge.  Private businesses involved in providing care should all be accountable, each and every one of them, and that includes private care home providers.  But they are not at present.

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Baby P and another knuckle in my experience of care

These words from Outside Left are causing me to remember that I have knuckles:

Slowly but surely, the true picture is emerging of widespread failure involving many people in different services.

I didn’t have a Baby P, but I had the equivalent of Baby P.  She had a longer life than Baby P, but an equally horrible death.  Baby P was only a baby; she was an 83-year old.  Baby P was neglected within his own family and by those who were charged with looking after his life; my 83-year old was never neglected within her own family, but was seriously neglected by those who were charged with looking after her life.

It’s almost 3 years on now since she was found to have suffered “sub-standard care” also known as neglect in a care home, and which resulted in her death.  A care home that was not fit for purpose.  But who cares?  Who cared about her?  I did, and I do.

There was indeed widespread failure involving many people in different services, in my own personal experience of ‘care’ aka ‘neglect’.  I’ll try to list a few of them:

  1. The Local Authority;
  2. the Mental Health Care of Older People Team;
  3. the Social Worker working for the first time ever on behalf of older people with dementia – a locum social worker who knew nothing of the locality or of dementia.  If only she had told us that then, we might have worked out a way to help her too, but we didn’t know it then;
  4. the next Social Worker  seconded to that same  MHCOP team from the Local Authority, but who seemed to have been ‘shackled’ sufficiently to render her in total awe of her job-providers and her experience-gaining-secondment from Australia (!);
  5. the extra-care sheltered housing, contracted by the Local Authority and recommended as ‘suitably suitable’ by the first Social Worker;
  6. the domiciliary care agency owning and providing domiciliary care to that same extra-care sheltered housing complex, which was run in the best interests of the agency staff working there and where the main focus was on independent dying, not independent living;
  7. the Assessment Ward of the Mental Health Unit via the NHS/PCT/Trust/Partnership …. changed its name so many times;
  8. the Local Authority’s Adult Social Services/Housing department with particular responsibility for housing those in need of care;
  9. the Local Authority’s commissioning department who are supposed to commission and contract safe residential care services;
  10. the CQC / CSCI departments charged with regulating, inspecting, reporting on and ensuring the safe regulation of residential care  homes with nursing and ensuring that they are/were all above board and safely guaranteed competent to receive vulnerable elderly people with dementia;
  11. the care home, who had no systems of protection in place;
  12. the care home provider with a 25-year contract to provide safe services to vulnerable elderly people with dementia;
  13. the Adult Protection Coordinator who could and should have helped us through the months that followed ….   …. ….
  14. All of the above agencies who had not realised that there were no systems of protection in place.

I can’t begin to tell you all how it feels to list the above, and I have to make a huge effort so as to avoid a further few ‘agencies’ involved.

I’m feeling almost weak at the knees remembering and trying to create a coherently readable list of all the agencies involved.

But they all failed.  From start to finish.  Each and every one of them failed.  Failed to protect and preserve life.

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Filed under abuse, care, care homes, Care UK, dementia care, Local Authority

Secret filming nurse struck off by NMC

A nurse can be struck off by the NMC for following “the behest of the filmmakers … rather than her obligations as a nurse”, and yet there are so many occasions when a nurse “follows the behest of a Care Home Provider” resulting in serious neglect of residents – and on occasion, death – in a  Care Home with nursing, but no action is taken against the nurse in question?  Or against all the other ‘bodies’ like SS, Local Authority, and even the Care Home Provider.


Margaret Haywood deserves an Honour, not the sack.

She did her job to perfection, by protecting and supporting the health of individual patients.  Shame on you, Nursing and Midwifery Council.

Update: I was delighted to learn that Margaret Haywood was reinstated.


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