Tuesday, December 27, 2016

Caring for our aged and frail.

Near everything is easier said than done, even when it's logical and obvious. No more so than the thrust of today's high profile Telegraph coverage of the need to switch some NHS funding to delivering social/nursing/even clinical care at home. Such change means more investment in GPs, more support for social/nursing care and less investment in hospital beds, more specialisation (which can mean more travelling), less investment in extending life beyond the natural end, and more support for social/nursing care in the home.

Let's begin by explaining my interest - beyond the interest triggered by personal experience that we might have with aged family. During my 'wilderness years' (politically speaking) between leaving the National Assembly for Wales in 2007 and arriving at Westminster in 2010, I did some work for a Residential Care Home business - setting up a Welsh management board, a system of lay visiting and a resident advocacy scheme. Learned quite a bit about social and nursing care - enough to know we do not remotely take social/nursing care seriously enough. The voice of the old and frail is not heard.

So what is today's story about. NHS England have divided the English NHS into 44 areas and ordered each to produce a "Sustainability and Transformation Plan" - a crucial programme of reform which will be highly controversial. So much so that I fear the plans may not be deliverable. We have just witnessed the disastrous result of attempted reform in Shropshire (which also serves Mid Wales). We had already received kickbacks on reform of stroke services and I am now hearing concerns about future of radiology. The decisions we face are tough to take but the NHS will collapse under the demands put on it, unless we find a way to not have in our Hospitals those patients who should not be there. The fundamental problem is that we are all living longer, with the more complex health problems that come with age, as well as the many new drugs and treatments which eat great chunks of the NHS budget. And we all know 'protecting' an unreformed NHS  service is the easiest campaign in the world to run for publicity - no matter how long term damaging.

I certainly don't have the answers. Reckon I've gone further than most accepting there's the problem. That's why I was in such despair following the shambolic failure to agree a reform plan for Shropshire and Mid Wales before Christmas. In my view, this is the second most serious issue facing the UK Government up to the next election. (I'm trying not to mention the first for a while). We must find a way of persuading/encouraging families to take more responsibility for care of their own. Some do of course, at great trouble and expense. But some just expect the state to take all responsibility. I did feel ashamed of the way we care for our old and frail, when the company I worked with was going to build two new care homes in India - for the ex-pats. When I asked why, I was told Indian families take care of their own. There needs to be a total reappraisal of all our care systems, with much greater emphasis on the aged and elderly. And if our system of government is too selfish to listen to their voices, think selfishly about the breakdown it will cause to the NHS that serves the rest of us.

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