Headlines in the Daily Mail again on the subject of the inhumane treatment of the elderly in NHS hospitals – “Elderly patients dying of thirst“.
This is a continuation of a campaign started nearly six months ago under the front page headline “Neglect Shames Britain” (see my follow-up blogs dated 6 December 2010, 22 December 2010, 23 December 2010 and 1 March 2011).
What brought this back to the Daily Mail’s rather half-hearted and sporadic campaign are reports coming from the Care Quality Commission visits to inspect hospitals and elderly wards in particular.
Here are some of the shocking findings:-
- 800 patients die partly from dehydration
- 300 patients die from malnutrition
Both these statistics are likely to be grossly understated because of doctors not wishing to invite further investigations.
A quarter of the hospitals inspected were failing to meet basic standards, for example:-
- Major concerns over malnutrition – meals being left beside sleeping patients and then later cleared away uneaten.
- Patients having to use commodes at their bedsides – indignity becomes the order of the day.
- Patients being examined in an open ward without adequate screening.
- Emergency call buttons left out of reach of patients, or when they are used not being answered.
These are everyday occurrences in a failing system of care of the elderly. Yet the outcry is muted to say the least. Relatives’ complaints are fended off with excuses or passed into a black hole of bureaucracy. For many less critical issues – student loans, fox-hunting, poll tax – thousands take to the streets to protest. For every soldier that dies in Afganistan, hundreds line the streets of Wootton Bassett with heads bowed in respect.
Meanwhile the Patients’ Association, Age UK and the Daily Mail beat their breasts to no avail because they don’t know how to campaign.
Now the CQC can be added to the list with their next step being the threat of fines – which are hardly going to help hospitals that are already short of money.
Above all of this strides the teflon Health Secretary, Andrew Lansley, proclaiming his hollow wish to “stamp out poor care”, uttering platitudes about “patients are the most important people in the NHS”.
One thing is certain – this problem will not go away. This grumble will rumble for a very long time to come, and more elderly patients will die unnecessarily in NHS hands.
The fundamental issue is that the NHS is being overwhelmed by the increasing numbers of frail elderly people. With cruel irony, this is in part brought about by the success of improving medical advances, which have led to increased longevity. Sadly this has not been matched by corresponding increases in resources, nor is it helped by the obvious inefficiencies and often ineptitude of the NHS. Politicians are reluctant to confront these issues for fear of the defensive reaction from the battalions of NHS staff, the medical professions and the trade unions.
1. Don’t take on the whole NHS – think divide and rule. Put more money into some specialist areas e.g. Cancer, hip replacements and obesity aimed at achieving “best in world” status and better outcomes for everybody.
2. Outsource care of the elderly to nursing homes and extracare housing with greater medical support in the community. However, in the light of the Southern Cross debacle, a necessary pre-condition will be to ensure that organisations are on a firm financial footing before any out-sourcing contracts are placed. Although as far as I am aware, this has always been the regulators responsibility, they just haven’t been doing it very well.
3. Also introduce a new qualification of “nurses for the elderly” to upskill the social care sector with practical training.
4. Make hospital a last resort for older people who have complex and chronic conditions. Ensure essential visits for acute treatment are kept as brief as possible and then support this approach with convalescence and rehabilitation in nursing homes and extracare housing.
5. Stand up to vested interests in NHS unions and some self-serving clinicians in the interest of better outcomes for elderly patients.