Patients are consumers too….
The carer looked at me over the top of her glasses. ‘I'm really sorry,’ she said ‘but we can't help you.’ I looked at her in disbelief. This was a private care agency, they had the capacity, I had the money, we needed help, what was the problem?
‘Your mother needs a proper assessment,’ she explained. ‘She may have broken something.’ Something was indeed very wrong. Over the last few days, Mum had deteriorated from being able to get up and down stairs - if slowly - to not being able to get out of bed without help.
I started with what I thought was the most sensible option, our GP. Everyone in staff training. ‘Call 111’ said the carer, ‘I’ll wait and speak to them.’ 111 was duly called, the carer explained the problem and paramedics were next to arrive. They diagnosed a broken pelvis. ‘We could take her to hospital for an x-ray so at least you’d know what you’re up against, but there’s no cure…’
But I couldn't move her and even private carers wouldn't help without an assessment, so our next stop was Accident and Emergency.
A&E meant a corridor trolley wait, then, still on the trolley (no pillow, only a thin blanket), an overnight stay in a side bay and finally, the next d ay into an A&E annexe, which at least had a proper bed.
The next morning, I found Mum frail, dehydrated and incoherent, but nevertheless dosed up with morphine for the primary purpose of being able to ‘prove’ to the discharge co-ordinator that she could walk from her bed to the toilet and could therefore go home, avoiding the need for admission and a ‘proper assessment’ of her care needs. One can only imagine the risk this posed - of making her fracture worse; of falling, or of creating further fractures. I caught the eye of the nurse making up the bed next to Mum’s. She rolled her eyes and whispered ‘it’s not right. I’ve told them, but…’
What can you do? It’s a good question. We’re told that it’s the fault variously of the GPs, the hospital management, and the patients who insist on coming to A&E but don't need to be there. It’s also said that we spend less than our European neighbours on healthcare, demand is rising, yet budgets are falling in real terms.
The Kings Fund has said that with NHS finances almost at breaking point, the system turns to deflection, delay, denial, selection, deterrence and dilution to cope, all of which impact on service users, or those who would use the service if only they could access it.
Mike Adamson, CEO of the Red Cross, was recently criticised for describing the NHS as a humanitarian crisis. It may not be a war zone as such, but to the patients trapped inside and those who love them, it can sometimes feel like one.
The NHS may be free at the point of delivery but we all pay for it through our taxes. Perhaps we do need to be paying more, but patients are consumers too and they deserve better.