Monday, 29 April 2013

Robbing Peter to pay Paul ?

£1bn raid on NHS to pay for Social Care

According to the Echo, £1bn of 'Ring-Fenced' NHS money ( sounds of hysterical laughter ) is to be diverted to what has become jocularly known as Social Care - in the community, of course.
Ok, so I'm being a clever dick and quoting English Ministers in Parliament, but does that mean that Welsh services will be spared further murderous cuts ?  Only The Shadow knows the evil that lurks in the hearts of men, but I know about the evil intent of NHS Wales to deprive us all of vital parts of existing services in order to save money, even though I'm no Cranston Lamont.

What ever happened to the principle of saving lives ?  It's bad enough for the more densely populated urban areas, but it's impossible for patients in rural areas to access health services, unless they are fairly well off, own a car, and don't mind taking a three hour drive ( minimum ) to the nearest 'Centre of Excellence'. For the ambulance service, the situation is - and will continue to be - dire. They will be transporting more chronically ill patients to distant hospitals with a greater probability of delivering more deceased patients to one of the five or so A&E departments that are left open to serve the entire population.  Contrary to popular opinion, paramedics and ambulance personnel provide an excellent service, under impossible conditions, with having to queue outside A&E departments because the hospitals have no beds.

And - Why do they have no spare beds ? - because of bed-blocking by elderly patients who have no care home places available for transfer to be made. So the hospitals whine that it's the fault of Local Authorities, whilst the LAs blame the government for not providing them with sufficient funds. The government responds that hospitals and the LAs are failing to work within their budgets. No one accepts responsibility and nothing gets done to improve the situation because of this puerile pastime of finger-pointing that achieves nothing except create destructive acrimony and more needless deaths due a failure of Anyone to Manage  any patient care.  Who - dear Mr Cairn - is going to provide this dream of 'customer-based' priority of services ?

It is an inescapable fact that managers in the NHS and those managing bureaucrats in Cathays park are only interested in one thing - self preservation and increasing rewards for their pathetic failures. The only entity to avoid any cuts is the management and bureaucracy who all give fresh new meaning to the word INCOMPETENCE. Not one of these immoral thieves puts the patient first - not one !
It's much easier to blame supposedly uncaring nurses and doctors who are expected to do twice as much work for the same salary.  Morale is poor throughout all medical staff.  They are instructed to discharge patients more quickly, so that GPs are left having to waste months by referring discharged patients back to hospital for the care that they are diagnosed to need.

With well over 800 beds having already been cut, the authorities continue to reduce the amount of care needed by so many patients, with absolutely no remorse because the need to save money is greater than the need to provide healthcare to the citizens of Wales.  R.W.

Regarding the provision of Social Care, the Vale of Glamorgan Council have no remorse about closing Bryneithin - the only home in the county to provide specialist care for the Elderly Mentally Infirm. For y don't miss ears these self-centred bureaucrats starved the home of essential maintenance and any capital expenditure to ensure that the home would be able to continue providing essential care to these incurable dementia sufferers.  So, if our government is allocated any of this £1bn of funding, will the Vale Council correct their negligence by keeping Bryneithin as the centre of excellence that it has always been ?  Then, it would be feasible to create more specialist care homes for the growing number of our elderly that are suffering in a lonely world that is increasingly uncaring about our most vulnerable citizens   

Monday, 22 April 2013

Llandough Ludicrousness

Visit to a Wales' LEGOLAND

Last week I spent a few hours trying to find a parking space within the grounds of Llandough Hospital, which is more difficult than trying to find a hospital bed.  One thing they're not short of is earth-moving equipment.  Opposite the Merry Harriers a new off-road parking space borders a strange road that makes the face of Snowdonia look like a kiddie ramp - yet another example of the brilliance of local planning half-wits. As I drove the winding uphill route to Marathon, I passed the smartly laid out base camp of Laing O'Rourke, the main site contractor. I found the jovial site manager who looked like a man who had won the lottery.  After I introduced myself he told me that "We did millions of pounds worth of work preparing the site of the new Mental Health hospital at Whitchurch and now that's safely in the bank, we're waiting to see if the NHS get the money for the new Mental hospital."

"Where will you put it ?" I asked waving my hand over the thousand or so parked cars in front of us.
"Well, we're in the process of building a 150 capacity multi-storey car park where you see that crane working"

Without binoculars, it was difficult to see the solitary crane, high above the land opposite the old maternity unit.  Still smiling, my host continued his guide.  "Below that, we're building a flat car park out of the side of the hill..."

I had to choke back my laughter.

"Your joking, of course..." I spluttered,

"....that's further away than a man can walk"

Ignoring me, he waved his yellow coated arm back towards the vast field of cars in front of the new Elderly Mentally Ill Assessment Unit.

"The car park should be finished in September ( this year ! ), then we'll clear all of those cars out of the way, ready for the new Adult Mental Health unit - if they get the money, of course."

Following a short conversation - interspersed with many expletives at the stupidity of these 'plans', I thanked my jovial host and made my way back home, wondering with incredulity over where on earth the existing cars would be parked in future.  There wouldn't be enough spaces for the staff cars, let alone the staff and visitors when ( and if ) Rookwood Hospital is relocated, and when ( and if ) the new Mental Hospital is built.

Obviously, I don't have the vision or forethought of the mindless idiots of the NHS Planning Departments.  Really, they have GOT to be kidding.     R.   W.


Sunday, 14 April 2013

The Mystery of the proposed "Making a Difference"

“Rome wasn’t built in a day, you know……….!”

“Ah but they weren’t hampered by the Cardiff & Vale Universally Inept Planning Director.”

The great ‘Making a Difference’ Document was approved in 2010, even though it contained no detailed plans and no costings.  We were to get the immediate transfer of Rookwood Hospital facilities on a ‘swap’ basis to a site-of-equivalent-value at Llandough hospital  [  A top Civil Engineer  has stated that establishing such a like-for-like-value is impossible ]. This move was to be funded by the sale of buildings and land at Rookwood, as promised in C&V LHB Board notes and, of course, the ‘Making a Difference’ document .

 Fortunately, the Charity Commission don’t allow for charitable land to be sold at a profit – a fact unknown to the Planning Director or his staff – to be used for such purposes.  Undeterred by this minor hindrance, the C&V LHB took the bold step of moving Rookwood Radio to the bottom floor of Llandough hospital, where it remains, one year on.  Since then, no move has been finalised, even though the Planning Director had the egg surgically removed from his face, privately at Squire Hospital, as the waiting list at UHW was 6 months IF a bed was available at that time.
Scurrilous rumours have it that only one ward, of the elderly, is being moved to St David’s hospital in Canton - the hospital that was stupidly conceived under a  Private Finance Initiative that will cost at least five times the original quoted price of £16m.  Others say that the wards are having to be refurbished at Rookwood, after twenty years of deliberate neglect by NHS Wales. 

This begs the question – Will Rookwood ever be relocated ?  If so, at what cost and under whose planning ?

Parallel with this ill-conceived scheme ( that failed to be approved by the patients and/or public at the bogus consultation ) was the new build of an Adult Mental Health Hospital at Llandough that would be completed four years after the proposal had been agreed.  Unfortunately, not a stone has been laid yet, and – if the scheme does start  this year – will be completed seven years from the date it was approved and promised ( if we’re lucky ).

The question ( here ) is : - Was there ever any intention to complete either proposal, especially in view of the Finance Minister’s allocation of only £16m for the new hospital that was to include  additional facilities that were promised ‘within the community’ ?  As the bogus consultation ( conducted by the Community Health Council, being the NHS’s approved lapdogs ) promised that £80m had been ring-fenced for the mental hospital alone ( verbatim Paul Hollard & Katie Norton ), it seems reasonable to assume that the Welsh Government, NHS Wales and the Universally Inept Health Board have not been open and honest about the possibility that the promised Adult Mental Health Hospital will NEVER be built. Being that there were no detailed plans ever revealed to the public and patients, it would appear that we have all been victims of yet-another-deception by the Government and NHS Wales.  [ I make this possibility known following at least four new approved plans for a new-build Whitchurch Hospital that were not implemented. ]

Excuse my cynicism, but I had to laugh out loud when Norman Tebbitt stood up in Parliament and said that  “If Mrs T had not stopped the miners, imagine what effect that would have had on our democracy ? Obviously, the silly old fart isn’t aware that we haven’t had any semblance of Democracy in Wales since then, under a Labour Government, at that, after more than fifteen years of devolution. !   Hence, all the public consultations that ignored the opinions and concerns of the public responses, were treacherously approved by the government-funded Community Health Councils.  

 The other source of hysterical amusement was the Dear Lady, Leslie Griffiths claiming that “We don’t need public forums or patient organisations in Wales as The CHCs ARE the voice of the people.” This at least displayed her contempt for the Health and Social Care Act, and its’ statutory commitment to Public and Patient Involvement .    R.W.


Friday, 12 April 2013

The Sounds of Heads Rolling.....????

Spring Cleaning at Last, and a New Financial Year for NHS Wales !

Well, here we all are - sitting at the start of the Fiscal Year - waiting for the expected cull of the Health Boards.  Strangely, the government has stopped wailing about the failure of the Health Boards to all be within their tight budgets, despite the £82 bail-out having been consumed.  The threat of the Canteen Lady, Leslie Griffiths ( to dispense with all of the heads of the failing LHBs ) hasn't been carried out yet.

Are we to assume that all of them were within their budgets, or do we finally wake up to the fact that the threats were as empty as the spurious budget short-fall figures ?  Considering that no budget figures were ever published - either at the start of the year or during the Dear Lady's reign of terror - it's hardly surprising that the cut-throats and the harbingers of doom are left speechless.

Perhaps it's out of respect for the passing of the Iron Lady, after 23 happy years out of office ?  But then - perhaps not.  So, Ministers, Mandarins, so-called Managers and bean counters - where are the figures ????  Or are we left to believe that all these Kim Sung Un threats were as imaginary as the budget shortfall figures that were plucked from the Bonsai Tree of Knowledge that sits in the foyer of the Cardiff Bay HQ of our stumbling, bumbling government ?  And, still, the new Minister, Professor Mark Drakeford remains silent whilst his script is urgently being re-written.

Anyway, I'm still waiting for the 'new boy', Adam Cairns to divulge details of the 'Patient Centred Service' that we will all benefit from - even though most patient centres in rural and urban areas have already been closed, or are ear-marked for closure soon. Perhaps he means that all patient services will be centred at the University Hospital of Wales in Cardiff....... who knows ??  Only one thing is certain - the 'Mushroom Management' system will continue - we'll all be kept in the dark except when the door opens and more B.S. is heaped on us !    R. W.

NB For those new readers amongst you, BS stands for Business statistics, of course. ( yeah right ).

Tuesday, 9 April 2013

Doctors' leader speaks over ''substandard care and rock-bottom morale''

"Looking at how bad the Welsh NHS is, I would not want to be a patient'' - Dr Dai Samuel, Chair of the British Medical Association'sWelsh Juniour Doctor's Committee.

Dr Samuel's blistering attack on the state of the NHS in Wales comes after the 'horrific' conditions faced by doctors across the nation, who say they are only able to provide "substandard" care which is compromising patient service.  He added that unprecedented workloads and high levels of admissions had left staff morale at "rock bottom". "There's not many of us and there are only so many beds. It's not just seeing a patient with one problem, they have a complaxity of needs at a time when we have fewer doctors. You have situations where you have four doctors for 50 or 60 patients which means that staff are going to get to breaking point.  Some of the doctors that are being brought in are not of the calibre they thought they were so we are having to cover for them.  I don't know which is worse - not having enough doctors, or having doctors who are not up to it. The pressure is intense and I know that patient care is being compromised.  We are seeing a miniature Mid Staffs situation every day, this is just the tip of the iceberg.  We need more doctors and need to reopen beds, but that costs money - we regularly open beds that have been closed but why not open them all the time ? We need more beds, more doctors, and more nurses and we need to look at patients who don't need to stay there - Health and Social Care are just not integrated."

Nursing leader Tina Donnelly says, "Working conditions in the NHS means that there is absolutely no respite for staff to take stock of the service they are providing for patients.

[ As a chronically ill patient, myself, with several serious conditions that are ongoing, I am frightened to be sent into hospital for 'assessment', when I usually have to spend at least a day on a trolley, yet only one day on a ward because doctors want to discharge me before I have been seen by a specialist. They tell me that I must go back to my GP in order to get a referral to see a consultant for 'further tests and investigation'.  So, what was the point in sending me into hospital when the GP has rightly judged me seriously ill enough to warrant hospital care ?  The Health Board and NHS Wales are making a farce out of a system that has worked for years, by ignoring the GP's assessment and telling them that they must refer me ( and similarly ill patients ) to consultants outpatients instead of allowing me the inpatient care I obviously need !  They are just adding to the costs by creating more expensive re-admissions and longer waiting lists that log-jam the services even more. It is an intolerable situation where the blame is continually being shifted downwards onto the poor patient, who has no where to go to get the much-needed treatment he or she needs. RW ]

I have waited patiently for four full days before publishing this post, in order to allow some minister or politician an opportunity to explain this totally unacceptable state of affairs that they have allowed to be created in our ( supposedly ) NHS 'service'.  The First Minister, Carwyn Jones, and the Health Minister, Professor Mark Drakeford haven't uttered a single comment that might serve to reassure the public and patients that all serious deficiencies will be dealt with as a matter of urgency and no expense spared.  Why the hell NOT ?

May I hereby request the resignations of Jane Hutt, Rhodri Morgan, Brian Gibbons, Edwina Hart, Leslie Griffiths and all of their equally incompetent subordinates at the NHS and the Health Boards, who have brought about us this totally reprihensible and unacceptable position - with immediate effect ???

All comments welcome.  R. W.

Tuesday, 2 April 2013

"Tell us the same old're running out of new excuses."

  'NHS must now get patients out of bed' - Echo 2nd April

How shocking it is to think that there might be people in hospital who shouldn't need to be there. What are the ruddy GPs doing wrong, anyway ? They work on the basis that anyone ill enough to require hospital treatment, is sent there - usually for emergencies or invasive treatment for chronic illnesses. However, if you try to follow the logic of so-called 'health expert' Marcus Longley, discharging them quickly will free up beds for more sick people - brilliant.  It takes a University Professor to state this authoritatively in order to solve the problem of 'bed-blocking' ( where patients  have no where else to go to go - say, for respite care or rehabilitation after major surgery ).  Under the Chairmanship of Simon Jones, the term bed-blocking was replaced with the more accurate term of Delayed Transfers of Care.  These are usually elderly patients who are due to go into Social Care homes which the local authority is supposed to provide.  Anyone with half a brain will remember that the hospitals blamed the local authorities for not providing these essential beds, whilst the local authorities complained that they were inadequately funded. And so the arguments and complaints see-sawed into the usual blame game, or as it better known as the abdication of both authorities' Duty of Care to the long-suffering patients.

What this Marionette Longley is saying is that the patients are to blame for not healing themselves .speedily enough to be discharged quickly, in step with the governments' position that we make ourselves ill due to our lifestyle choices. For the past decade, we have had a growing number of elderly or vulnerable people requiring urgent secondary care, whilst the numbers of beds in the community - provided for by the local authorities -  are being downgraded or eliminated in order to cut costs.  Even 13 years ago, when I had heart surgery, patients were being sent home within a week, which is quite ridiculous, considering the huge trauma suffered as a result of the surgery and the amount of anaesthetics required to keep patients asleep for their five or six hour stint in the operating theatre.

Whatever your personal viewpoint, it is completely inaccurate to say that 'NHS must now get ( bed-blocking ) patients out of bed'. What is correct to say, however, is that well over 800 beds have been cut over the last decade - in defiance of all reason and common sense - in order to bring the present orchestrated crisis in the NHS about.  Imagine the horror felt by dementia patients and their relatives when they are informed that there is no longer any specialist care centres forn these terminally ill people ?  You have only to contact Margo Farbrace of the 'Keep Bryneithin Care Home for the Elderly Mentally Infirm' campaign to hear the horror stories.

This kind of mischief-making may be ok to keep Marcus Longley and his government puppeteers in lucrative employment, but it has nothing whatsoever to do with the failure to provide adequate healthcare for the people of Wales.    R. W.