Thursday, 30 January 2014

Stop Blaming Ambulance and A&E staff !!!

"A&E handovers a 'complete mess'" ; also "Patient Safety Must be at the forefront" and "Injured driver's 40 minute wait for ambulance" [ South Wales echo 22nd and 30th January 2014]

It is utterly disgraceful that blame for patient deaths or ambulance targets being missed, should imply blame on these hardworking, valuable staff. Responsibility for these failures lies squarely on the shoulders of our incompetent government, who have systematically reduced services to well below a level where they even begin to meet public need. One of the ambulances that responded to my chest pains referral was sent from Merthyr Tydfil all the way to Penarth.  All the ambulances from this area were tied up at Llandough hospital or the University Hospital of Wales, waiting to be unloaded.  This was NOT because of any failings on the part of hospital staff but solely on the fact that there were not enough beds in which to place patients from assessment.

The facts are that neither the Ambulance Service nor the A&E staff had any say in the reduction of bed numbers, nor did they have any say about reductions in staff levels or the reductions of patient waiting areas.
The ambulance staff and the triage staff are excellent and have to work under impossible conditions where no patient can receive the proper treatment in time.  By this I mean that patients are generally turned around in Assessment ( on orders from Health Board ) or are placed in a bed overnight, then discharged without any proper examination or treatment being made available. Again, this is on the instructions of the Health Board which completely changed the way and manner in which patients who are referred by their G.P.s to hospital for urgently required treatment.

The protocol has changed dramatically in the last ten years in order to suggest that; a) Hospital referrals should not have been made, b) Those patients held up in assessment are 'stabilised' quickly and sent home. or c) Patients are given a bed overnight, then discharged the following day and told to get a referral from their G.P. to see the appropriate consultant ( 6 months wait if your lucky ).
This new system makes a complete mockery of the proper system of diagnosing the problem and giving full treatment while the patient is in the hospital. Beyond this , patients were treated holistically and not discharged until all their health problems had been identified and, if possible treated

Unfortunately ( for us ), the people managing our health service have gone completely against the purpose that the NHS was created - to treat patients as, and when, needed, within reach of their own homes. The health services should not be a target-driven, money saving service, run by incompetent politicians who have no training whatsoever to do their jobs. And, of course, it;s NEVER THEIR FAULT if ANYTHING GOES WRONG ! - it's the patients and their lifestyles or parts of the service that fail to meet their budgets and targets.    R.W.

Tuesday, 28 January 2014

Revolutionary Ideas from the B.M.A

NHS review 'should be for benefit of patients'

After decades of  misdirection of medical priorities and the totally blinkered view that cost-cutting within health services is the only basis for economic salvation, the British Medical Association makes this revolutionary statement.  Until now, the B.M.A. have been one of the myriad of sycophantic mumblers that have supported the changes to N.H.S. Wales despite serious misgivings expressed on behalf of their members - the General Practitioners.

Like most of us, they hoped that Care in the Community would become a viable reality with 'bed equivalents' being created to compensate for the massive reduction in hospital beds. Needless to say, these hollow promises have proven to be a myth, used to mask the government's priority of reducing health spending, throughout Wales by as much as a billion pounds.Now, we all find ourselves in the lost world between heaven and hell where the hell of inadequate health service provision has succeeded in dragging us away from the Shangri-La that we were led to believe would be a'Service Fit for Purpose' ( whatever the hell that was supposed to mean ).

The naivety we lived in was based on a belief that our elected government really did have our best interests at heart and, when it came to the health of its citizens, the Welsh Government would place the provision of healthcare at the pinnacle of public services, essential to our future development as individuals and as a nation.  Now, ashamed of our own complacency, we face having to make do with health services that are woefully inadequate to meet our needs.  How did we let this happen - were we sleepwalking or just too lazy to keep up with changing events ?

A few of us have been campaigning for well over a decade to stop the decimation of our health services, for the mentally ill and those of us with physical ailments requiring inpatient care at one of our many hospitals.  My friends and colleagues;  Greta Sainsbury, Max Wallis, Eifion Edwards, Margo Farbrace, Pamela Flowers, Lynnette Spragg, Francis Creemer, and a host of their friends and colleagues have devoted a part of their lives to helping the sick, the elderly and the vulnerable being able to feel confident that their health services were being maintained and even improved.  I could fill a book with the names of medical staff,at all levels, that have helped us with reports of the reality of modern healthcare, as opposed to the fantasy world, created in the minds of our incompetent government and N.H.S officials. For every good report their are a dozen horror stories of the deliberate manipulation of waiting lists, failed care and deaths of patients in hospital or at home awaiting essential surgery.

To return to the main point of this post, it is Dr Richard Lewis, Welsh Secretary of the British Medical Association crystalises the one absolute truth - that the N.H.S should be reviewed for patients rather than financial pressures.

I conclude by stating the obvious - the National health Service is an essential Public Service that is not a 'private, for profit organisation' from any Point of View. Therefore, the costs of providing adequate health care at the time and the point of need is non-negotiable and must be met by our government.   R.W.

Friday, 24 January 2014

Prudent Treachery of the worst kind

Specialist baby care will move despite protestors – Minister

Over 25,000 written replies and an unknown large number of unrevealed verbal responses – most against the proposed South Wales Programme – all following a completely sham public consultation, and The Minister for ‘Prudent’ healthcare ignores public opinion with a contempt rivalling that of  the evil Iosef Vissarianovitch STALIN.  

Even after his predecessor’s erroneous declaration that , “We don’t need to consult the public, the Community Health Councils ARE the voice of the public”, Professor Prudence decides to move  the Specialist Baby Care Unit at Withybush hospital, Haverfordwest  to Glangwilli Hospital at Carmarthen.  

The Tsunami of shock over this unnecessary relocation of an outstandingly popular and successful baby unit is larger than the horror shown over  a decade of sham public consultations that all ignored public concern.

The words of that despicable deceiver, Paul Hollard, ring hollow still – “I sincerely hope that the Health Boards take notice of, and act upon, the unprecedented level of public responses” . A completely insincere, fatuous and deliberately misleading statement, made after he was given the task of implementing the proposed changes of the South Wales Programme.

Expectant mothers, politicians, GPs and consultants have all expressed their opposition to the Minister’s decision that (supposedly) endorsed the findings of a scrutiny panel which stated that current care facilities across all health board hospitals was “Neither safe nor sustainable”.

 What an irrational conclusion !     What was it based on, for pity’s sake ?-  reading tea leaves ? or the well-greased palms of Prudence’s sycophantic colleagues ?  What ruddy Scrutiny Panel are they supposedly quoting ?  Who made up this panel ? Where is their report, showing  the evidence of  their  findings that prove that  ‘all care facilities……….. were neither safe or sustainable’  ????

Let’s face it, IF this conclusion was even remotely justified I fact, where was the day-to-day management of these services ?  All this proves is the gross incompetence of management within the NHS and our government, and this is demonstrably indisputable. 

All we are waiting for now is for Prudence Drakeford to confirm that all the changes proposed in the South Wales Programme will be implemented with no less a contempt for public  opinion !       R. W.

Friday, 17 January 2014

'Prudent' Healthcare the new buzzword

'NHS has no choice but to change'

Not content with creating a whole series of meaningless insincere phrase that say nothing, the dear Minister has now created one more in order to keep us on our toes - Prudent Healthcare.

Prudent : "Acting with or showing care and thought for the future"  

Well....... that's what the Oxford Dictionary gives as a definition - but - do YOU recognise anything resembling this in The South Wales Programme ?  Nope ? - neither did I.  All I saw were pages of bland rhetoric that gave absolutely NO detail as to what the programme was.  Maybe this is what the Minister wants us to believe is his aim ( now that all the closures of hospitals and beds, rationalisations, centralisations of services, reduction of services. Of course , none of these changes were at all helpful and, in fact made the services fewer and more inaccessible.

The latest article in the Echo says that only 1 in 5 people in Wales believe that the changes will work, which I thought was rather high, as nobody I've spoken to sees anything other than the continued destruction of the NHS in Wales. The most cruel part of this so-called programme is the pre-meditated deception of the populace in making them believe that the public consultation would be meaningful.  With 25,000+ responses having been received, the vast majority of written responses were against the changes and the Minister's flunky, Paul Hollard failed to give any of the verbal responses or any resolutions from the so-called public consultation meetings.  The depth of his deception is such a disgrace, I really do not understand how the man can look anyone in the face.  Having failed as a Planning Director, he was given the job of implementing all of the programme of changes before the sham consultation had even begun. He made such a huge mess of planning the Llandough hospital site additions hat he should have been sacked.  Directors like him are the lowest of the low in professional standing, being only kept on as loyal henchmen to their paymasters.

Before I continue, has anything above shown you that Prudent Drakeford or NHS Wales 's fulfilling the definition of prudent i.e. Acting with or showing  care and thought for the future ??? I didn't think so.

What is actually happening is that the Welsh Government are trying to transform the Minister into a sympathetic believable chap almost as though they were creating the next Dr Who out of a cloud of smoke and a flash of light Hence the appearance of Prudence Drakeford - Professor Prudence to his colleagues and just 'Pru' to his friends.

Unfortunately, this cruel deception has manifested itself with 2 people dying already with ambulances being held up for as long as 4hrs outside A&E departments, where the delays are due to short staffing or a lack of beds.  This is hardly surprising after over 1000 beds have been closed in the last 13 years and many hospitals and local health services have been closed. Add to this the incredibly daft reduction of A&E units - only 4  ( 5 when Cwmbran hospital has been built - 4 years) then you can immediately see that these few A&E units cannot possibly cope with existing demands, let alone future demands.

Therefore, regardless who the government tries to blame for these problems the cause is always their fault for implementing such a massive reduction in services - in the first place - for saving money at the expense of adequate healthcare resources.  Consequently public and patients are being made to suffer, deliberately, because the government refuses to fulfill its' constitutional obligation to provide adequate healthcare services, wherever and whenever they are needed. Bearing in mind the fact that 152 cardiac patients have died over two years, whilst on the surgical waiting list, the latest cuts will only make the situation worse i.e. the death rate among patients awaiting treatment must increase due to inaction of the NHS/government.

In conclusion, the government has to provide adequate healthcare services to its'citizens, regardless of cost. In my own opinion, the fault lies in incompetent management throughout the NHS structure and our ineffective government. Get rid of this layer of incompetent managers and petty money-grabbing bureaucrats and allow the people qualified to manage such important services, to come in and restructure this failing services.  Until this is done, patient care and patient safety will never ever improve under the current structure and ridiculous changes, currently underway.   R.  W.

Thursday, 16 January 2014

Renegotiate GP Contract = New Contract - Right ?

Welsh GPs Shrinking Share of NHS Budget

Graham Henry of Western Mail fame reports ( January 23th 2014 ) that the GP's share of the NHS budget has dropped from 10.27% in 2005/6 to 7.87% in 2012/3.  Conservative A.M. Mohammad Asghar called for the Minister to take "urgent action", and the General Practitioners Commission said that they were "deeply concerned" over the figures.  Dr Charllotte Jones, Chair, said that these reductions had taken place against a background of "increased complexity and demand for work".
Incredibly she went on to say that this had included "significant amounts of work being moved from secondary to primary care". [ SAY WHAT ? ]

My last post quoted the Minister saying that the GP contract was "going to be renegotiated".  Well then, how the blazes did the old contract have all this extra work added, without a corresponding increase in GP's funding ?  There appears to be a heck of difference between 'renegotiation' and changing an agreed contract without the corresponding contractual agreement having been made.

So, I ask - Why did the GP's and their General Practitioners Committee, allow these changes to become a fait accompli ? and, Where is the evidence of any renegotiation having been agreed, in the form of a new contract. ?

Now I and Magpie have nothing but admiration for the GP's, although we both feel that the last contract paid the GP's a whopping rise that was excessive ( to put it mildly ).  However, that was what was agreed, in the form of a legally binding contract.  In light of this, it's hard to believe that these GP's and their General Practitioners Committee were dull enough to accept changes to the contract without a new one being agreed.  So.....wha hoppend ?  Is this what the Minister calls 'renegotiation', or is he now saying that the result of all the extra work being moved from Secondary to Primary care has already been agreed ?  If so, where are the additional resources and where is the new contract ?????

In my opinion, the Minister appears to be rewriting history in the manner that has become the typical action of our Welsh government.  I do not consider this to be equitable in any way - do you ?    R.  W.

Thursday, 9 January 2014

Minister to Re-negotiate the G.P. Contract

"This will give doctors more time for doctors to spend with their patients"

Minister Drakeford provided BBC Radio with his ( vague ) intentions of agreeing a new contract with our G.P.s.  I was asked to comment by Oliver Hyde as to what we wanted from our GP ( ? ).
Having listened to the Minister - as far as was possible - he stated that the main objective of this work-in-progress was to keep people out of hospital beds and especially from cluttering up AandE departments with their frivolous requests for healthcare.  He also meandered on about; nurse practitioners instead of doctors being a positive step forward, whilst establishing a relationship between the patient and the practice, as opposed to depending on seeing the same doctor.

He then rambled on about practices working in clusters so that patients might not only be unable to see a doctor of their choice but may be required to see an unknown doctor from another practice. It was agreed that, perhaps, a phone-call from the doctor to the patient would help determine the seriousness of the ailment, necessitating the request to be seen by a doctor.

[ I pause here to explain (In layman's terms ) that the GPs already have a contract that was agreed with them four years ago by the incompetent Local Health Boards, who paid them lots more money for less work ( eg no Out of Hours, no minor injuries, and only four days a week). Now, it seems that our government - in the form of Prof. Drakeford - want the GPs to do more work for the same money ( or less ), that might have them opening from 8.00am until 8.00pm, seven days a week.  Of course, the GPs have their contract already, so why would they want to agree to re-negotiate this when they aren't told the extent to which they will be worked ? Legally, the Gps could tell the minister to "get stuffed", unless any new contract is specifically detailed in advance and that they will get more money ( if and when they are dull enough to agree new terms ). ]

To me, there seems to be a boat-load of trust required by the GPs to enable them to formally agree ANYTHING with the minister, especially in the absence of any detail. Let's look at their point of view - Would you buy a used car from Mark Drakeford ?  No? - well how can we expect our hard working GPs to agree anything with a man with a history of unfulfilled promises ?

The minister continued his declarations in fluent Klingon, saying that he is deducting 300 points from the GPs target, but didn't explain what they were.  He assured us that this act would 'in one  Fell Swoop allow the doctor more patient time instead of imposing the maximum 10 minute appointment length.  Some requirements from N.I.C.E ( National Institute of Clinical Excellence ) were not deemed to be necessary, which should add even more free time for the doctor to be with his/her patient.

It was pointed out that the surgeries were limited on diagnostic equipment  X-Ray, Scanners etc.. but no response was given to this important point.

In conclusion, my opinion is that the Minister would be seeking an open-ended contract that would enable him and/or the government to make more changes by further revision to the contract.  So, I feel that this newly negotiated contract will not be worth the papyrus it would be written upon. I'd go so far as to say that this continues the Minister's stupid plans and demonstrates that his word isn't worth trusting, even for a second ! R.W.

Wednesday, 8 January 2014

If You are able to go to A&E, You Don't Need It !

Emergency Patients ONLY for Busy A&E

Following the closures of many A&E departments, there will only be a maximum of five remaining to cover the whole of Wales.  As a result anyone needing A&E as before will now find it extremely difficult to access emergency treatment.  Even if they manage to complete the pilgrimage to Cardiff & Vale University Hospital for Wales, you are highly likely to be redirected to a 'Minor Injuries' unit, miles away from the capital.

As yet, we haven't had any clear definition of what constitutes a 'minor injury', but, the definition of an emergency has been partly explained as : severe chest pains, a stroke, breathing difficulties or major trauma ( eg.seriously burned, major traffic accident, major haemorrhage, falling from a great height, being hit by a lightning bolt, or caught in a meteorite shower ). Of course, being brutally stabbed, mugged or shot will also be included in this category but - as with all trauma cases - treatment will only be available to survivors of the long ambulance journey.  In future, the word 'avoidable' will not be used to describe deaths 'in transit'.

Potential candidates for emergency treatment should not forget the Revolving Door Protocol ( see earlier post ) which should save unnecessary journeys, resulting in being denied access to A&E treatment. Another important fact is that people who imagine they are ill or seem to suffer broken limbs, could ( and should ) take their problem to their local GP or the Out of Ours service - providing that you telephone within a certain time, and are prepared to wait up to four weeks for an appointment.  The Out of Hours rules are somewhat different, being that, if you aren't bed-ridden you must travel the 15 or so miles to their base to wait in a queue to see a doctor.  If you are bed-ridden, Out of Hours staff say that if they send a doctor to you, you will be sent to hospital so you might just as well dial 999 in the first instance.

I sincerely hope that these explanations have given you a degree of comfort and that - if you are foolish enough to become ill ( mostly self-inflicted ), stay away from hospital A&E hospital departments, take two Aspirin, and then call me in the morning !     R.  W.

Tuesday, 7 January 2014

Sickness Matters - to patients and staff alike

'People Must take Control over their own Wellbeing'

Just a week into the New Year and the Minister has begun reciting from the annual litany of unnecessary sayings.  Here, he asks us to consider taking control of our own health and wellbeing.

After listing the 'usual suspects'; drinkers, smokers, eaters, fatsos, and those silly people who expect the health service to help them stay healthy, Minister Drakeford reminds us of "the bargain struck between the public and the health service".  I don't know about anyone else, but I don't remember making such a bargain: perhaps he's starting to rewrite history again ?  He seems to have forgotten that NHS Wales has lost over 800 beds, closed hospitals, lost doctors and nurses, as a direct result of pre-meditated cost-cutting that has resulted in our health service now being half the size it was yet expected to provide health care for nearly double the population - legal and illegal.

With regard to the spurious figures, he fails to mention who carried out the survey, how many people were surveyed and whether or not these were representative of the entire population of the Principality.  Still, as politicians and journalists always say "Never let the truth get in the way of a good story."

Of particular interest in the next days' press, were the articles entitled 'NHS Sickness Concern', which bemoaned the absentee rate of hospital staff due to mental health conditions such as anxiety, stress and depression.  It seems that, in the real world ( beyond Cathays Park and Cardiff Bay ), that matters on the hospital front are not as we have been led to believe.  Staff are being so overworked that 2,224 incidents of staff being absent for more than a week due to illness as a direct result of work-related pressures - in ONE year alone !  How then is the NHS "well prepared for the winter surge" as claimed by health service leaders.

Of course, a Welsh Government spokeswoman was quick to state that "Measures were in place to help staff and manage their sickness".  Well all I can say is "Why aren't they working ?", and "How in blazes do you expect to manage sickness in communities, if you can't even cope with your own internal problem ?"

We have other workers in Wales subject to huge pressures and even unemployed families suffering from anxiety, stress and depression as a direct result of the government's stringent austerity measures.  In addition - also according to our press - food prices have risen by at least 20%, along with fuel and other utility bills. and, not forgetting Value Added Tax and all public services. What measures have the government put in place to protect the general public from price rises - especially amongst the avaricious retailers ?

As usual, our government wants the Penny and the Bun - cut back on health expenditure and services, whilst expecting US to accept blame for their mismanagement !   R.  W.

Sunday, 5 January 2014

Targets that Matter - Where are they ?

"NHS Needs key targets that matter to Patients" - Minister Drakeford

That's it - January 1st 2014, and the Ministers is out of the blocks !

  Professor Drakeford is planning on changing  reviewing all the existing NHS targets in order to make them more meaningful to we stupid patients ( who fail to see the massive improvements being made to our services whilst the hospital waiting time for 4000+ of us have extended again to over nine months ) who don't seem to understand that all the cutbacks, rationalisations, centralisations, closures that are being made to our services are changes that are essential to provide us with a better health service ( but these cynics probably don't believe in Santa Clause or the Easter Bunny ! ).

As usual, the old mystic manages to fill two pages of the Echo without saying how any of these targets are to be changed, or whether they'll actually mean anything to either patients or clinicians alike. His photograph makes him look like a man gazing over his allotment and thinking "How the blazes can I keep these pesky patien birds away from my vegetable patch ?"  Being two of these pesky birds, Magpie and Robin answer "Impossible, you silly old goat".

So, in short, ( and as-per-ruddy-usual ) no one knows what these changes will be - except the Assembly critics who accused the Minister of scrapping the targets and that the move was an admission of failure to meet the targets.  Unfortunately, the critics are correct, as there isn't a single target ( budget or operational ) that has been met, since their inception.  So, the deception continues to limp on, with failures all around us, and not a spare bed to be found anywhere !

Good News !  Yes, this really is - the new mental health hospital at Llandough has been started, as evidenced by a mountain of gravel having been fenced in on the proposed site. So, optimism all around, with the desk porter assuring me that the new hospital is due to open in TWO years - yes, you heard it first here first- only TWO YEARS ! And that's not all - Ward 6 of Rookwood hospital has been moved to ward 2 at Llandough, with all these beds being lost for future general use. Another ward has been re-sited at St David's hospital, Riverside, and all wards are to be moved this year. We are still awaiting news of the fate of the old Rookwood site, assuming the stumbling blocks placed by the Charity Commission and the Cardiff County Council are not allowed to further impede Mr Hollard ( newly made Director of car parks, toilets and sluice rooms ).

How nice it is to be able to end on a good note, eh ?        R. W.