In My View: Caring at Home
One of the roles I have, as a Hampshire County Councillor, is a seat on the Health Overview & Scrutiny Committee. As the rather grand title suggests, we meet and examine different aspects of health, particularly NHS service delivery in different parts of the county.
Over the many hours spent listening to the various health experts that are called before the committee, I have noticed that certain themes repeat themselves time and time again. One of these is a move towards closing hospital wards or removing beds, in favour of providing more care in the community.
In areas like Adult Mental Health or End Of Life Care, the received wisdom is that people prefer to be treated at home. Given a choice, most people prefer to be at home than in a hospital, so there are all sorts of intiatives called “Hospital at Home” or “Virtual Wards”. The basic idea is that health professionals will visit the home and provide an appropriate level of care for as long as is necessary.
Time and time again, the various NHS bosses say that the new ways of working are not about saving money but are about providing what people want. I’m afraid that I am very sceptical about such claims.
Firstly, I am old enough to remember the Thatcher years when Care in the Community was anything but. Hospitals were closed and former patients were left in the community, with little or no support, usually ending up sleeping on park benches or shop doorways. It was a national disgrace that so many vulnerable people were effectively abandoned in this way.
Secondly, the new initiatives are certainly being driven by the need to cut costs, not to deliver greater choice. If patients are to be given choice, the new arrangements would not be accompanied by early and non reversable ward closures and withdrawal of hospital beds. To ratchet up the pressure, health bosses often say that unless this or that ward is closed, we won’t get investment to do something else. They even dismiss any notion of waiting to see if caring for people in their homes is safe and effective before implementing the cuts.
Thirdly, in all these discussions, the most under-represented people and those that matter almost as much as the patients are the carers. Almost everytime somebody is sent home to die, or for their mental health problems to be treated, there is a very great burden placed on the shoulders of other family members. Often, it is a very elderly lady or gentleman. Even if they get a gold standard service of four visits a day (very rare), they are there doing the caring work, day and night.
A caring society should make sure that the carers within it are looked after. I’m going to put the needs of these people before the needs of health bosses who are under pressure to cut costs.