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We're delighted to be linking with the Townswomen's Guilds for a live webchat with Paul Burstow, Minister of State for Care Services, on 1 March 12.30-1.30pm. Paul is the Minister in the Department of Health with responsibility for carers, adult social care and safeguarding elderly patients.
The Townswomen's Guilds are running a campaign, Hear My Voice, which reflects many of the themes of our ageism in hospital threads, so it's great that we have an opportunity to put the questions that are bothering us jointly to the man who could really make a difference.
Find out more about Paul Burstow, the Townswomen's Guilds and Hear My Voice.
Hello Mr Burstow. What's your explanation for almost every single relevant professional body being opposed to the Health and Social Care Bill? If this government believes that GPs are best placed to make decisions about healthcare, why doesn't it listen to GPs when they tell the government that the bill should be scrapped?
Do you think the Lib Dems have genuinely managed to improve the NHS bill? Sometimes I worry you're making concerned noises but not improving what seems like a pretty unpopular piece of government work. Thank you
Stephen Dorrell has said that the changes suggested in the letter from Nick Clegg and Shirley Williams designed to allow the Health Bill to pass aren't at all radical but are ideas that have been kicking around for a long time.
Is this embarrassing?
Do you expect that in 10 years' time most people will be taking out some form of health insurance?
I wanted to follow up hopefulgran's question above - Number 10 has said there will be no more changes to the Health Bill following Nick Clegg's letter.
Nick Clegg must have known that - presumably he does talk to Cameron? So is it just an attempt to fob off LibDem opponents of the Bill by showing "we tried"?
Are you arguing inside government for adoption of the Dilnot proposals, which would save people from having to sell their houses and spend everything they have if they need care?
Do you think social care should be integrated with health services? When money is taken from care (by hard-pressed local authorities - it's not ring-fenced, of course) the NHS has to pick up the pieces anyway.
Wouldn't it be better to have a more integrated, strategic approach?
Hello Paul, thank you for coming onto Gransnet. My question is: Is it your aim to bring in a national care system, as recommended by the Law Commission, to end the postcode lottery in care?
Your own party chairman has said that the Health Bill should be dropped. Is this the most precarious moment yet for the coalition?
Any word on who we might expect to replace this talented lady at the highest levels of public sector expertise in looking after the interests of our vulnerable elders?:
blogs.telegraph.co.uk/news/judithpotts/100139462/the-left-attacks-greedy-bankers-non-stop-why-does-cynthia-bower-of-the-care-quality-commission-get-let-off-the-hook/
Especially in an environment of market rate talent, where rewards for failure are no longer as embraced as before, of course.
There are, certainly, other questions posed that may make what has happened vs. what should more explicable, if not excusable. Less comfortable to others at high and indeed higher levels yet.
Oddly, I have notes telling me to 'back off' from two other Ombudswomen that seem awfully in complement, and protective of 'the system' of which Ms. Bower is... was but a part.
Who judges the judges indeed?
Where is the democratic mandate for the health bill. It wasn't in either yours or the Tories' manifesto, wasn't in the coalition agreement, is opposed by the 160,000 people who signed a petition against it. Who are you representing when you push for it to be introduced (from what I can see not the professionals)?
To your knowledge, are there any members of the Cabinet who are dependent on the care system for their relatives?
And what solutions have they found?
Thanks
Nursing older patients - now the mainstream activity in our nursing services - is a skilled and complicated job, because many older patients present with multiple conditions and needs. In this context, has it not proved a mistake to see so many health care assistants employed, with little of the required training and awareness?
A elderly relative of mine is currently in hospital at the moment. He has been in 3 different wards since entering hospital. The care that he has received in these different wards has been phenomenally different, to the point at which we have formally told the nurses in his current, good ward that moving him back to another one will be a death sentence. The differences are eg. nurses ignoring him when he asks questions, his requests for help etc.
Why and how do you think these differences arise in ward care? Is there anything to be done to make sure that all wards are AT THE VERY LEAST at the standard at which they are not making their patients worse off than when they started?
What are you personally doing to ensure that people of your age won't suffer the terrible care today's elderly are suffering?
<sorry for the many questions...>
Seconding the question about the flippin' car park charges!
People don't ask for their family to go into hospital - please don't penalise them for looking after their families (and god knows what would have happened to my dear mum if I hadn't been in there bending the ear of the nurses and doctors every day). Seeing as you NEED family to provide pastoral care that busy nurses don't have time for, it would be great not to charge us a three quid for 20 minutes in the car park!
Oh, I forgot, there is a weekly pass, available on reception. Which is only open 10-3. on weekdays. excluding lunch hours.
Exasperated...
No real doubting changes are required.
Just to put any new and future proposals in frame, please simply confirm whether there will be in complement tangible, personal accountability on the part of any person or entity who transgresses beyond an acceptable (unleashing a Pandora's Box of get-outs there, I concede) level of elder care in application or presides over it in oversight.
Or will we be simply continue to be patronised by powerless politicians and too powerful representative bodies unable to see beyond all or nothing solidarity approaches, hence seeing our nearest and dearest still offered no more than empty rhetoric and platitudes as what is unacceptable get accepted over and over?
Why, in the area of care, is it necessary to have so many overlapping, yet competing bodies doing roughly the same thing, yet only serves to create opportunities for cracks to appear through which the vulnerable can fall? And, worse, seems actively-designed to enable a 'not me, gov' environment where, if push comes to shove no one is responsible because all can say it was everyone else?
I realise that last is rhetorical.
Why is it the default presumption of 'the system' that, if a vulnerable elder has in excess of £23k in assets, and next of kin near and willing to be part of their twilight year journey, the entire family can be essentially cut loose from any sensible, experienced support, or advice in favour of those less well funded or supported by family?
Might it not make sense to grasp that few in the public know up front much about the NHS' labyrinthine systems and protocols, or many care issues, but might serve to ease the burden upon the NHS if keen and willing to play a part in their elder relative's care, if simply given proper guidance?
Chemical coshes... views?
If necessary, what checks and balances needed to apply?
The view of a possibly less than objective care home alone, or more?
GP? DMHoP expert? Next of kin. 2cnd opinions? What?
And if applied, what responsibilities for monitoring should be expected of those complicit in signing off on it? None? Just leave it to the care home?
Care homes and GP oversight.
Who is the patient's advocate? What should be happening to represent those often no longer able to make decisions on the own behalf?
How should concerned next of kin be involved, by whom, and hen?
Oh, and in the case of homes owned by doctors, is it a possible conflict of interest if they are also senior partners of the surgery that oversees the care plan being operated?
Sometimes the interests of the patient may not be in the best fiscal interest of the home managers.
A quick note to say the chat will be starting very slightly later than 12.30 - but will be beginning shortly
We're delighted that Paul Burstow has now joined us and we're ready to go. He's got lots he wants to say, so here goes....
Do you think that the many reports concerning poor care of the elderly reflect a wider problem in society to do with our attitudes towards the old and infirm?
(Townswomen's Guilds member and supporter of the Hear My Voice campaign)
JessM
Paul - it is an incredibly common experience for older people in hospital to ring their bell and ask for help to go to the toilet and be fobbed off repeatedly. I have seen this with my own eyes and my mother in law, who has been in hospital a few times recently has just confirmed how common it is. Once I found her shaking with pain because she had been forgotten after a request and her call button left out of reach.
There seems to be little priority put on this for some mysterious reason. Also it is so much easier to pop someone onto a commode next to the bed than take five minutes helping them to walk to the toilet. If you do this for a few days an elderly disabled person quickly gets "off their legs" - unable to walk at all. If you point this out the nurses say they will refer to physiotherapy, a if it is not their problem or concern.
Then the patients have to be admitted to a rehab ward for specialist physio to try to get their independence back. Result: more expense to the NHS. They would not "block beds" if they could get themselves to the loo.
I guess my diagnosis of the problem is that those in charge of wards do not adequately manage their nursing assistants and make it clear to them that help in this area is a very high priority. My mother in law used to be a ward sister in a London teaching hospital in the 1950s and she agrees that she would never have allowed such a thing to happen on her ward!
Have you got any suggestions as to how this basic but vital issue can be addressed?
Hello, it's good to be taking part in this webchat, I've had a good read through the whole thread and hope to pick up as many of the points you've made as I can, even if I don't answer every individual question.
I can start by answering JessM, who I notice has posted a couple of times in this thread. You make a really powerful point, which is echoed in a number of other postings. I've been an MP since 1997 and care and dignity for older people has been the thing I have talked about and campaigned on in parliament all of that time, so I feel very strongly when I see the audits, the investigations, the reviews and just yesterday the Commission on Dignity report repeating things that should be common sense, and should be commonplace in our NHS and care services. It really isn't good enough, ever, for someone to be left lying in a bed unattended to, not helped to go to the toilet, not treated as a human being.
For me, as a minister, I'm clear that the answer to the problems that have been so well-documented for so long is not going to be a ministerial edict. There isn't a switch that I can flick that will suddenly turn compassion on where it doesn't exist.
What heartened me about the Commission's report yesterday was that its recommendations were practical and addressed to the medical profession, to the regulators, to the educators and to the organisations that provide care and health. All of them along with the Government must work together now to take forward the actions described in that report.
And one thing I feel particularly strongly about is that we need to ban age discrimination in our health and care system. One of my first acts as a minister was to agree that there should be no exemptions for the NHS from the age discrimination duties. No if buts or maybes.
Why do wards for older people have fewer registered nurses on them (1:9 against 1:6) than adult surgical and general wards? Is this right?
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