The stories as related by Linda Goss on Dartmouth Healthcare Action Group's facebook page are horrendous and appalling, and listening to them made one’s blood run cold. However all of these stories began with the patient’s discharge from Torbay. Perhaps in the first place the Dartmouth Area Healthcare Action Group - which seems to be holding a lot of meetings with the Torbay management and getting on with them very well - should be tackllng the Torbay management about the protocols in place for the hospital to follow (i.e. Intermediate care teams already in place before discharging patients), especially the very old. And of course it is quite likely, as I have heard in other cases, to surmise that Linda Goss’s mother might have been asked if there was anyone at home to care for her and she might have replied ‘Yes, my daughter’ - as one would in the circumstances so the discharge team was acting on that information. It seems to me that Torbay needs to beef up its procedures.
The difficulty, which was well brought out in the whole of Dartmouth Healthcare Action Group video, is that this is not just a Dartmouth problem, it is a national problem. The problem is that there are not enough nurses and there is not enough funding to provide, say 4 beds - meaning how many - nursing staff, to hang about and wait for patients, which is why the Riverview solution would have been such a brilliant result. And of course, Linda did relate horror stories but without balance, to show how many people had been successfully supported in their homes with Intermediate Care during the same period, either on returning from hospital or to help them stay out of hospital, and nor, with the exception of Linda Goss’s mother, was there any idea given of how recently the cases cited had taken place. This latter is relevant as I believe the Intermediate Care package has been being introduced during this year; certainly during the St Saviour’s meeting there was a statement about when the IC package would be fully in place, which it obviously wasn’tat that time.
Just think for a moment of the increases and improvements in medical care which the NHS is called upon to provide since its inception in 1948, all of which create enormous financial demands: for example in 1948 a baby was classed as ‘premature’ if it weighed less than 5 1/2 pounds, prem. care was generally pretty basic (wrap the baby in thermogene and keep it warm); now a tiny baby which would have died in 1948 can be kept in intensive care and fed by tube for months to bring it up to a reasonable weight before going home. Abortion was not provided on the NHS, there was no IVF, no AIDS; cancer treatments were rudimentary, replacement of organs was not the norm, techniques and technology used in cataract surgery completely revolutionized, the list goes on and on. Equipment such as scanners had not been invented, there are now many more drugs available for cancer and other treatments, equipment has become more and more specialised and expensive, operations are far more complicated and use far more expensive materials such as titanium for spine ops or for rebuilding damaged limbs; there are now transplants, and operations involve far more staff for far longer as more and more techniques have become possible, hands sewn back on - micro surgery, brain surgery - the list (and cost) is endless. Add to this an enlarging and ageing population as well as a change in our culture in that we are more transient and so families less willing or to help look after their elderly relations - so is it any wonder that the NHS is creaking and has to change the way it delivers its care? And also remember that currently the real risk of infection in hospitals because antibiotics are less efficient is another reason to try to get people out of hospital quickly.
It should also be remembered that the remit of the Health Service is to heal people who are sick in any way, but this does not mean providing care homes for the elderly, though I absolutely take the point that it would be lovely for Dartmouth to have a few NHS convalescent beds! I wonder what we would have to give up to achieve it? The difficulty is that everyone in this working on this problem has to balance the needs of the whole community against the needs of the few. From
that point of view it would be absolutely terrific of the D.A. Healthcare Action Group achieved what would be a truly wonderful result, of ensuring that the monies from the sale of the hospital site would be reserved for the Wellbeing Centre at the top of the town which would be of much easier access for more patients. I have not seen the plans, but for all the wonderful idea of underground parking under the 'rebuilt hospital’ in the centre of Dartmouth, has a tally been made of the number of people who would actually be working in the Wellbeing Centre, and therefore also the likelihood of the number of patients at any one time (with an overlap as people come for consultations before the previous patients leave)? I cannot imagine that anything like enough spaces could be created, especially as very soon with the number of holiday homes in the town increasing (so fewer full time residents) while housing at the top of the town growing, as well as in outlying villages, the majority of the Dartmouth surgery patients will not be living in the St. Petrox and Hardnesse areas.