By AN Other, NHS patient
In hospital once again, it seems I am at an age where trips to the hospital are more frequent than trips to the pub. This time it is my kidneys that are not playing ball, refusing to process all the toxins that have built up in the body, which is a bummer, as I was to start chemotherapy for my skin cancer this week, but that is now put on the back burner.
As you expect, the nursing staff maintain your care to an excellent degree, even if that means waking you every three hours in the night to take blood sugar or blood pressure observations or medical alarms. However, this disturbance has its negative effect on some patients, especially in the time of Covid-19.
Total isolation from families
Sleep deprivation, along with anxiety about your own well-being, is not helped by total isolation from your families. This produces a state of heightened apprehension and in some patients, it manifests itself through a desire and even attempts to go home, or the removal of drips or dressings. In this hospital it becomes an additional burden to staff who have to station an extended care nurse to stay with the patient to talk them down from their anxieties.
Nurses are suffering from deskilling, where tasks normally in the remit of a qualified nurse are now passed down to Healthcare Assistants (HCA); for example the fitting of saline drips. Tapping into a vein is a highly skilled undertaking. Believe me, with my body, finding of a blood vessel can be extremely hard. A lot of HCAs are very capable but using them where qualified nurses should be used is a tool to lower the skill mix on a ward and therefore reduce costs.
36-hour wait for hospital bed
Your introduction to hospital is usually by one of two means: either by A&E ambulance, or by walking in through a GP referral to the Medical Assessment Unit. It doesn’t matter which one is chosen for you: it’s a lottery whether or not you get a bed straight away. This time I waited for eight hours, sleeping on the consultant’s examination couch before I was allocated a bed. This is actually pretty good, because on one occasion I spent 36 hours in A&E.
Like in all hospitals, it is a common sight to see ambulances parking up outside A&E, waiting to discharge a patient. That means they can’t be on the road, upping response times and putting other citizens at risk.
Why is this the case? We are told the lack of beds is dude to ‘bed-blocking’ by the elderly infirm who have not been allocated to care homes. This is nonsense. The truth is that drastic cuts in allocated hospital beds has taken place the last twenty years. Here I am lying in a ward in a Private Finance Initiative (PFI) hospital which lost 20% of the number of beds compared to the three old hospitals it replaced. It is worse if the bed occupancy goes over 90% and the Hospital Trust has to pay a penalty for treating more patients.
Paying through the teeth for PFI
PFI also has the strange effect of having private hospitals built on adjacent land, so they can profiteer from the large-scale use of public land. Both Coventry University and Birmingham QE have private facilities which offer a small number of public beds.
We are an ungrateful bunch: we got a new hospital but apart from paying through the teeth for it, it was built in the wrong location. Instead of building it alongside a surgical unit in the centre of the city, it was decided to build it on the fringe of the city, which means for those without a car at least two bus journeys to get there.
This hospital was a Labour Government PFI, ie very costly. When we challenged its location at the planning stage, we were told a that the old surgical unit was too dilapidated, but when the university took over this ‘decrepit’ building, it was refurbished, and halls of residence were built on the land that could easily have been the new hospital.
‘improvement’ not fit for purpose
A problem with PFI is that the taxpayer pays through the nose for it, but the building still belongs to the PFI consortium and any improvements have to paid for, even if the building work is a disaster. From my hospital bed I can see a great PFI folly: the Trust request a bridge linking up the top floors of two buildings, the idea being that patient transfer from one ward would not necessitate long journey in the open weather.
The work was completed, but the Trust never specified the maximum gradient so it is not fit for purpose because it so steep it takes a team of huskies to pull me up it, although the return journey would be like one of the rides at Alton Towers.
The hospital was handed over in 2004. You would think everything would be built to last, but this is not the case. In the ward I am in, the window frame is out of alignment, resulting in a 2cm gap that lets in the cold December air. Repair this fault? No, it is too costly because PFI charges are extortion, so the nurses’ solution is to roll up some bedding to make a draught excluder.
Parking charges rip-off
PFI rips patients off. The old days, when you had a patients’ ‘day room’ with a TV is now replaced by pay-as-you-view monitor hanging over your bed. It costs £6.99 a day. Visitors are no better off: the cost of visiting a relative means excessive car parking charges. If visiting an outpatient department leads to a delay in your appointment, it can knock you parking charge to over £10. This is often portrayed as revenue for the hospital, without which services would have to be cut. But this is a load bullshit: it is solely revenue the PFI consortium shareholders.
This hospital, along with the university, trains nurses, therapists and paramedics, so half their time is spent in the classroom and the other half getting ‘hands-on experience’ which gives the Trust access to cheap labour. It is only this year that burseries have returned, but final year students must commit to over 900 hours ward time without pay.
To make things worse, travel to and from the university and the hospital was OK when there was a direct bus service, but now the bus company, seeing an easy way to make money, cut the direct service in two, so you have student nurses waiting in the cold late at night in the city centre for a bus that might not come and having to pay for the privilege.
The NHS was the proudest creation of the 1945 Labour Government with its architect, Nye Bevan eventually resigning as Health Minister over the introduction of prescription charges. Principled Labour MPs are those who defend the sick, not those who sell off bits of the NHS to the highest PFI bidder and then settle for a cushy seat on the board of these parasites when politics gets too rough for them.
December 15, 2020
