I must apologise for the duplication of some parts of the beginning of my blog last week. Although I obviously think that my words of wisdom are worth repeating, even I would not go as far as to suggest that they are worth repeating verbatim in the same paragraph. I will try to do better in future.
I read that the government has warned local authorities that funding will be cut if councils do not hit targets to free up beds in hospitals. I have always been dubious about the principle of fining public bodies if they fail to meet targets.
Farewell, The Party Shop; you will be missed. Good luck, Lawrence, wherever life’s journey may now take you, and let us hope that the empty space you have now vacated will soon be filled by an emporium bringing us as much joy as you once did.
I travelled to Cornwall last week, along the A39, the Atlantic Highway, and, if it weren’t for the signs along the road, I defy anyone to tell where Devon ends and Cornwall begins. Of course, further south, there is the Tamar, and the border becomes obvious. Moreover, the Cornish have made a big thing of their unique culture and have turned this into a selling point for tourism – good for them. However, I can't help wondering whether much of North Cornwall and North Devon have more in common with each other than either has with the south of its respective county.
I haven’t said anything about the NHS or our hospitals recently, but, unfortunately, this doesn’t mean that the problem has gone away. A report I read recently brought the problem back to mind. Apparently, the Care Quality Commission has recommended that the Royal Cornwall Hospitals NHS Trust should be placed in special measures as a result of a failure of services in several departments. The inspectors said that people had probably died as a result of delays in cardiology, had gone blind when they might have retained their sight as a result of delays in ophthalmology, and had suffered harm as a result of delays in treatment for sepsis and because of cancelled operations, including some for cancer. Then there's the 150 heart monitoring tapes that have not been reviewed although some of them date back to March – this is something that should be done almost immediately.
The medical issues are not the only problems. There are also building maintenance issues that have health implications and which have been left, literally, for years unattended.
No one can be happy about this. Obviously patients who are waiting for treatment now have the added worry of not knowing whether their treatment has been or will be delayed to the extent that they will suffer harm, but also the workers at the Cornish hospitals must feel terrible. I have heard of health workers in other parts of the country going home in tears knowing that they have failed their patients, and I cannot believe that those in Cornwall are any less compassionate.
At the moment, there is no official explanation for these problems, but, to me, they show all the hallmarks of an organisation which is struggling to meet demand in great excess of its capacity.
So far, most of the reports coming out of Barnstaple Hospital (the North Devon District Hospital) have been pretty positive. However, it would not do to get too complacent. For one thing, if patients who would normally be treated in Cornwall are instead treated in one of the Devon hospitals, this could export Cornwall’s problems to us. For another, if our funding is cut, which seems increasingly probable, we could find ourselves in the same position in a matter of months!
There is a report in BMJ Journal of Epidemiology and Community Health on 2 September 2017 which everyone should read. The report concludes that “The increased prevalence of patients being delayed in discharge from hospital [“bed-blocking”] in 2015 was associated with increases in mortality, accounting for up to a fifth of mortality increases. Our study provides evidence that a lower quality of performance of the NHS and adult social care as a result of austerity may be having an adverse impact on population health”.
It goes on “The period July 2014 to June 2015 saw an additional 39 074 deaths in England and Wales compared with the same period the previous year. While mortality rates fluctuate year-on-year, this was the largest rise for nearly 50 years and the higher rate of mortality has been maintained throughout 2016 and into 2017. These recent trends contrast with the long-term decline in age-specific mortality rates throughout the 20th and 21stcenturies. The majority of these additional deaths were in frail elderly individuals.
“The increase in mortality rates has occurred during a crisis in the National Health Service (NHS). The number of NHS trusts with budget deficits has increased sharply since 2014/2015, as did waiting periods for elective surgery in 2015. Issues within the NHS are being compounded by problems with the provision of adult social care to support individuals leaving NHS care and pressures of increased demand.”
The authors of this article work for several prestigious universities and the article has been peer-reviewed. It should, therefore, be taken seriously. In view of its conclusions, does the policy of aggressive bed closures currently practiced by the NHS make sense?
Finally, please remember Marcus Hutchins, still stuck in America.
If you can afford to, please contribute to the costs of his defence at https://www.crowdjustice.com/case/malwaretech/. In any case, let him know that he has not been forgotten.
The very first column I wrote for the North Devon Journal was almost three years ago – doesn’t time fly when you're having fun! In it I reported that Pearl and her family, who used to run the Muddiford Inn, had called it a day. I went on to say “It's not altogether surprising that Pearl, the proprietor, has decided to call it a day. It seems almost every year, the road past the Inn has been closed for road works. One year, during a 12 week closure, I'm told the Inn had just 4 customers. No business can continue like that. Even if the rest of the year's business is enough to cover the lost trade, the heart ache of sitting around for weeks on end waiting for customers who never come must be devastating.”.