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Welcome to my blog. If you live in Surrey and birding is your obsession (to get out of bed at some ridiculously early time of the morning, no matter what the weather, to go and look at birds isn't normal behaviour, believe me) and you're still a bit of a novice (like me) then, hopefully, this blog is for you.



Monday 9 June 2014

LOST MOJO AND THE NHS – IS IT REALLY WORTH IT?

Anyone interested in reading about birding, I'm afraid this post is not for you. There are few birds mentioned in this post... apart from the Bonaparte's Gull at Staines Reservoir I dipped a week ago on Sunday.

If I had been single with no responsibilities and few potential repercussions for changing plans/missing dinner at the last minute on a Friday night after work I would have seen it without a problem. A tap in. But unfortunately for me, real life got in the way and waiting until 8am two days later wasn't the perfect recipe for twitching success.

It's not that I haven't seen a Bonaparte's before. The Eastbourne bird was amazingly good value last year, but seeing one on Staines Reservoir would have been great and it would have been my 200th all-time Surrey bird species – a brilliant way to mark the event. But, it didn't happen.

From a birding perspective 2014 has been very, very disappointing apart from a handful of highlights. My birding has been sporadic and, on the whole, unproductive. I've pretty much lost any enthusiasm to venture out. Even an evening visit to Crooksbury Common to see a Nightjar or two feels more like a chore at the moment. I really can't be bothered to make the effort. My mojo has evaporated.

For that I blame the NHS.

One thing I've discovered recently is that, from my tainted outlook of the future, the NHS is irreversibly flawed. You only understand this properly when someone really close to you is in trouble and needs the NHS to come to the rescue, and pretty much let's them down.

The other very scary discovery is how inadequately prepared we are as a nation to deal with a growing elderly population. It is alarmingly scary.

My dad is 87 years old. Incredibly fit and active for his age, he worked on the land as a farm worker as a young lad of 14 until in his 50s when it finally dawned on him he wasn't going to make any money working on a farm. So he changed tack and over a ten-year period worked flat out with a market stall selling greetings cards. It wasn't long before he owned his own shop in Redhill, and bought his own house.

Retiring to Cliftonville near Margate, life sauntered along pretty seamlessly until three months ago when he caught a bladder infection. From then on his life, and the life of my mum, who is partially-sighted, has fallen apart.

It was not as if he had cancer or suffered a heart attack. He just suddenly was unable to pass water, and over a period of weeks ended up in A&E, had a catheter inserted, had a fall, banged his head, ended up in hospital delirious with a urinary tract infection, had a subdural haematoma discovered (due to the fall) after a scan and spent a month in hospital before being moved to a care home in Sandwich.

There he was doing well until another infection turned his brain to mush, and he became paranoid and convinced he had been kidnapped. The care home couldn't cope as he was becoming aggressive and was sent to hospital where they looked at him and tried to deliver him back to the home the same evening, but the care home didn't want to let him in.

There was a stand-off at the door but in the end my dad stayed at the home overnight before I was able to get him re-admitted into hospital, where he has been ever since. At the hospital he was still agitated and aggressive and attacked a nurse on his first night there. Security got involved. A nightmare. Thankfully, having had antibiotics, he's calmed right down since then and the nursing staff have been great with him.

In between times he had been taken to hospital for a urology appointment.

It was here that the NHS and any sensible decision-making went AWOL. He'd been to Urology before, where all that happened was he had a test to witness whether he could pass water, but because he was dehydrated the results were inconclusive.

For this second appointment, he was delivered by the care home to the hospital, still delirious, and a urology nurse whipped out the catheter, tested whether he could pass water, and when he couldn't he was sent on his way back to the home. He told my mum afterwards it had been 'the worst day of his life'. No-one went in with him from the home at the appointment.

It was only last week – three weeks after the urology appointment – and after I had driven 70 miles to the hospital to try and collar a doctor (I'd failed three times in three days to speak to ANYONE involved with his care prior to this) that one junior, new to my dad's case, eventually showed me my dad's notes and together we discovered vital information.

The urology nurse had asked my dad during the appointment whether he would be willing to have an operation on his prostate. Delirious and confused, he had said no. She simply wrote his answer down.

A urology nurse. One would think someone who works in that department would have some modicum of knowledge regarding infections of the bladder and how they can affect the mind. This one clearly didn't or was just indifferent.

Worse still this information was relayed to the hospital via a letter, but not questioned by doctors or even mentioned to a family member. It was just accepted as if the answer had came from a man with all his mental faculties in place. They only had to take one look at him to know that wasn't the case.

During all this time – two months – no doctor has said a prostate operation would probably sort out his urinary problems. And during this two-month period he has never been referred to a urology consultant, even though I have pointed this out umpteen times.

So it was then this junior doctor confirmed a prostate operation would be in his best interests. No shit, Sherlock. The longer my dad wears a catheter the more risk of infection and the more impaired his mental faculties are going to become.

So we had wasted three weeks. In the meantime social services are currently under pressure from the hospital to find somewhere for my dad to stay as they want the bed back, even though it transpires it is due to their ineptness he is still there.

The hospital say he is physically fit enough to leave. He is a liability to them. What is frustrating is if it hadn't been for our perseverance we would have been unaware of the letter concerning his prostate. If the doctors had informed us we could have made a decision sooner.

Aware of pressure from social services and the hospital Annie and I have been to visit care homes to find one that would suit his needs. These are NHS dementia homes as, even though he doesn't suffer from the illness, but they are more appropriate for he needs... apparently.

Dear God. There are some horrors out there. Most smell of piss, many of the staff are well-meaning but not very bright, and the environment is utterly depressing. One step away from the incinerator.

These are the places you do not want to end up in later in life, unless you are so far gone you don't care what happens to you. Truly awful. We saw three homes with at least 100 patients in care. This was one small pocket of homes in one small seaside town. There are too many people queuing to get in to too many crap homes. And the number is growing by the day.

The government can't deal with the numbers or refuse to acknowledge them. The elderly take up much of A&E time. As Annie says, there should be two A&E departments set up, one for elderly people and the other for the rest of us.

Back to the care home situation, we found one good one, but after a team from the home had been to assess my dad, they said it would be inappropriate for him to stay there.

There is light at the end of the tunnel. We have decided to go down the private route. As a family we can just about afford it. My dad needs an operation but to get to see a consultant and then wait for an operation on the NHS it will take months, and by that stage he could have had another two or three infections due to the catheter, his kidneys could deteriorate further and we wouldn't get him back in any decent mental shape.

The bottom line is if you are want anything done quickly in Britain you simply have to pay for it. The NHS has its uses but if you are old and your mind's on the blink, forget it.

Needless to say, after one phone call today my dad now has an appointment to see a urology consultant before the end of the week. It's going to cost money but at least progress has the potential to be made. If it's agreed he should have an operation on his prostate it will probably be done within a fortnight. Just as it should be.

There is a caveat, however. I'm currently in a fight with the hospital who want him turfed out. Fortunately at this time no-one wants to take him on. I want him to stay in because the private clinic he has the appointment with on Thursday happens to be joined directly to the main hospital. It's only a matter of walking him a few minutes down a few corridors rather than dragging a confused old man from a home and taking him back again afterwards.

All this time spent on one old man. There are thousands out there just like my dad – just as deserving of proper care. Tragically for us, this country hasn't a half-decent system in place to deal with them all.

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