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The Commentary

Hope I die before I get old?

My father has been in hospital since last September. He is now 87 years old and is very frail. Visiting him there, and taking my mother each day to visit, I have, over the last few months seen a snapshot of the workings of the NHS for the elderly. Unfortunately, what I have seen has not been good.

There have been many incidents which have disappointed us including my father contracting a number of conditions with which he did not enter the hospital. An infected toe did not have the dressing changed for well over a week, despite my mother pointing this out on a number of occasions. Another man in the ward was moved out by his family to a private hospital. The nurses had accidentally thrown away his false teeth but had done nothing to replace them. The man was having great difficulty even eating. The stories could go on.

Change in nursing

I mentioned all this to someone in our congregation who trained as a nurse in the late 80s but who is now out of the profession. Her comments were interesting. She explained that when she trained, you only needed five GCSEs to be accepted for the course.

Then, some years ago, a change was made. Nursing was upgraded. ‘A’ levels were encouraged and to become a fully-qualified nurse meant taking a degree in nursing. The nursing bodies went along with this, thinking it would lead to more status and bigger wages for nurses. But what has actually happened, according to my friend, is that it has led to a two-tier system. Qualified nurses now tend to have a management role at a distance from the patients. In particular, litigation against hospitals has led to an exponential rise in the amount of paperwork. The day-to-day, practical, hands-on aspect of nursing now tends to be the domain of very low paid health care assistants, who are often untrained. The maximum wages for such health care assistants is around £12,000. More able people look for jobs with better pay. So the overall effect of ‘upgrading’ qualified nurses has actually produced a deterioration of the quality of care at the practical level. NHS managers may not agree with this explanation, but that was my friend’s assessment.

Further, health care assistants’ jobs now tend to be taken up by people from overseas. This is fine, but it can and does lead to more problems. Cultural and language difficulties arise. An old, frail chap like my father may well have difficulty simply understanding what is said when a tired health care assistant with a thick foreign accent asks him a question. My friend said that for a high quality of nursing care, good communication between nurses, patients and relatives is essential. But that is crumbling.

It all seems to be the fault of long-term lack of investment and the low status given to caring in our country. But real change on this is hardly likely to happen in our materialistic society where the idea of service (though given the applause of cheap words) is actually despised and very few people are prepared to pay higher taxes.
Of course, my experience with my father is limited, and other areas of the NHS might be performing beautifully for all I know. But from what I have seen of the care of the elderly, I can imagine many people thinking, ‘I hope I die before I get old’. And, sad to say, perhaps that is what society wants.

John Benton