09th February 2017

Attitudes to healthcare

We have a valued and envied health care system in this country. Recent surveys in Scotland by the Government showed overall high levels of satisfaction with the services received. A visitor from America who required medical help for his family wrote glowingly about how effectively and helpfully it was provided, with little delay. Other countries struggle to provide public health services, free at the point of delivery.

Winter crisis

But it is not hard to see that there are recurrent problems at times of high demand on Accident and Emergency departments. Bed blocking, waiting times, shortage of beds and of the staff seem to crop up each winter, and this year is no exception. Nurses have spoken openly about the frustration of being there to help people, but not being able to do this because of delays, waiting times for treatment and increased numbers of patients.

Targets for waiting times are widely unmet, with some (would-be) patients having to wait on trolleys in undignified circumstances, sometimes for more than twelve hours. The reported effects on their health are extremely easy to believe and are a threat to life itself.

Solutions?

It is easy to call on trite answers. People have called for increased funding for home care services, to speed up bed availability. Others say staff recruitment and training needs to be boosted to enable quicker treatment. Some politicians have mentioned that some people unnecessarily come to A&E and so slow down the overall process. Others say that the situation has been overblown by the Red Cross, who compared the situation in some trusts to a humanitarian crisis.

There is merit in some of these arguments. But increasing resources, or the promises made to that effect, have had little influence on this annual problem.

Prevention

I think we have to ask ourselves, are we a healthy society? Beneath the statistics of waiting times and the political rhetoric which abounds, there is a cold fact that many chronic illnesses are increasing in prevalence, combined with an increase in the age to which people are living.

The King's Fund is an independent charity working to improve health and care in England. They have recently reported on the increase in illnesses and co-morbidity, where a person has more than one chronic condition requiring treatment. They have also posted opinions on how the issues should be dealt with, which propose helpful solutions.

The report is worth reading, and is easily available on their website, called 'Long-term conditions and multimorbidity'. It points to increases in dementia, mental ill-health, diabetes, chronic obstructive pulmonary disease, arthritis and hypertension. Social disadvantage and deprivation are common factors.

As the report suggests, there are behavioural and lifestyle answers which may go some way towards reducing the incidence of disease and consequent demand for our services. Healthier eating, reasonable alcohol intake, more personal activity, and eliminating smoking are changes which, if widely implemented may stem, or even reduce the tide in future generations.

I think we all have to be part of the solution to this problem. Instead of success being measured in the size of our cars, or the number of motorways and ready meals, we need to adopt healthier lifestyles. Public policy can assist us in this also. Personal solutions I favour are switching transport funding to more sustainable and healthier methods, cycling, walking and a decent modern railway.

Food producers need closer, effective, and courageous regulation to stop the damaging use of high sugar and fat levels in our food. Better community resources, not institutional health provision, could impact dementia, mental health and associated conditions.

Conclusion

None of these are expensive solutions, indeed they would save a lot of money and help improve centralised healthcare where it is needed. It is good to see these solutions being looked at, and it is in all of our interests to take those steps which are under our control, whether we make policies or simply make our daily life choices.

*All information is correct at the time of publishing

Tony Clarke

Scottish Care Inspectorate Specialist

Tony began care work as a care assistant in care of the elderly here in Scotland in the 1970s. He very much enjoyed promoting activities, interests and good basic care. After a gap to gain a social work qualification, he worked in management of care services, latterly as a peripatetic manager which gave him experience of a wide range of services.

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