tag:blogger.com,1999:blog-25200961.post3401933175261263281..comments2024-03-14T09:50:40.819+00:00Comments on Dr Grumble: Closing NHS hospitalsDr Grumblehttp://www.blogger.com/profile/04417731064007601504noreply@blogger.comBlogger40125tag:blogger.com,1999:blog-25200961.post-9463518831423332382013-11-19T23:05:57.979+00:002013-11-19T23:05:57.979+00:00I like the ѵaluablе іnfoгmаtion уou prονіde in you...I like the ѵaluablе іnfoгmаtion уou prονіde in youг articles. I'll bookmark your blog and check again here frequently.Human Growth Hormone Houstonhttp://www.antiagingcostarica.com/hgh-texas-dallas-human-growth-hormonenoreply@blogger.comtag:blogger.com,1999:blog-25200961.post-28378236860055225632011-10-02T16:47:57.298+01:002011-10-02T16:47:57.298+01:00For those of us who get upset at seeing madness al...For those of us who get upset at seeing madness all around us a blog can be very therapeutic.Dr Grumblehttps://www.blogger.com/profile/04417731064007601504noreply@blogger.comtag:blogger.com,1999:blog-25200961.post-13826879205354582872011-10-02T13:33:52.829+01:002011-10-02T13:33:52.829+01:00Yes indeed, Dr G, even those of us who are prepare...Yes indeed, Dr G, even those of us who are prepared to stick our necks out can be seduced especially if we still want to be in our jobs in a year or so. As therapy I have started a blog guiltycommissioner at wordpress. howling at the moon maybe but it is better than sinking into depression.guiltycommissionernoreply@blogger.comtag:blogger.com,1999:blog-25200961.post-17987947935017285892011-10-02T10:56:41.960+01:002011-10-02T10:56:41.960+01:00Lovely people without the ethos of professionals a...Lovely people without the ethos of professionals are becoming brainwashed by a system that cares only about the finances. They are preferred by the system because they don't have all that inhibiting baggage that we carry.<br /><br />The saddest thing is the the professionals who should have higher ideals are being brainwashed too.Dr Grumblehttps://www.blogger.com/profile/02459592334604944530noreply@blogger.comtag:blogger.com,1999:blog-25200961.post-79928122498673750992011-10-01T19:53:21.330+01:002011-10-01T19:53:21.330+01:00I was at a conference the other day and got into c...I was at a conference the other day and got into conversation with a commissioner in social care (my field). She seemed a lovely person and happily informed me that since she does not have a front line background ( e.g social work ) she was not troubled by "ethical stuff". <br /><br />At the same conference I risked a comment that one council's commissioning plans for care home beds verged on the unlawful. I didnt actually see anyone roll their eyes but the irritation in the room at being reminded of old peoples' legal rights was palpable.guilty commissionernoreply@blogger.comtag:blogger.com,1999:blog-25200961.post-31058476013495911622011-09-29T11:01:22.993+01:002011-09-29T11:01:22.993+01:00I wonder who is going to let the Palestinians off ...I wonder who is going to let the Palestinians off Dr G, a whole people, in millions, being lashed nonestop, and ethnically cleansed, while the world is not only just watching, but many are paying in support of the lashing too!Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-25200961.post-40065345709669688642011-09-29T07:01:58.352+01:002011-09-29T07:01:58.352+01:00The king has let her off I am glad to report.The king has let her off I am glad to report.Dr Grumblehttps://www.blogger.com/profile/04417731064007601504noreply@blogger.comtag:blogger.com,1999:blog-25200961.post-2733507045884761342011-09-28T23:48:33.775+01:002011-09-28T23:48:33.775+01:00About this Dr G,
http://www.guardian.co.uk/world/...About this Dr G,<br /><br />http://www.guardian.co.uk/world/2011/sep/28/saudi-woman-lashed-defying-driving-ban<br /><br />Where is the international community then?!<br /><br />... or maybe they know, that's what you get when states mix religion and politics; weirdos! ... and people do suffer!Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-25200961.post-36755855172588936122011-09-26T21:42:53.342+01:002011-09-26T21:42:53.342+01:00re "the old NHS may live on in Wales and Scot...re "the old NHS may live on in Wales and Scotland" na its not<br /><br />ive been out in the remote west of scotland and they aint happy there with the scot nats version of healthcare i can tell you for freeAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-25200961.post-29487126347550447922011-09-26T15:43:24.603+01:002011-09-26T15:43:24.603+01:00Yours, Anonymous, would appear to be the view of t...Yours, Anonymous, would appear to be the view of the majority of MPs so I think you will soon have your way. <br /><br />An interesting experiment may be about to take place. The NHS in England will be chopped up into lots of competing businesses while the old NHS may live on in Wales and Scotland. It will be interesting to see what happens. The new system will work as it does elsewhere but it will only be better than what we have now if it gets more money - which might happen as people are pressed into providing healthcare for themselves. <br /><br />Purchasers and providers in healthcare are a very expensive way of doing things.Dr Grumblehttps://www.blogger.com/profile/04417731064007601504noreply@blogger.comtag:blogger.com,1999:blog-25200961.post-28728230758340713132011-09-26T14:43:12.814+01:002011-09-26T14:43:12.814+01:00cloud cookoo land stuff this
and so much emporers...cloud cookoo land stuff this<br /><br />and so much emporers clothese stuff<br /><br />for one people are euthenised every day in the nhs, nobody even healthy people can survice the "end stage" medications, sedate someone and up the pain relief and WITHDRAW ALL FLUIDS and anyone can and does die<br /><br />i sat and watched a close relative being killed to the timetable decided by a nurse, not even a doc, sure he was terminally ill but he would certinly have lived more months if fluids had not been withdrawn<br /><br />for 2 we dont even need a doctors signature before considering someone dead enough to put them in a fridge, sorry folk but when i pop my cloggs i think the docs owe me a casual once over before i go in the fridge, a nurses signature is NOT GOOD ENOUGH<br /><br />moving onto compasion? lets set up an experiment an monitor how long it takes from patient asking for pain medicine to it actually being given to them in our general hospitals? if i was termanilly ill i would stay at home or go to hospice if for no other reason than not having to wait for an hour to get the morphine after the wave of pain hit<br /><br />moving onto quality of life? i can tell matey boy below many diabetics get operations including hip replacement and go onto live happy and full lifes<br /><br />personally i think the nhs stinks<br /><br />we NEED the worst hospitals to shut, the public need to be allowed to take their business elsewhere<br /><br />there is a natutal cycle which improves all businesses which is lacking in the mao style nhs, that is customers taking their business where they dam well like<br /><br />grumble mate come with me for a few weeks i can show you how shit your precious nhs if for many patients, and i can show you many other western countries which do it so much better<br /><br />nobody copies the nhs elsewhere because its crap, success breeds success and in the case of the nhs failure is there for all to seeAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-25200961.post-74041715692310409732011-09-22T17:55:44.447+01:002011-09-22T17:55:44.447+01:00Well, whether we like it or not, the NHS party is ...Well, whether we like it or not, the NHS party is over.<br />In fact, 12 million patients may be watching rather anxiously to see how things pan out for the 60 hospitals affected the current PFI debacle?<br />http://www.telegraph.co.uk/health/healthnews/8780363/NHS-hospitals-crippled-by-PFI-scheme.html<br /><br />"The reality is that all too often the marketisation of public services fails to produce value for money for either the public sector, or for the citizens who depend on the services. Meanwhile, far from saving the Government money, private finance increases the costs and exposes it to massive new risks of service failures, that the Government will have to step in and resolve. The marketisation of public services represents a failure of policy that increases the Government’s financial exposure and presents a potential personal catastrophe for vulnerable service users" - (p60).<br />http://www.unison.org.uk/acrobat/PP8917.pdf<br /><br />In this current climate the bad things will increasingly affect oldies will probably be a result of omission rather than dastardly health workers trying to decide who is and who isn't entitled to another slice of the shrinking health cake?the a&e charge nursenoreply@blogger.comtag:blogger.com,1999:blog-25200961.post-32138969760633341932011-09-21T17:20:08.869+01:002011-09-21T17:20:08.869+01:00I agree with many of Julie's points. Whilst i...I agree with many of Julie's points. Whilst it is entirely fair to discuss the matter of quality of life, considering flicking the off switch rather than allowing someone to linger on in an horrific state etc, like Julie, I also felt uneasy by some of the things that were mentioned in the comments. <br /><br />The example given was of a diabetic/heart disease sufferer patient needing a hip replacement and the next thing I know, someone talks about "letting nature take its course". I started to think of a number of my relatives and particularly my mum's diabetic brother, who is in his 70s, needed a quadruple bypass a couple of years ago, but aside from that is active and has a very good quality of life and many people of that age and generation are still productive members of society. If all he needed were a hip operation, my thoughts certainly wouldn't turn to "letting nature take its course".<br /><br />It did look like the discussion was veering too much towards "the 'e' word" without actually saying it rather than discussing better quality of care, research etc.<br /><br />Btw my sister refers to care in the community as "Don't care in the community" hehe. <br /><br />NeeluMyalgic Muslimahhttps://www.blogger.com/profile/02258580111613489025noreply@blogger.comtag:blogger.com,1999:blog-25200961.post-75454983447624398272011-09-21T11:37:25.100+01:002011-09-21T11:37:25.100+01:00How about voluntary euthanasia like an advanced di...How about voluntary euthanasia like an advanced directive, when I am demented and cannot recognise my own family and have no quality of life please put me to sleep peacefully, permanently.<br /><br />This will become socially acceptable and become legally allowable, but probably not in my lifetime!Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-25200961.post-81038121110393436152011-09-20T17:09:13.396+01:002011-09-20T17:09:13.396+01:00"I would like to see a minimum nurse staffing..."I would like to see a minimum nurse staffing requirement in elderly wards like they have in Australia and California" - this would be a minimum first step in my opinion, and rather begs the question why on earth has it not already happened in the NHS? (coughs-money-coughs).<br /><br />The problem of elderly care is compounded by the fact talking about dying, or the gradual loss of physical and psychological well being is still something of a cultural taboo - or it is a conversation left until very late in the day in many cases.<br /><br />You may or may not remember a 5 episode Channel 4 documentary called "The Trust" (2002) - one scene depicted a hapless geriatrician talking to oldies about their resus status.<br />"Would you like us to try and start your heart if you have a cardiac arrest, Mrs Smith"?"<br />"Eh ..... am I about to die, doctor"?<br />"Oh, no, Mrs Smith, well I don't think so, but if you do what would you like us to do about it?" <br /><br />It was one of the funniest and saddest things you could ever wish to see in part because oldies often regress, especially when confronted by the hideous combination of serious illness, and unfamiliar surroundings or language.<br /><br />I saw this phenomena with my Dad (who had been a fairly astute and independent bod) and also my Mum when their time was nearly up.<br />Fact is (much as we may personally resent it) people who are past their sell by date are simply no longer valued in the wider culture - at least if we use action, rather than words as criteria for assessing the validity of such claims - I wish it were otherwise.the a&e charge nursenoreply@blogger.comtag:blogger.com,1999:blog-25200961.post-54318782873377396492011-09-20T14:50:20.944+01:002011-09-20T14:50:20.944+01:00If we were just talking about the very old, very f...If we were just talking about the very old, very frail demented elderly, A&E nurse then it would be straightfoward. It is a judgement call in those cases whether to treat or not to treat. I know. I had to make those decisions for my mum. But the elderly are not simply made up of people at the very end of their lives. There are those who have all their wits, but might be physically incapacitated. There are those who are physically fit (like my mum was) but have dementia. And we are simply not dealing with this at all. We want them all to go away out of sight. We don't want to think about them or pay for them. I'm not looking for a doubling of health spending, although if we did, we'd then be spending the same as America does on health. I want to see things happening like investment in Alzheimer's research to find a cure. I would like to see a minimum nurse staffing requirement in elderly wards like they have in Australia and California. I would like to see some planning that doesn't look like it's been written on the back of an envelope for a growing elderly population. Because the fact is the oldies are there and they're not going away.Julienoreply@blogger.comtag:blogger.com,1999:blog-25200961.post-30706105713637434832011-09-20T08:41:24.252+01:002011-09-20T08:41:24.252+01:00"I'm always intrigued to note how quickly..."I'm always intrigued to note how quickly discussion of the growing elderly population moves onto euthanasia. You'd think the two were connected" - death is an inescapable part of the equation when we think about very old, very frail, demented patients with no ability to care for themselves.<br /><br />Think about it this way - NHS staff would be unlikely to countenance a 30 bedded ITU run by a couple of nurses and HCAs - yet this is par for the course for most elderly care wards ....... why?<br />One thing's for sure - the gap between the rhetoric (oh, isn't terrible what happens to oldies in hospital) and the reality (patchy, and at time abysmal health care) has not not changed very much in my life time.<br /><br />Maybe it's because good health care for such patients is labour intensive and ruinously expensive if the same standard was to be afforded to every bed bound, uncommunicative, and socially isolated person near the end of life?<br /><br />A precursor to any sensible discussion about debilitated older patients should include quantifying the extent of their needs (which will include far more than just health care in many cases), setting standards, and then figuring how much it will all cost.<br /><br />Perhaps one of the reasons such an approach has never been contemplated is because nobody really believes it would ever be attainable without doubling the % of GDP spent on health.the a&e charge nursenoreply@blogger.comtag:blogger.com,1999:blog-25200961.post-76921303389461385312011-09-20T01:05:21.811+01:002011-09-20T01:05:21.811+01:00Thank you for the explanation Old Codger, I am not...Thank you for the explanation Old Codger, I am not so much as worried about the involvement of the private sector, which will still be a small percentage of the whole when the bill becomes law, but rather about the vaccum hospital closures will create and the impact of that on patients and staff alike ... and on training the young doctors too.Anonymousenoreply@blogger.comtag:blogger.com,1999:blog-25200961.post-429529323443690772011-09-19T19:42:50.633+01:002011-09-19T19:42:50.633+01:00Anonymouse,
It was very early in the process when...Anonymouse,<br /><br />It was very early in the process when I thought my surgery might develop into something like a cottage hospital. If it had happened it would probably have been a gradual 'organic' process. They seemed to be taking on more minor procedures but it went into reverse when that partner retired. Mind it was around the time of Bliars interference so perhaps it was not all the next senior partner's fault.<br /><br />Now the place is run by a manager nothing will happen unless there is significant profit from it.Old Codgernoreply@blogger.comtag:blogger.com,1999:blog-25200961.post-46504501682505847682011-09-19T19:06:28.162+01:002011-09-19T19:06:28.162+01:00Julie, Euthanasia is actively taking part in endin...Julie, Euthanasia is actively taking part in ending someone else's life by one/more persons who have that predetermined goal and hence, work in collaboration towards achieving it. This is not the same as neglect, lack of provision, funds or research, although these too are essential elements for providing quality care to the sick and needy and you are right to insist on all of them being adequate.<br /><br /><br />Old Codger:<br /><br />"Cottage hospitals"<br /><br />A modern version was rejected outright by GPs, it was called 'Polyclinics'. Now, whether for financial reasons or for modernising and reform, it is inevitable many hospitals will close, what is there now to replace them and be the centre of that care in the community, and provide employment for the frontline staff who will become 'available' upon those closures too?Anonymousenoreply@blogger.comtag:blogger.com,1999:blog-25200961.post-45404081808651078302011-09-19T17:58:22.254+01:002011-09-19T17:58:22.254+01:00Care in the community means out of sight and out o...Care in the community means out of sight and out of mind. A good GP will fight to get the individual appropriate support but it is sometimes a losing battle.<br /><br />I remember cottage hospitals, good things. About 60 years ago my father had a hernia repair in the local cottage hospital. Close to home, convenient and comfortable. Used to think my local, multipartner surgery might be developing into a modern version of the cottage hospital but it has now gone all commercial under a manager who has been to management school. Seems to have difficulty keeping new partners these days, more and more of the doctors are salaried.Old Codgernoreply@blogger.comtag:blogger.com,1999:blog-25200961.post-50762821571060980552011-09-19T15:10:53.882+01:002011-09-19T15:10:53.882+01:00"This is not about euthanasia"
Are you ..."This is not about euthanasia"<br /><br />Are you sure? Dr G mentioned the growing elderly population and how it was madness to reduce facilities at a time like this. Now the conversation could have gone two ways. We could have discussed raising health spending by 2% to come in line with other European nations. We could have talked about adding some more money to the lamentable amount that is currently spent on Alzheimers research to see if we could find a cure to it and enable people to live independently at home. We could have talked about bringing in spot checks in care homes to ensure that the elderly had a better quality of life. What we have talked about instead is that people are living too long. We have suggested withdrawing treatments such as hip replacements and allowing 'nature to take its course'. We have talked about getting DNR tattooed on our chests. In short, we have talked about every method we can think of, to shorten the patient's life, rather than what we can do to improve the quality of their life. And the worrying thing is, I'm not sure that you're even aware that you're doing it. Just because you don't use the e -word, doesn't mean that it's not there.Julienoreply@blogger.comtag:blogger.com,1999:blog-25200961.post-91694755442219716062011-09-19T12:35:15.297+01:002011-09-19T12:35:15.297+01:00http://www.patient-experience.com/index.php/keep-o...http://www.patient-experience.com/index.php/keep-our-nhs-public-andrew-lansleys-health-and-social-care-bill-is-this-the-beginning-of-privitisation-of-the-national-health-service/<br /><br />This article may be of interestBelinda Shalehttp://www.patient-experience.com/noreply@blogger.comtag:blogger.com,1999:blog-25200961.post-6733518205450415712011-09-19T11:36:46.870+01:002011-09-19T11:36:46.870+01:00Yes, this is the one Dr Grumble, thank you, if tha...Yes, this is the one Dr Grumble, thank you, if that is not torture, I don't know what is! The doc himself says that he would not want to be subjected to this 'treatment', I would like to join my voice to his.Anonymousenoreply@blogger.comtag:blogger.com,1999:blog-25200961.post-66603253415658001342011-09-19T08:34:40.987+01:002011-09-19T08:34:40.987+01:00Was this the video?
http://www.abc.net.au/compass/...Was this the video?<br />http://www.abc.net.au/compass/s3025007.htmDr Grumblehttps://www.blogger.com/profile/02459592334604944530noreply@blogger.com