I wanted to say more about bed blocking because it is the tabloid headline phrase, the shorthand used to conjure images of elderly people waiting for places in nursing homes. But it’s a lazy stereotype, and it’s one of the means whereby the concept of value in public services can be so easily reduced to one of finance and ‘efficiency’, and the so-called ‘difficult choices’ in cutting funding to the point where they collapse.
There are many reasons why someone might be in a bed which is needed for someone else. By definition it is almost always the case that such a person is also not having their needs met in an acute setting, because so many of those needs are pastoral rather than treatment-based. Their best interests might be to take them home with support; to take them to residential or nursing care; to begin specialist rehabilitation; to access specialist care and treatment centre for those with a particular acquired condition; or perhaps a hospice or other end of life care. None of those decisions will be straightforward, all will involve a multi-disciplinary team of professionals to assess and coordinate what’s in the best interests of the individual.
These are not decisions to be rushed. Where it’s clear cut, there should be the provision in the social care system to action the decision of course, and that’s largely missing. The halfway houses (community hospital wards being one vital resource that’s been decimated) are at best overstretched. In the meantime, a purgatory exists between the two systems of acute medical services with the potential for a level of recovery, and the decision to move to palliative care.
Imagine the complexity, the medical ethics, the emotions, the fading hope. I want to say that today, because I fear I’m guilty of a lack of sensitivity towards the many human beings, families and friends in that position. I’ve chosen freely to publicise my own thoughts and worries and to highlight the wider political implications, to have a mission. But how easy it is to casually trample yet another diverse and vulnerable group of individuals into the mud of a tabloid headline. These individuals are equally deserving of proper, well-resourced and funded care, and very often they are not getting it. They are also deserving of the time they need to negotiate the inherent web of emotion and conflict.
On 11 March there will be an attempt led by Caroline Lucas MP, with support from a cross-party group of MPs to introduce the NHS Reinstatement Bill.
I’ve given the link to 38Degrees‘ page which has a further link for your MP’s contact details. There is also a link explaining what the bill aims to do.
If you’d like to do something proactive, might I ask you to contact your MP and ask her or him to support the bill?
You might also ask questions about cancelled operations in your area, and about cuts to social care and community and general hospital beds.
My MP has yet to respond to my points, perhaps because he is too busy earning his £460,000 annual salary as a barrister. But maybe yours will.