Thursday 25 September 2014

The Whittington Hospital: a sinking ship?

Like many north Londoners, I have marched to save the Whittington several times. I have attended meetings, and spoken out about planned bed closures, endless reorganisations and staff shortages. Last week, I attended the hospital as a patient for day surgery; my gallbladder was removed using keyhole surgery.

We have all read stories about the crisis the NHS is in; government cuts, and a constant move to outsourcing and privatisation are having negative consequences for patients across the country. However, nothing prepared me for how much the Whittington would have declined since I was last admitted there in 2011.

The first thing to mention was the filthy state of the hospital. When I arrived at 7.30 am, I saw most, if not all, of the hospital workers entering completely ignoring the very prominent hand sanitising stations; I seemed to be the only person availing myself of them. I thought that perhaps the workers would be cleaning their hands when they reached their areas of work, and dismissed my concern. However, as the day wore on, I saw more and more alarming signs. A bin on the day treatment ward, metres from where people lay recovering from operations, was overflowing. A full bag of rubbish sat on top of the bin, into the bargain.

A nurse, attending one of my dressings, asked my partner to help, without first asking her to wash her hands, despite her just having arrived. 

Another nurse, having dropped the disposable peak flow mouthpiece on the floor, looked at it for a moment and then fixed it to the machine and offered it to me to put in my mouth.

A toilet was so caked in excrement at one point that I felt obliged to find an alternative one. 

There was no soap in a hand to a big sign about how important it was to wash one's hands.

Apart from the issue of hygiene, there was clearly low, nay no, morale amongst staff. I do not want to criticise the staff; low paid, working long hours, mismanaged and undervalued, I am an awe of nurses. There was clearly tension between nurses and their superiors; at one point, after being criticised, I think by a doctor, one nurse walked away muttering "how stupid do you think I am? God help us..." It is not reassuring for patients to hear this sort of altercation.

One of the issues we have heard much about in terms of the Whittington is the planned bed closures, and the worries that it would have adverse effects on healthcare out outcomes. Last year, in an apparent u-turn, the Whittington board stated that there would be no bed closures. However, in their report, they said, 'changes to wards and beds will still happen...these are dependent on services continuing to be commissioned at the Whittington Hospital.' (1)

When I remained in a lot of pain, to the extent that I fainted at one point, and when one of my incisions kept seeping through the dressing, it was reluctantly suggested that I stay overnight. The nurse in charge of my care at that point explained that there were no beds and so they would need to get rid of someone else before offering me a bed. I waited for several hours, in pain and afraid, but also angry that our vital NHS had deteriorated to this appalling extent.

When I was finally taken to Coyle ward, the nurse who took me there struggled for some time to find a nurse to hand me over to. "Is there a nurse on the ward?" she incredulously asked out loud, walking from bay to bay. Several emergency response alarms were constantly going off at once, as people buzzed in vain for medical attendance. Later, an elderly woman got out of her bed and, holding onto a wall, asked my partner and I to help her find a nurse. She was clearly desperate and distressed.

Another woman was informed that she could go home that night, but they wouldn't be able to give her any pain medication to take home, as they had run out.

I myself kept asking for pain medication, and was eventually given some. It was shortly after that point that I decided to go home. I explained to the nurses that I felt it was the safer option, and that the hospital was in meltdown. They tacitly agreed.

The next day we managed to procure me some painkillers through the out of hours service, which was very efficient. When my partner explained the experience we had had at the Whittington, a doctor replied "well, you should have had a better experience than that, but I am not surprised to hear about it."

The fact is though, what I have described above is scandalous. We should be surprised; we should be outraged.

I never once believed that having less beds and more 'ambulatory care' was anything other than a cost-cutting measure, and my experience, and clearly that of others, has sadly proved that. One hears of winter bed crises; one wonders if they can be so short of beds now, in September, how much worse it can get, and how may lives that will cost?


Monday 13 May 2013

Babies don't make money, and other revelations.

Yesterday I attended an open day at the Whittington Hospital. I was interested to see the buildings that the trust are planning to sell off, and so booked myself, along with my husband and two children, on the tour.

We were led by Phlip Ient, the Whittington’s Director of Estates and Facilities. The first building we viewed, albeit from the outside, was Waterlow, which is the big big brick building on Highgate Hill, straight after the ‘Whittington & Cat’ pub. The building has been empty for ten years, having originally been part of the mental health services accommodation.

Behind this building was historically nurses’ accommodation. It looks quite dilapidated from the outside but it is still occupied, now by medical students, letting them live right next to their place of study at very modest prices. Once this is sold off, medical students will instead live in accommodation on Sussex Way. Although of a much better standard, this accommodation will cost students about three times as much.

We asked whether this might deter some students from studying medicine, seeing as a degree in medicine is already reported to cost students somewhere in the region of £100,000? Mr Ient said that many students already take advantage of the better accommodation at Sussex Way. What he neglected to say was that many of them do not, and are currently residing in the accommodation at the Whittington, which they are planning to sell off.

On the other side of this building, on the ground floor the Whittington currently houses the physiotherapy department. I have made use of these services myself and can report that the staff were excellent and the service first class. Mr Ient explained that they need to move the physio department into the main hospital because it would be “better”. Better, how, I asked? He replied that people cannot find where it is at the moment. I responded by saying that I had never had a problem finding it, probably because there are lots of signs up and my appointment letter came complete with a map.

We then discussed the issue of the maternity wing, which needs modernisation – no arguments there. I know many women who have given birth at the Whittington and have reported that the facilities are positively Victorian. Mr Ient said that they needed to improve or they would lose ‘business’ to better maternity services, such as those at University College Hospital.

He said that they are aiming to increase births to around 6000 per year. I asked why then, in the original plans, they had said they were ‘capping’ births at 4000 per year? “We made a mistake there,” he admitted. “Well, I did.”

“When it comes to maternity services,” he explained, “it doesn’t make any money for us. We just about make the money back that we put in, but that’s about it.”

We found it staggering that he was talking as though the NHS, and, by extension, the issue of life and death, was a money-making venture. Profits and loses. But then, with the marketisation of our health service, introduced by Labour and carrying on apace under the Tory-Lib Dem Coalition, that is exactly what we have now. It is thoroughly depressing, as all health campaigners will attest.

I asked why, when the Care Quality Commission reported just two weeks ago that the Whittington was doing well in all areas except putting patients on the correct wards, due to lack of beds, they are planning to close a further 177 beds over the next five years? I was given the answer that, because of the way they planned to care for people at home, they would not need beds as much any more. Reiterating the point that the board members keep making, that the ‘clinical advice’ is that keeping people in hospital is a bad idea, he explained that there would be  60 beds closed initially, with the space being used as an open-plan admin space. If, he went on, there were more beds needed again in the future, they could turn the space back into a ward. Why don’t I believe that would be likely to happen?

In conclusion, we went home with Ham’n’High bags full of crap for the kids (they foisted these on us, naturally), and heavy hearts about the future of our local hospital and the NHS in general.

Friday 3 May 2013

Defending the Whittington

I spoke with Robert Aitken, Whittington board member, at our Camden Green Party stall in Highgate last Saturday.

He told me that they were closing the 175 beds because of clinical evidence that being in hospital is bad for people. It confuses elderly people and it results in muscle loss generally. He said people should be cared for by friends and neighbours, or, failing that, the NHS would take care of them in their homes. Ah yes, care in the community...ring any (alarm) bells?

This week, a report showed that the Whittington is doing well in 10 out of 11 areas. The one area it is failing in is putting patients onto the appropriate wards because - guess what - they don't have enough beds. And so I'm not sure how closing another 175 beds is going to improve that, particularly as London's population is projected to hit 9m in 2018.

I put this to Robert. He said they had factored that in. I'm not sure how. He also said that "if we need more beds we will just have to find them." Forgive me if I don't believe that. People will be turned away and lives will be lost.

As for selling off the dilapidated, disused buildings, I am not completely opposed to this, unlike the Defend the Whittington campaigners. My only concern with that is that the hospital will become much smaller and, at some point, they will say it is 'no longer viable'. Robert denied that this will happen, and that "it is not in our [the board's] interest to close it down!" but, if we look at Haringey - 6 hospitals at the beginning of the '80s, now down to one, with only 3 wards, one of which is about to close - I don't see why we should believe that.

Furthermore, as I pointed out to Robert, the board has completely lost the trust of the community, having tried to sneak these plans through without consultation. "We shot ourselves in the foot there..." was his response to that. Indeed.

Thursday 4 April 2013

Horse Deaths: A Racing Certainty

There is an increasing focus on the cruelty of the Grand National, which for decades has continued to claim the lives of horses despite several adaptations of the formidable obstacles on the Aintree course. Today, in the Foxhunter’s chase, a race for amateur jockeys, a horse collapsed and died of a heart attack, a fact that was reported by the BBC despite this not being the ‘big race’ of the meeting.

That there is more of a public outcry when these deaths occur is welcome, but it doesn’t reflect the fact that horses die throughout the year at UK race tracks. Wetherby, for example, has a high mortality rate, but where are the reports of the horses that die there, or calls for the fences at that track to be modified?

I know quite a lot about horse racing, having been a regular attendee at meetings throughout my teenage years and an occasional ‘punter’ over the last decade. There is no doubt that it is an exciting sport, a daring spectacle and can provide an enjoyable day out. That enjoyment, however, is too often overshadowed by deaths and injuries. It is a rare horse racing fan who doesn’t care when a horse is killed. The atmosphere at a meeting when the infamous screens go up around a horse is grim, and the rest of the day will be tarnished for many.

The Green Party has a very strong policy on animal racing, arguing for a ban of the whip and closure of all tracks with poor safety records. Actually, I wouldn’t completely support that, though I would support a ban of use of the whip in all situations other than when completely necessary (i.e. when using it to control an out of control and therefore dangerous horse). In terms of closing down tracks, I think that tracks should be modified before we consider shutting them down. Horse racing does after all provide much-needed jobs and livelihoods, in terms of both those who work at the courses and those who breed, train and ride the horses.

I’d also like to see something added to our policy about cruel practises involved in the breeding of thoroughbreds, as well as what happens to animals when they retire.

Having walked the National course at Aintree and having examined the fences, I was concerned about the infamous Beecher’s Brook, which features a big drop on the landing side. This, as aforesaid,  has been modified but the way that horses ‘buckle’ on landing is testimony to the fact that it remains a cruel obstacle.

I hope the public remain engaged with the issue of the cruel aspects of horse racing, and all National Hunt race courses – not just Aintree - continue to feel the pressure to adapt their fences, meaning that horse racing deaths become rarer and the sport moves away from its present tarnished state.

Wednesday 13 February 2013

Whittington public meeting: no room to swing a cat

Following the news that Whittington Hospital bosses had secretly agreed – as in, with zero consultation – to sell off part of the hospital, almost halving the number of beds and capping the births at 4000 per annum, a packed public meeting took place last night, with as many as 700 attendees. Like many people, I was in one of the several ‘overflow’ rooms, where audio from the main hall was piped through.

We first heard from Joe Liddane, Chairman of the Whittington. Liddane claimed that “these plans are about improving, not downgrading, services,” and that “many conditions are treated better in a clinic or a home setting rather than a hospital.”

On the issue of whether the plans had been kept secret, Liddane claimed that this allegation ‘pained’ him. This provoked much incredulous laughter from the audience. When asked by an audience member why he hadn’t made the plans public, he claimed that he would have told people if they had asked. Again, laughter. This guy has a great future as a stand-up. However, we don’t need him in charge of our hospital, especially on a £170k salary.

A Camden Unison member spoke from the audience, countering that the sell-off was just part of ‘farming things out’ to the private sector, and if they really were going to be providing services in the community, they needed to set that up first before selling off part of the hospital. This comment received much applause.

I asked a question (via a piece of paper since I wasn’t in the main hall!) about the capping of births at 4000. Why, if they planned to spend £15 million (later revised to £10 million later in the evening, interestingly) of the sell-off profits on improving maternity services, were they going to cap births at 4000? And where, I asked, did they propose the other babies should be born?

We were given assurances that women would not be ‘turned away’. That’s good. I had visions of women having to labour in the car park.

One of the most curious comments of the evening came from local GP Greg Battle, who is in favour of the sell-off. He commented that hospitals are not seen as ‘safe places’ by many people, and there is a need to get people out of them and home as soon as possible. Wow. This coming from a GP. But surely, then, the answer is to improve hospitals, not sell them off?

Indeed, safety was a key issue for many. The Whittington has the lowest mortality rate of any hospital in the country, we learned last night. Yet closing half the beds, when at points, such as last winter, 95% of the beds were in use, could, in the words of one former Whittington staff member, mean that “there’s going to be another mid-Staffordshire in Archway if we’re not careful.”

We heard from Labour MPs Jeremy Corbyn,  David Lammy, Emily Thornberry and Frank Dobson, all of whom made good and passionate points, but sadly they were all seemingly suffering from amnesia. They seemed to have forgotten that the dismantling of the NHS continued apace under the last Labour government, with targets meaning that clinicians lost sight of patients as individuals, as humans, and instead became fixated on statistics.

As Candy Udwin, of Camden Keep Our NHS Public commented, “Under Labour, we saw the drip, drip, drip of privatisation. Under the Condems, we are now seeing a full frontal attack on the NHS.”

One of the most amusing moments of the evening was when a poor bumbling chap stood up and declared he was there to represent Lynne Featherstone, Lib Dem MP (and cabinet minister). Instant booing, obviously. (I didn’t boo, though I may have smiled wryly). People shouted “where is she? Why isn’t she here?” The poor fellow didn’t have much luck, and made the colossal mistake of saying “we’re all in this together.” Cue hilarious, if somewhat bitter, laughter.

I made a comment – again, via paper – that Haringey, which used to have six hospitals, now only has one: St Ann’s, and that this hospital only has three mental health wards left. In September, patients and staff of Downhills ward were told that the ward was closing in five hours, leaving vulnerable people scared and confused. Most of the land at St Ann’s is going to be used to build housing, leaving only a small area as a hospital. I commented that people who are suffering from mental health problems are being left without any assistance as a result. We mustn’t let what has happened to St Ann’s happen to the Whittington.

The meeting was lively and heated, and as well as planning for a demo on March 16th to save the Whittington, it was concluded that strikes may well be in order and that we should begin planning for a London-wide (or possibly national) demo in mid-May. Nine hospitals across London are currently at risk of losing at least their A&E, so it makes sense that we work together to defeat these plans.

As Jeremy Corbyn MP pointed out, London’s population is rising and rising. We need to plan ahead. Selling off and closing down hospitals is short-sighted, and “we are in danger of throwing away a very, very valuable public service.”

See you at the demo on March 16th!

Tuesday 5 February 2013

More than Marriage

Well, hurrah! Gay marriage is finally made possible in England, and many of us wonder what the fuss was about. What’s so controversial about letting two people who love each other commit to a life together? Nothing, that’s what.

The whole debate over gay marriage has been very useful in highlighting just how many dinosaurs still reside on the Tory benches. I mean, how stupid are these MPs, who not only hold such bigoted views but will admit to it, with the nation watching?

Sadly, these bigots are not only in the House of Commons, but they’re out in the real world, causing misery for LGBT people every day. I’m thinking particularly of the homophobic bullying that goes on in schools, and the suicides of young people such as Jadin Bell, the Oregan teenager who died this week. Bell had been taunted about his sexuality and had hanged himself as a result. This week he died in hospital, having been on life support.

It may seem like a leap from talking about gay hate crime and suicide to talking about gay marriage, but actually it’s not. Gay marriage is an important way that we, as a society, can proudly state that we believe in equality, and that we have no space for bigotry, hatred and victimisation.  

Tuesday 13 November 2012

Paedophilia: time for an honest debate

With the on-going furore surrounding the BBC’s handling of the Jimmy Saville(et al) scandal, I had hoped that the focus would by now be firmly on the wider issue of child sexual abuse and what we, as a society, should do about the problem. I’m not about to defend the BBC, and there’s no doubt they have made some serious errors, which should lead to an examination of how the ‘chain of command’ works, as well as other organisational issues.

However, over the past few days I have been wondering how much of the media’s fixation with a BBC ‘in crisis’ isn’t rather a distraction from the main issue. That is children in crisis, right now, as well as the crises faced by adult survivors and by abusers themselves. Perhaps the fact that these are difficult issues to discuss, and perhaps because they are almost impossible problems to find solutions for, we’d rather fixate on whether George Entwhistle was asleep at the wheel when in charge of the BBC.

According to the Survivors’ Network, 1 in 4 children are sexually abused. The NSPCC puts the number at 1 in 5. It has also been reported that up to 90% of sexual abuse isn’t reported, so goodness knows which figure – including that one – is accurate. What we can be sure of is that it happens. It happens behind closed doors in what look from the outside like happy, ‘normal’ families. The notion of the scary man in the woods abusing children or the perverted paedophile loner isn’t completely erroneous – those men do exist – but children are most likely to be abused by someone they know, and possibly trust and love. One can imagine how damaging that must be.

Indeed, statistics show that a high proportion of female prisoners have been sexually abused as children. Runaways are often escaping from such abuse. Some figures have shown that those involved in the sex industry are more likely to have experienced sexual abuse than those in other industries (though actually how many other industries would conduct such a survey? Where’s the stat about how many cleaners, for example, were sexually abused? So I would query that stat).

There are so many questions we should be asking. How can we better protect children who are being sexually abused right now? How can we ensure that when a child comes forward, they are listened to, believed and protected from any further abuse? What about abuse within institutions such as children’s homes? How can such places be better regulated? How can we help survivors of sexual abuse get on with their lives without being permanently scarred by their experiences? How can we prevent those men – and women, let’s not forget – who are tempted to sexually abuse children from offending in the first place?

Can a paedophile, or someone with paedophillic tendencies, be ‘cured’? The Lucy Faithful Foundation, who work with such people, say it is less about a ‘cure’ and more about people understanding the impact of their actions and learning not to act on them.

I have been talking about writing a Green Party policy on this important issue for a couple of years, and have had talks with the Lucy Faithful Foundation. Sexual abuse is a difficult, harrowing topic, but it’s a subject we ignore at our peril. Whilst the media evades the real issues and the other political parties brush the issue under the carpet, I think the Green Party should have something brave, useful and important to say.