Thoughts from the criminology team

A personal tale about the NHS – I am one of the lucky ones

This blog recounts the experience of the care of my parents in the last two years, which has been exemplary and, in the context of the recent reports about the crises in the NHS, reminds me how lucky I was to experience this. It also reveals how well the NHS can perform when it is not under stress, is properly resourced and valued, even when dealing with health problems associated with old age and during the extra strains which occur during winter.

My father passed away at the end of August last year, after 2 years under the care of an NHS facility specialising in caring for dementia patients. The illness had not just affected his memory, but had also led to aggressive behaviour which required him being sectioned under the Mental Health Act. This was obviously a stressful time for us all, but also a time when we understood this was the only option. He soon settled into a new routine, in a home where he felt safe, cared for and where his needs could be met. It was also vital that this was located near his home in North Yorkshire, so that my mother could visit three times a week, and maintain the bond of their marriage, providing both of them with the companionship they so valued. Visiting could be difficult if he had a bad day, but most of the time he appreciated the company and was clearly happy to be in a place where he just did not have to worry about anything.

What struck me most about the place was the demeanour of the staff – they were helpful, kind, accommodating, caring – all the things you would want from those in the health and social care professions. This facility brought these sectors together in a partnership to meet the many physical health needs of dementia patients, while remembering their role as carers. It was not just about administering the medication needed to keep patients calm, it was also about interacting with them, taking them for walks, days out and bringing in a variety of forms of entertainment. Patients celebrated Halloween, Christmas, Easter and engaged in activities which took them back to places and people they could remember, often through music of various genres. Dad always liked jazz, and occasionally classical, with a real fondness for Ella Fitzgerald. These times were so important, for 2 years, even though things had changed, the Dad we knew was back during some of our visits, and we could just appreciate this time until he passed away.

I feel sadness now at his loss, but also because I know not everyone with dementia who needs this sort of care will get it. In the lottery of health and social care, we won, and the prize was the sort of care I think everyone should have access to. What angers me about this is that it is NHS Trusts across the country, simply cannot provide this. They have to make decisions about the care of citizens based on budget spreadsheets and staff availability, rather than what is understood to be the best practice, clinically sound and will create the best outcomes for patients and relatives. The recent BBC report on the ‘10 charts that show why the NHS is in trouble’ (see http://www.bbc.co.uk/news/health-42572110) clearly illustrate why not everyone receives the care my Dad received. For example, it emphasises that we have an ageing population, meaning the NHS is dealing with increased numbers of patients with chronic conditions such as diabetes, heart disease and dementia. These are conditions which are described as ‘more about care than cure’ where patients need support, where healthcare requires as much of a focus on social care as it does on medical interventions. This has financial implications, as care for ‘average’ patients over 65 years old costs the NHS 2.5 times more, compared to the ‘average’ 30 year old, and this only increases with age.

Spending on the NHS has decreased from 6% of the government budget during 1997 to 2009, to 1% as part of the austerity agenda of the Conservative/Liberal Democrat coalition, with a slight increase back up to 2.5% under the current government. This also represents a lower proportion spent on healthcare compared to other EU countries such as Germany, Sweden and France – who are all above the EU average. They do this by through increased taxes, and this seems to be the crux of the matter. Would the citizens of the UK tolerate a rise in taxes to have better provisions in health and social care, for themselves and their family? According to a poll by Ipsos MORI, 40% would back a rise in income tax, with 53% supporting an increase in National Insurance payments. However, it was also revealed that the majority of participants valued the NHS and did not wish to change to an insurance based system.

So, a choice must be made. Personally, with what I experienced with my Dad and more recently, when my Mum had heart surgery to replace a valve, from which she is recovering very nicely, I cannot imagine not having the NHS. Perhaps we do not recognise its value until we need it, but given the strains it is under now, and that one way to alleviate this is to increase funding, then governments should surely consider tax rises to provide this. The NHS provides health and social care we will need one day, if not for us, then for loved ones, and it seems to be a model of healthcare most people in this country would prefer. With an ageing population, the current investment being below the average of 4% provided to the NHS since its inception in 1948, is having an impact. It is an impact which Jeremy Hunt and Theresa May seem to bat away as isolated problems, not trends, and as problems they are dealing with. I do not think we should be discussing our health service as being able to cope with crises and unexpected demands. We should be discussing in terms of being able to provide equality of care, even in the face of the unexpected, using a service which reflects the values of the welfare state, to ensure wellbeing, safety and healthcare from cradle to grave, for all citizens.

Susie Atherton
Senior Lecturer in Criminology