5 April 2015…..Recently, inspectors have been swooping on our hospitals and producing scary reports of staffing inadequacies and quite high levels of bed blocking. This week we read in the Argus that it has been the turn of Brighton & Hove’s Royal Sussex County Hospital.
One whole ward was bed-blocked, for instance, and it is not just an ageing population that’s got us in this mess. Historic political decision-making set us up for it. Attempts to save money by cancelling and abolishing services just squeezed need into the long grass of future responsibility, out of sight. Well; the future is now here; and it’s even poorer. Three specifics have put our hospitals in this compromised position.
The first, and possibly most foolish, of the Government’s political moves (good old Maggie Thatcher) took place back in the 1980’s-90’s when convalescent homes along with facilities for the mentally ill were abolished, country-wide. ‘Care in the Community’ is now an epithet spat out colloquially to comment on bad behaviour but moving care out into ‘the big society’ and making it the responsibility of councils and individuals has had massive consequences. That dispersal tactic and funnelling of costs into the more expensive future was arguably negligent.
Many of our former convalescent homes were located in converted housing – some being very large and built-for-family-plus-servants houses. There was one in Cliftonville, Margate in which this writer spent a week or two back in August of 1973. By now it will either have been demolished and the site redeveloped or converted to flats, no doubt. It had a lovely lily pond in its garden…. It was a wonderful place for regaining strength, even allowing short outings on the train with other patients. A simply exquisite lawn bowling club surrounded by the tall grandeur of trees was in the same area and I still have the teapot from the junk shop up the street…. My time there was so important to regaining strength and health. Others, like the one in The Drive, in Hove, opposite All Saints Church which still had a tile on the wall indicating where the ‘Tradesman’s’ entrance was, round the side, were converted to flats in the 1990’s.
The purpose-built and quite grand red brick police convalescent home from the Victorian era survives in Portland Road, Hove, as a conversion for use now as a residential home for the elderly and stands as a reminder of the mindset of long ago that understood the process needs such half-way houses meet in aiding physical recovery from illness or injury.
The compassionate recognition of need to cater for that halfway space between outright hospital care and ability to cope back at home was simply abolished. The reasoning is hard to comprehend, frankly.
The second political move was both a boon and a curse. The Disability Discrimination Act (DDA) instantly made a whole swathe of residential homes for the elderly illegal. Many were, and are, located in terraced housing and detached houses that cannot be converted to become fully DDA-compliant. Too, one by one the soaring house-price inflation of the last 30 years has tempted owners to sell up in order to make a killing in des res areas. The elderly are now pushed further and further into suburban isolation, into purpose-built institutional care homes, away from the shops and daily life they could still access on short walks from inner city residential homes. But that is another subject.
The third political move has been progressive reduction of grants to local authorities and consequent cancellation of home helps in vast numbers as a brutal way of reducing council spending. The rising numbers of mentally ill and substance abusers who would once have been housed in those abolished specialist facilities now get ‘Care in the Community’ support from local authorities; and because of the disruptive nature of some of them, and their youth, they get priority spending from councils, often in expensive B & B dumps or on the rescue of their children who go into expensive foster care. The quietly crumbling disabled and elderly have been soft targets for deep frontline cuts for several years now that humiliate and disvalue; and these people can’t fight back, nor are they heard or noticed until they become bed blockers. It feels like a cull.
Not everyone leaving hospital who needs convalescence or assistance needs to be in a DDA compliant place. Some of those residential care homes seeking closure could so easily be suitable for re-use as convalescent homes instead of being converted to flats. Indeed in 1990, when this writer needed a half-way recuperation space, it was a residential home for the elderly in Davigdor Road that kindly came to the rescue, offering a convalescent space. I spent six weeks in that residential home for the elderly, which provided a valuable insight into how the elderly live in such places. There was no lift, just stairs. Not DDA compliant these days. But fine for anyone convalescing before going home who can do stairs.
Dual Purpose Residential Care
Instead of allowing residential homes to close and be converted to housing, the Govt could consider encouraging dual use of non-DDA compliant residential accommodation, on a formally licenced basis, for both residential accommodation for the elderly (ground floors) and people who need to leave hospital but who are not yet fully able to just get back in the saddle and carry on as normal (upper floors). Convalescence!!!! Mixed use! It has to be cheaper and more efficient for the NHS to do this than to keep whole wards bed-blocked! Indeed why can’t the NHS build such places themselves and make a profit from them. People’s ongoing home help needs are better assessed at the end of convalescence too rather than prematurely on the harassed hospital wards.
Was it wise for Southlands hospital to sell off part of its buildings for conversion to housing? Why could that not have been kept for transfer of bed-blockers needing to get their strength back? Only political will to destroy services (false economy) or serious political negligence explains it.