‘Abandoned by the NHS, I was all alone’
Cancer patient Jane Kelly recalls her struggle to cope after a hospital sent her home too soon
Last May I was gutted like a fish. I arrived at Queen Charlotte’s Hospital in west London, on May 4, for a radical hysterectomy, including a tumour on the ovary, but three days later I was back home.
For two days after my operation, nurses had one message – no one goes home until they have moved their bowels. But, the next day, a doctor appeared, moving swiftly from bed to bed without examining or questioning anyone, and declared us all fit to go home. We were issued with a rucksack-size pack of pills, hastily instructed how to inject ourselves and shown the door.
With a large wound and a head full of morphine, I went home to an empty flat. I woke at midnight with a nagging pain, but was too weak to do anything about it. I felt lonely and vulnerable. How would I manage all those pills, the cleaning, the shopping – feeding the cat? For the first time in years, I felt truly helpless.
In the morning I injected myself in the thigh, as instructed, and tried to work out five pills. They had to be taken with food, but hours apart, leaving a long, miserable gap in the afternoons.
Friends called after turning up at the hospital to find no one there. One eventually found a nurse who told her, “She felt much better, so she discharged herself.” I felt outraged hearing this, but she pointed out that the girl spoke poor English and probably had no idea what she was saying.
There is no national standard for when people are discharged from hospital. It is all down to the doctor in charge. Gordon Brown’s target of 18 weeks between GP referral and treatment put pressure on hospitals to treat more patients, faster. At the same time, bed numbers were cut, dropping by 30,000 in the past 10 years. With no free beds, the only way to meet targets was to send people home.
Recently, many hospital wards have been slyly shutting up shop at weekends. According to the NHS Confederation, which represents managers, closing wards reduces overheads by cutting back on staff. Cash-strapped NHS trusts also reduce community nursing services.
But this miserable cheeseparing hasn’t worked, as 500,000 people annually are readmitted as emergency cases within 30 days of hospital treatment. A report last month showed that in 2009, hospitals received an extra £1.49 million for treating 820,395 patients who were readmitted within one month of surgery.
Two days after I got home, my wound opened. I noticed blood on my nightdress and called my GP. After holding on for 10 minutes, in tears, I discovered that home visits had gone the way of leeches.
Fortunately, I can hobble to the doctor in 10 minutes, so I wiped away my tears and set off. The waiting room was crammed. I was offered a chair in another room as there was nowhere to sit. When I saw the doctor, she looked flustered. I had disrupted her packed schedule.
She wrote a prescription, but I realised that I didn’t have any cash left. I had to walk home to get my credit card, then shamble off to the chemist in the other direction. The first course of antibiotics cost £20. I suddenly realised the high cost of drugs, and I was facing a long illness. I wondered how older people cope with this abandonment and anxiety?
Figures show that the number of patients aged over 75 rushed back into hospital has risen steadily, with 159,134 in 2007-2008, compared to 147,257 readmitted in 2006, and 94,283 in 1998-1999.
I tried to apply my own dressings. Hopelessly tangled and sticky, I ran through them quickly and had to keep returning to the GP’s. Where, I wondered, is Florence Nightingale when you need her, the convalescent homes we used to have, and, above all, the district nurses?
At the same time, I was trying to get a date for a final diagnosis of my cancer. Queen Charlotte’s could not find my details on their computer. “They seem to have forgotten you,” said a girl on the line as if it was a joke. Previously, they had not received letters from my doctor as their fax had broken.
I decided to get in touch with my cancer “keyworker”. A keyworker is available to every woman who has been diagnosed with gynaecological cancer, but I hadn’t expected to need her so soon. To my surprise, she told me that I was entitled to a district nurse and all cancer drugs for free.
Two days later, Emerald bustled in carrying an enormous bag. She didn’t wear a uniform but had the bearing of a nurse. “They’ve only allotted me 45 minutes with you,” she said.
I wondered why it would take that long to put a dressing on a hole the size of a 50 pence, then she brought out piles of forms. “No one has told me anything about your case,” she added, “I didn’t know what dressings to bring.”
It was chilly lying there like a baby on a changing mat while she waded through endless questions and rummaged in her bag. One dressing took over an hour, but it was such a relief to feel just a little bit looked after.
I wondered why my own doctor didn’t tell me I could see a nurse, or that cancer drugs were free? Too busy perhaps, but I have been told by doctors since then that, “In the NHS, no one connects up with anyone else.” Michelle Mitchell, charity director for Age UK, says: “There is a lack of joined-up care.”
The Government published a white paper last week, stating that if a patient returns to hospital within 30 days for the same illness, hospitals will not be paid for their second treatment. This plan, called “re-ablement and post-discharge support,” aims to keep patients in hospital until they are fit to leave, although that will still be at the discretion of a doctor. The new plan includes more community nurses.
But Katherine Murphy, of the Patients Association, spots a loophole. “You can’t prove that the condition they are readmitted for is related to their original complaint,” she says. “After being left to cope alone, people often return to hospital with new infections and breathing problems.”
Nevertheless, Professor Steve Field, chairman of the Royal College of General Practitioners, is optimistic. “There is still a lot of work to be done about who will provide community nurses,” he says. “But these new plans will allow us to create locally sensitive services, with the patient at the centre. This is aimed at keeping people out of hospital.”
It sounds like a new start, but before anyone will be able to hear the needs of patients, GPs, nurses and hospitals will have to start listening to each other. Apart from huge reorganisation, the NHS will need better secretarial staff, faxes that work and an efficient computer system – rather unlikely in these penny-pinching times.
I was diagnosed with stage 4 ovarian cancer, and I will be having chemotherapy until September. Throughout my journey into the NHS, I have met with an alarming mixture of confusion and indifference, kindness and skill. The system is so patchy and disjointed that you never know what to expect.
I would advise anyone about to enter hospital not to wait for government plans to kick in, just fill your freezer and line up all the help you can from friends and relations. And when you are talking to anyone in the NHS, never take no for an answer.
Parents’ fury as ‘healthy’ kids (aged 5 and 6) are branded “overweight” by NHS health police
They look like happy, healthy children – and that is exactly what they are. So it would take a particularly cruel and misguided sort to call Gracie Hill and Bailey Russell fat.
Step forward interfering NHS officials. They singled out the five-year-olds from their classmates and wrote to their parents, claiming the pair are overweight and at risk of health problems including cancer.
Yesterday their parents told how they were sent letters which began with the stark warning: ‘Your child is overweight for their age and sex’. The letters went on to say that ‘ dangerous amounts of fat could lead to cancer, diabetes and heart disease’ and were signed by the local director of public health.
Gracie’s mother, Laura, 28, said yesterday that when her daughter overheard her discussing the letter, she became upset and asked: ‘Mummy, does my teacher think I’m fat?’. Bailey, meanwhile, has begun turning down fattening foods because of his supposed weight problem.
The children, who are in the same class at Chellaston Infant School in Derby, were weighed with their peers as part of the National Child Measurement Programme, which was introduced in 2005.
Gracie weighed in at 3st 11lb, which is at the upper limit of the healthy range, and stands 3ft 10in tall, which is above average, but also within the normal range for a girl of her age.
But her body mass index, a mathematical formula which takes account of height and weight, was slightly over the recommended 92. Anything over 90 is classed as overweight.
Her mother, a part-time operations manager for a company of chartered surveyors, said: ‘There’s not an ounce of fat on Gracie. How dare they start scaring us with warnings about heart attacks and cancer? ‘We all know the dangers of girls and boys being obsessed by being fat and their looks and a five-year-old should not be thinking about her weight. It’s just nonsense.’
Mrs Hill and her husband Bruce, 35, regularly take Gracie on family bicycle rides with their other child, 15-month-old Poppy, and Gracie also does swimming and gymnastics.
Bailey was judged to be just 2lb over a ‘healthy’ weight for his 4ft height. His mother Donna Pell, also 28, said Bailey was healthy and active and ‘certainly didn’t get fed McDonald’s meals every day.’ The receptionist added: ‘I was horrified by the letter. They asked for permission to weigh the children, but I thought they’d just give you the facts and figures.’
Miss Pell did not tell Bailey about the letter but said he overheard her talking about it, at which point he told her: ‘I’m not fat’. He then fled to the bathroom, thinking that was the best way to lose weight. She added: ‘Then the next day we went out to have fish and chips and he said he couldn’t have them because of his weight. ‘The two comments were really quite upsetting.’
Under the national measurement programme, children are weighed and measured in reception class aged four or five and in year six, when they are 10 or 11. NHS Derby City is one of a number of trusts across the country to send the results to parents.
A Department of Health spokesman said the letters were ‘about giving parents information to help them make decisions about their children’s health’.
Earlier this month, the Mail told how Tom Halton, 11, refused to eat after being branded overweight. NHS officials warned that at 7st 10lb, Tom was 3lb outside the ‘healthy range’ for his age. [A range which is all made up anyway]
White Christian Britons being unfairly targeted for hate crimes by official prosecutors
White Christian Britons are being unfairly targeted compared with minority groups for committing hate crimes, a new report says. The study from think-tank Civitas argues that new hate crime legislation is restricting freedom of speech, and has effectively introduced a new blasphemy law into Britain by the back door.
A foreword attached to the main report, “A New Inquisition: religious persecution in Britain today”, argues that prosecutors and police are unfairly singling out alleged crimes by white Christians, while ignoring other similar offences by minority groups.
It says: “Some police forces and the CPS [Crown Prosecution Service] seem to be interpreting statutes in favour of ethnic and religious minorities and in a spirit hostile to members of the majority population, defined as ‘White’ or ‘Christian’.”
Report authors said it is “legitimate to ask” whether these agendas are being driven by “sectarian groups” within either police forces or inside the CPS.
It claims “there is evidence of biased application of the law”, citing the case of a Muslim man who sprayed the words “Islam will dominate the world – Osama is on his way” and “Kill Gordon Brown” on a war memorial in Burton-Upon-Trent.
He was prosecuted for criminal damage – “that is neither a racially nor a religiously aggravated offence”.
The CPS had argued that “the defacing the memorial did not attach to any particular racial or religious group” despite the fact that the monument was “a Christian and British memorial, carrying Christian and British symbols.
“People who read the story found themselves thinking that, if a non-Muslim had defaced a Muslim building the system would have thrown the book at him”.
This compared with a Christian couple in Liverpool, Ben and Sharon Vogelenzang, who were prosecuted and then cleared last December of a religiously aggravated hate crime after a strongly worded discussion with a Muslim guest at their hotel about the relative merits of their respective religions.
Civitas questions whether the CPS’s decisions are being influenced by an internal staff association called the National Black Crown Prosecution Association (NBCPA), which has in the past received tens of thousands of pounds from the CPS.
It says the NBCPA’s “main objective is to advance the careers of ethnic minorities within the CPS but it also takes an interest in the impact of CPS decisions on members of ethnic minorities”.
It adds: “Whether this concern threatens the impartiality of the CPS is not clear. But other harmful effects of race-based politics have already led to open criticism by some CPS staff.” It cites a newspaper report which claimed “that ethnic minorities were being given jobs within the CPS that they could not do”.
It adds: “The activities of race and religion-based groups within the criminal justice system, including the police, the probation service and the CPS, are such that a public inquiry is now needed. “Groups that act in a sectarian spirit have no place in a system whose essence should be justice and impartiality.”
A hate crime is officially defined as a “criminal offence which is perceived, by the victim or any other person, to be motivated by a hostility, or prejudice based on a person’s religion or perceived religion”.
Yet the report argues that these definitions are without substance and result in confusion and silliness in their application.
Although the total number of these crimes has fallen from 13,201 in 2006/7 to 11,845 in 2008/9, the report says the volume of hate legislation has rapidly expanded, with 35 Acts of Parliament, 52 statutory instruments, 13 codes of practice, three codes of guidance and 16 European Union directives which have a bearing on “discrimination”.
A spokesman for the Crown Prosecution Service said the NBCPA was “a highly regarded staff association” and “the trailing of the suggestion that the NBCPA may affect the CPS’ impartiality is without foundation.
“The NBCPA has no influence over specific casework decisions. The decision to prosecute is based solely on the application of the principles contained in the Code for Crown Prosecutors.”
Prosecutors only take allegations of a racist or religious crime to court when they are satisfied “there has to be sufficient evidence for a realistic prospect of conviction. “Where there is evidence of a racially or religiously aggravated crime, the public interest will usually require a prosecution.
“When making their decisions, prosecutors are not influenced by the ethnic or national origin, religion or belief of the suspect or victim and it is incorrect to suggest any one group is singled out more than another for prosecution.”
British charter schools (Academies) ‘failing to teach traditional subjects’
Academies are shunning traditional subjects such as English and History in favour of less challenging qualifications in an effort to drive up results, a think tank has claimed.
Figures disclosed in parliament revealed that the proportion of academy students taking GCSEs in courses including English Literature, history and individual sciences are outstripped by those at maintained schools.
In foreign languages and geography, entries from academies were more than a third lower than the average for maintained schools.
Opponents said the figures showed academies had abandoned non-compulsory academic subjects in favour of less challenging GCSEs and equivalent qualifications to boost their performance in league tables.
Academies, which are not subject to freedom of information laws, have faced calls to be more open over the curriculum they offer and the pay of staff.
The figures, based on exams taken last summer, came to light following a question in Parliament by Tristram Hunt, MP for Stoke-on-Trent central, and research by Civitas.
It follows data showing that academy pupils are awarded twice as many A* to C grades in non-GCSE qualifications as maintained schools, but two thirds as many of the equivalent GCSE grades.
Anastasia de Waal, Director of Education at Civitas, said: “Academies are supposed to be improving not impoverishing education, so to find that the proportion of academy students doing core academic subjects is much lower than average makes a mockery out of the notion that academies are exemplary.
“Withdrawing academic GCSEs and replacing them with weak substitutes has been great for academies’ league table position but hugely detrimental to the already often limited opportunities available to the young people they serve.”
In academies, just 21 per cent of pupils took a GCSE exam in history and 17 per cent in geography last year, compared with 30 per cent and 26 per cent respectively in maintained schools.
Academies entered just eight per cent of pupils for individual exams in physics and nine per cent in chemistry and biology, compared with 12 per cent for each of the three subjects in maintained schools.
The biggest difference was in foreign languages, where just 26 per cent of academy pupils were entered for a GCSE compared with 41 per cent in all maintained schools.
Dr Mary Bousted, general secretary of the Association of Teachers and Lecturers union, said: “There is nothing wrong with academies devising a curriculum which will get the children to school and get them wanting to learn.
“But the difficulty is when the qualifications are a spurious equivalent to a GCSE, which are widely used to push up the GCSE results of academies to show that they are getting much better results than state schools.”
A spokesperson for the Department for Education said: “The fact is that Academies are working – academies have been over three times more likely to be rated outstanding by Ofsted than other state schools, since their new tougher inspection regime was introduced, while half as many Academies are judged inadequate.
“Ministers are clear that young people should be entered for the qualifications that are in their best interests rather than being entered for exams simply to boost the league table position of the school.”
Official British garbage snoopers
Councils are secretly rifling through thousands of dustbins to find out about families’ race and wealth. Waste audits allow officials and private contractors to check supermarket labels, types of unwanted food – and even examine the contents of discarded mail.
The local authorities are using social profiling techniques to match different types of rubbish to different ethnic groups or wealthy and poor households, as part of a recycling drive initiated by the last Government.
Householders can then be placed into social categories, which in some areas range from ‘wealthy achievers’ to the ‘hard-pressed’ – and subsequently targeted for future leafleting campaigns.
But last night critics condemned the move as ‘highly intrusive’. Most homeowners have no idea that their rubbish is being searched or that data collected could be used to prosecute those who place rubbish in the wrong bin.
At least 90 councils ran covert bin-rifling operations last year, according to Freedom of Information requests. They targeted a total of more than 10,000 families and argue that Government guidance suggested all checks on bins should be done without the knowledge of householders. ‘Ideally, you do not want to inform the public of an audit taking place, as this could alter their disposal behaviour,’ it said.
But the secret nature of the audits will raise concerns about privacy. Although some councils used their staff to conduct the operations, many hired in private contractors.
Often, officials deliberately picked streets where different types of men and women lived to see if their ethnic origins, type of home or wealth affected the amount or rubbish they threw out.
Councils in Leeds, Poole, Kensington and Chelsea, Swindon and Cheshire East all used some form of social profiling to target homes for bin searches. In Hackney, East London, researchers targeted homes based on their potential ethnic and social mix, collecting data separately on four different groups, including ‘multi-ethnic private flats’ and ‘prosperous young professionals’ flats’.
The study found that ‘as expected’ the ‘educated urbanites’ living in ‘trendy’ flats threw away the least rubbish.
Hackney also found a number of electrical items which should have been recycled, including a microwave oven, a foot spa and an electric heater.
In Bracknell Forest, Berkshire, researchers sifted through discarded food. They concluded that more than half of it could have been recycled or composted if householders had behaved more responsibly.
Officials in Wokingham, Berkshire, went through the bins of almost 500 homes, identifying almost a ton of rubbish that could have been recycled.
In Southampton, officials found that homeowners were more likely to put general waste in the recycling bin in the week after Christmas.
Fiona McEvoy, of the TaxPayers’ Alliance, condemned the move as ‘highly intrusive’. ‘Councils shouldn’t be paying contractors to rummage through resident’s bins when there’s huge pressure on their finances. Local authorities should abandon their fascination with what’s inside our bins once and for all and concentrate on cutting the considerable fat within town halls.’
Dartford Council, in Kent, has refused to carry out the secret surveys. Jeremy Kite, who is the council’s Tory leader, said: ‘I strongly object to the analysis and examination of waste put out for collection unless specific permission is obtained from the householder and have intervened to prevent such exercises in Dartford on more than one occasion. I do not believe it is right.’
Councils cited little-known guidance from the Department for the Environment, Food and Rural Affairs for secret searches. Enfield Council, in North London, said: ‘In line with Defra guidance we took the view that householders would not be notified in order to avoid prejudicing the results.
‘When waste is placed out for collection by the householder the law regards this as being discarded, ie: not wanted or owned by the householder. When collected by the local authority the waste falls into their ownership.’