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Monday, May 30, 2011

Family Nursing and Home Care Cutbacks: A Comment

From  Tony the Prof.  http://tonymusings.blogspot.com  



PATIENTS using Family Nursing and Home Care may soon have to buy their own medical
products after the charity announced cuts to its service. In a letter sent to FNHC patients on
Monday, the charity's finance director, Andy Cook, said that there were plans to get patients to
purchase their own dressings from their local pharmacy. In the letter Mr Cook said that the range
of dressings and other medical items distributed by FNHC district nurses would be reduced
to 'conform to an agreed list of products between us and Health'. The move has been heavily
criticised by Unite union official Nick Corbel, who has warned that patients will be put at risk.


What will happen in the future if you are one of those who require medical products that are
currently supplied by Family Nursing & Home Care (FNHC) who have recently announced the
closure of their outlet?


Currently you have to join FNHC and pay a membership fee of £50 upwards to be able to access
this service, and the scheme includes the provisions of feeding tubes, dressings and incontinence
pads for children three years and above. Dietary drinks are also medically required by the person/
patient for their well-being (to keep them alive).. The change in policy means that members will
no longer be receiving the service they have paid a membership fee for.


Financial assistance is currently provided to FNHC by Health & Social Services and Social Security
Department fund, and there are free medical supplies to under five year olds. Families with
children over five years pay 15% of FNHC retail price for the products.


According to the staff of FNHC stores, who received their redundancy notices on Easter Saturday,
the outlet closes on the 1st July 2011. One of my correspondents commented that "The staff
runs efficient and personal services which believe no private company would, or could provide."


The alternative will be purchasing items required from chemists or other outlets at full cost.


This reminded me very of the true story told by theologian Frances Young, in her book, "Face to
Face", and this was about the NHS in England. Cuts there came in earlier than in Jersey, under
the regime of Margaret Thatcher and the so-called policy "care in the community", which actually
often simply meant State care on the cheap:


Arthur's incontinence has always been with us, and the way we have handled it has really been
an extension of the babyhood practice of using nappies. We are geared up to it with suitable
washing machines and drying arrangements. But plastic pants became a problem: he got too big
for the typical baby-pairs you can get in chemists' shops. We heard from other parents about the
supply of disposable rolls and plastic pants. I asked our social worker. She said I could call in at
the Community Health centre and pick up what we needed. I could and did. There was a funny
old man who would just take your word for it, fill a plastic sack with rolls, produce a couple of
pairs of plastic holders and all was fine. We went about every three months. We only needed
rolls for school.


Then came the cuts. So what did they do? They employed a secretary to check up on every issue
from the Community Health stores. The secretary must have cost more than they saved. The
informal arrangement no longer worked. A call from the social worker got us on the list, but then
they would only give us a couple of rolls at a time, and we were lucky to get any plastic pants.
There was no way we could call frequently enough to get enough rolls for school use. School
kept pressing. Other parents were on the laundry service; they had a regular supply delivered
every week. Why didn't we apply? Eventually I tracked down the District Nurse and a formal
application was put in. We were put on a two year waiting list. Think of it - people coping with
incontinent old people on a two year waiting list! They're likely to die before they get what they


That is the trouble with removing a system that works. The alternatives usually require form
filling, and bureaucrats checking, and replacing the front-line staff who know the people and
their needs, decisions become bedded down with line managers checking decisions at a lower
level; instead the whole enterprise, as I am sure will also happen in Jersey, becomes more
formal, with forms to complete, assessments to check, before any alternative support is given to
the needy.


They now will have to justify their need to clerical staff, rather than it being assessed on a
common-sense basis by an organisation which can supply nurses to change dressings, for
example, and who will know how people are coping. It is another burden, another hoop to jump
through. As Frances Young says:


Professionals are always telling us to keep fighting for our rights, but we have got better uses of
our time and energies. What concerns me is not our particular situation, but what it reveals
about the stupidity of the whole set up, what it reveals about the hardships more vulnerable
people must suffer. And this is supposed to be a caring society. Those who need the care are
subject to suspicion and discouragement. They are exposed to unnecessary indignities - like the
time my husband and I were sent separate bills to cover the parental contribution to Arthur's
care. I hear people from disadvantaged backgrounds, immigrant groups, crying out at the way
they are treated and saying this society is racist; I tell them it is not just those with the `wrong'
colour skin who suffer in this way in our society. It should not simply be interpreted as racist.
Granted that it is worse for them at times because of racist attitudes, it is still a fact that even
people like us, white, Anglo-Saxon, Protestant, comfortable, middleclass and articulate, are
subject to being treated as non-persons when we present our vulnerable face to officialdom.


There is something about the way state services are organized which creates an 'us' and `them'
situation which is profoundly alienating. I am glad that I have experienced something of this, and
can stand with at least a small measure of understanding alongside the real poor and
inadequates in our society. It is time we realized just how uncaring and inhuman our institutions
are. It is time Socialists realized that this is what their ideals have produced -- it has gone bad on
them. It is time Conservatives realized that cuts have hurt the most vulnerable members of
society whatever they say, and that stopping waste has created waste, and hardship .


And she notes what we will see in Jersey, that more expensive options will be available, and an
extra financial burden placed on those who are struggling with enough burdens as it is:


It is since they came to power that supplies for incontinence have mushroomed in Boots and in
chemists' shop windows. At last we can get what we need - by paying for it. Society may need
handicap, but it will not bear the cost of handicap. The unfortunate are made to feel that they
are to blame for their misfortune.


One of the comments on the JEP website is particularly pertinent in this respect:


Someone needs the Nurse opinion on this one as some patients, like my late father have leg
ulcer problems and the amount and cost of dressings is extortionate to them. For the old its
often a choice between food and electricity or changing dressings regularly. Looks like we'll be
back to the old days when the patients had to rewash bandages.!!


Links:
http://www.thisisjersey.com/2011/05/23/family-nursing-patients-may-have-to-provide-own-
dressings/
"Face to Face", Frances Young, 1986

1 comment:

  1. Family Nursing and Home Care nursing are very much helpful and i am proud of those who are caring the elders.Thank you for sharing information with us.

    ReplyDelete