Do We Need To Close More Hospitals?
I’ve believed that we have too many hospitals for a long time. Often politics mean that the needs of getting votes come before the needs of good healthcare. No-one would ever get elected, if they were in favour of closing their local hospital.
When I lived near Newmarket, we had two hospitals at the same distance away, Addenbrooke’s and Bury St. Edmunds. The first is a world-class facility and the second is a typical general hospital on a cramped site with bad transport links.
No-one ever chose to go to Bury St. Edmunds and I always remember once turning up at A & E there in the middle of the night to find no-one waiting, but it still took me three hours to be seen. The whole hospital should have been down-graded years ago. This is unlikely to happen, as the powers that be in Bury still resent the fact that Ipswich became the county town, when West and East Suffolk were merged. So we all pay extra through our taxes for local vanity.
So should we close more hospitals? Lord Cross who used to run the NHS, apparently thinks so according to this report on the BBC.
NHS Waiting Times
There was a report yesterday that said that some NHS Trusts are imposing a minimum and maximum waiting time for some operations and treatment to save money.
If they are they, they are breaking the First Law of Scheduling, which is you maximise your efficiency by agreeing dates between both parties as soon as you can.
I first came across this, when I worked in the Research Department of ICI at Runcorn. We had a small workshop that would make equipment you needed. Everybody used to put a delivery date of ASAP on everything, even if they didn’t want it for a month or so. The outcome was that nothing got delivered in a reasonable time.
The situation couldn’t go on and the manager of the workshop decided that no work would be accepted without an agreed delivery date.
The outcome was harmony and everybody was happy. One interesting side effect of this method, was that when the workshop could see a high peak of future work, they would sub-contract some jobs to an external firm.
I must admit that I stole this technique when I wrote the task scheduler for Artemis, but of course this was a legitimate steal and it made the task scheduler very good.
Some NHS Trusts do use this agreeing of appointments method. Addenbrooke’s in Cambridge do and I’ve negotiated a suitable date and time on the phone several times.
I know too of a farmer, who needed a hip replacement and got the operation done at one of the quietest times in the farming year and a slack time for Ipswich Hospital.
Now most of us have e-mail or can use SMS, surely this negotiation can be an almost painless and automatic process.
It oviously won’t work for emergencies, but say you need something like a hip replacement, a mutually convenient date is best for all parties and in my view will probably add a few percentage points to hospital capacity.
How many NHS Trusts still manage appointments and waiting lists on a non-scientific basis.
Laptops in Hospital
In a previous post, some of the comments were about smart phones in hospitals.
I’m all for allowing patients to have laptops in hospital. I had my stroke in Hong Kong and I was allowed one there. It allowed me to do things like listen to Radio 5, talk on Skype, do the Sudokus in The Times and send e-mails, that I wouldn’t have been able to do otherwise.
I could also have done things like watch videos, which I never do anyway.
In Addenbrooke’s laptops were effectively banned and I don’t think it helped me.
The reason they are banned is that if they were allowed, it would mean they’d lose all that money they get from that crap Patientline system. The bandwidth wouldn’t be a problem, as they can now get enough Megabits easily.
The laptops could also be integrated into patient care and support. For instance, a physio in Hong Kong told me that typing would help my hands work properly again. She was right!
So let’s have some 21st century, healthcare thinking!
Remember too, that happy patients are less trouble for staff and might even leave earlier.
To me allowing laptops in hospital is a no-brainer. But then what do I know about healthcare? But I have seen good healthcare at work and know what works.
I am also in contact with universities, where they are developing computer games to help stroke patients. Let’s make those free and downloadable!
A Setback Yesterday
\i spent most of yesterday in hospital at Addenbrooke’s after what they thought was a post stroke seizure. I was back home by eight with a prescription for Keppra, which is an anti-epilepsy medicine. They also gave me a CT Scan, which showed there was no new damage. So that is good news.
The Sting in the Tail
There always is, isn’t there!
I’d decided that the best way to get home from the hospital, would be to take a bus to Haverhill and then take a taxi.
As I left the hospital the 13 bus was there, so I ran to get on it. I may have had a stroke, but I can still run ande walk a few hundred metres or so.
I assumed that the bus would go straight to Haverhill Bus Station, as the previous one had done a couple of weeks ago. But this one did an unguided tour of all the delightful estates and I ended up being dumped in a place I did not recognise. It hadn’t helped that because of the rain I couldn’t see out of the bus in the dark.
So it was a long walk to the Bus Station and then I couldn’t get a taxi without half-an-hour’s wait.
So something that should have been easy, made me late!
I get more fed up with the countryside every day.
And Now The Good News!
Well I suppose it’s good news, in that the hospital doesn’t want to see me again about the stroke! I suppose I should be pleased but I don’t think I showed much emotion as I was getting tired after the travel. In fact if I have any emotions now, it’s about going to London, hopefully for a new start! At least when it’s like tonight, I won’t have to stay inside watching nothing on the television.
My State of Health
Since I ended up in Addenbrooke’s a week ago, I’ve not felt well at all.
- My teeth feel like I haven’t cleaned them in a week and it’s almost as if they’re covered in slime, which I guess is the muck pouring out of my sinuses.
- My arm and face are in pain. But it seems that my left hand is better on the keyboard though!
- But at least my eyesight has improved and I am able to use a pair of binoculars. I thought that yesterday at the football, I followed the match better than at any time since my stroke.
- My throat hurts and I suspect that is the coughing to try to clear it.
- I thought for a while yesterday that I was totally constipated, but that cleared up this morning.
- At least I’m sleeping reasonably well, but I don’t like the number of pain killers I’m taking. I’m well below limit set by my doctor, so I suppose that is one thing.
I’m seeing a consultant about my sinuses on Tuesday morning, so at least the end might be in sight.
I really hope so!
Feeling Much Better This Evening
Because of the infection I had treated in A & E on Sunday, I’ve been taking anti-biotics. And I’m feeling an awful lot better. For instance, I just got a pair of binoculars out to see if I could see any of the heavens. It’s overclouded so the stars were all obscured, but I could pick out lights in the distance easily. So my eyesight definitely is better! Last time using binoculars was actually painful.
So have I had this infection ever since I’ve come home from hospital? I really do think so!
A Bit of a Scare
I got up at the usual time of about six this morning, as I was intending to see the Japanese Grand Prix. However, within a few minutes, I had such pain in my face, that I did the only thing I could think of and that was dial 999. The thought of another stroke occurred to me, but then I could still type and speak!
The ambulance arrived fairly quickly and I was taken off to Addenbrooke’s after they found me wandering about in the house.
It turned out to be a blocked sinus, or that’s what they think it is. I’ve had bad taste in my mouth for months, teeth and cheek pain and a lot of other symptoms that fit with a severe sinus problem. I should also say, that for years as a child I suffered from the same problems and they really only went away when I went gluten-free.
At least now, as i write this, I feel a little bit better! but i must get to see a specialist.
For example could the blocked sinuses, which often cause a lot of muck to discharge into your throat and gut, be the cause of my almost permanent soft and very ginger motions?
A Bone Scan at Addenbrooke’s
My gastroenterologist thought that as a coeliac, that I ought to have a bone density scan and I did today. I also decided that it would be easier, if I took the train to Cambridge and then got a bus to the hospital. I could have got someone to drive me, but in some ways there is less hassle if you take a bus, especially, as the stop is in the station forecourt.
I actually arrived early and after being booked in by the receptionist, she advised that I went and had a coffee and returned on the booked time. That shows a high degree of professionalism and confidence that the radiologist can keep to te set schedule.
They’d said if I didn’t want to wear a hospital gown, then I should wear clothes without zips and fastenings. But as I haven’t been warm for a few days, I wore my usual uniform of blue cord trousers, short sleeved shirt, jumper and Jodhpur boots. The radiologist said that would be fine, as all I would have to do is drop my trousers to my knees. I could make a comment about when young ladies say that, but I won’t!
It took perhaps fifteen minutes to do the scan, with the machine moving up and down my lower body. It was completely without any feeling and all I’ve got to do is wait for the results to be assessed.
I think as medicine progresses, we’ll see more and more specialist machines like this, developed with clever software and hopefully operated as many hours of the day as is possible. Assets should always be made to sweat!
About an hour after arriving, I was back at the station waiting for the train home.
The Anonymous Widower 