NHS Care of Older People

Julie Hilling Excerpts

Thursday 27th October 2011 Westminster Hall

[Julie Hilling (Bolton West) (Lab)]

It is a pleasure to serve under your chairmanship, Mrs Brooke. I congratulate the hon. Member for Stourbridge (Margot James) on securing this important and timely debate. I beg your indulgence as I tell a personal story about my mum’s recent journey through the national health service. As many colleagues will know, my mum had a bad stroke in June this year, and we have had a bumpy ride over the past four months. I want to make it clear at the outset that the vast majority of care workers, nurses, doctors and other staff with whom we have come into contact have shown my mum a great deal of loving care, but she seems to have been let down by system failures.

Mum is 86, but before her stroke, she was still working, teaching three yoga classes a week, doing reflexology, driving her car and leading a totally full life. As hon. Members can imagine, it has been devastating not only for her but for all of us. After the stroke, she was first admitted to Luton and Dunstable hospital’s accident and emergency department. At about 4 in the morning, she was medically ready to be transferred to a ward and was taken up to the stroke ward. However, when we got there, we were told that there was no bed. We were not too fazed at that point—it was the middle of the night—so we accepted it, and she was transferred back to the emergency admissions ward. At the time, the medics were not sure that Mum would survive, so it was a difficult time for us.

By the following afternoon, we were getting agitated—[Interruption.] Excuse me, Mrs Brooke; you can tell how it made me feel. Anybody’s journey through the national health services in such circumstances is difficult, and ours has not been made better by what has happened to us. We were agitated by the following afternoon. Mum was still on the emergency ward, which was very busy and noisy. Eventually, we started the journey back to the stroke ward, to be greeted at the desk again with “Sorry, there’s no room.” At that point, I started to become six foot tall, thinking, “My mother is going to come into your ward.” Fortunately, a sister behind the desk treated us nicely, saying, “This woman will be admitted on to our ward.”

Some time later, concerned about her breathing, I called for a nurse. The nurse came in and said, “Well, you know she’s do not resuscitate, don’t you?” I said, “Yes, but I’m concerned about her breathing.” The nurse said, “Oh no, she’s fine. She’s actually in a deep sleep and things are good, but oh dear, I’ve not hung up the drip.” I spent the next half-hour holding up the drip so that Mum would get saline and holding Mum’s hand until the nurse eventually returned with the drip stand.

That is just the start of a chapter of system failure. It was a great frustration going to the desk and seeing all those people behind it, but being totally ignored. I did not know whether they were physiotherapists or doctors. When I said, “Mum needs the commode,” or “Please can you,” I was ignored. That was not just our experience but the experience of everybody on the ward.

[Stephen Pound (Ealing North) (Lab)]

Sorry, but I cannot believe I heard that. Can my hon. Friend confirm that the charge nurse said to the patient’s daughter that the patient was do not resuscitate? Please God, I heard that wrong.

--- Later in debate ---

[Julie Hilling]

No, indeed. That was what was said to me when I questioned her breathing. We knew that Mum was gravely ill and that they would not make extraordinary efforts to save her at that point, but the way that it was done did not make it the best thing that happened.

As I was saying, the great frustration was being ignored. One day I went to the desk, saw the doctor who was doing the round and said, “We really need to speak to you.” The doctor said, “I’m very busy at the moment, but I promise I will speak to you before I go home.” I went back to the desk a few hours later to discover that the doctor had gone home. We only got results by complaining. It was a difficult period.

Mum was on thickened fluids because she had difficulty swallowing. Each day when we went in, on her trolley would be a glass of ordinary, unthickened water. However, the good thing was that every day it was out of reach, so fortunately she could not choke on it. Then they complained that she was not drinking enough.

Food was a mystery. We would fill in the menu form, but each day it would be a lottery what turned up. Mum was on puréed food, but three times in one week, the lady in the next bed got no evening meal. Each time, they said, “Well, you didn’t fill in the form.” Her family said, “Yes, we did,” and they said, “Oh well, we’ll give you sandwiches.” Fortunately, that happened to Mum only once. Thank heavens my sister was there, because they said, “We’ll give her a sandwich.” My sister said, “Look on the chart over her bed—puréed food only.” Had she not been there, goodness knows what would have happened.

One day, Mum choked. They had got her out of bed, so she was sitting next to the bed, and she was choking. She was unable to ring her buzzer at that point, so another patient rang it, trying to get somebody to assist. Nobody came for about 10 minutes. The other patient’s young husband then had to assist my mother, mopping her up and getting her sorted out so that she was no longer choking.

For a few days, there was a lady in the bed next to Mum’s who sat on a pad that spoke every time she stood up. Clearly, she wandered, and they needed her to stay in place, but the message on the pad said, “Dear Mr Such-a-body, please sit down again and somebody will come to you.” Of course it was no trigger for that woman, as that was not her name. The name had not been changed. The lady opposite Mum could eat, but was not eating a great deal. She was not helped to eat or given prompts such as “Please have a bit more”; somebody would just come and say, “You need to drink a bit more,” instead of helping her.

I asked my assistant to send a card from my right hon. Friend the Member for Doncaster North (Edward Miliband) and the Chief Whip. I nearly asked for a card from the Prime Minister. I thought that maybe if they knew that I was an MP—I have never in my life told as many people that I am an MP as I did during that period—they just might give my mum a bit of extra care or show more concern. I even took in a box of House of Commons chocolates, as if to say, “Look after this lady, please,” but that did not make a great deal of difference. The staff did care, but the system was not in place. We felt that we had to make sure that, every day, somebody stayed for the full length of visiting hours.

After two and a half weeks, mum was transferred to Biggleswade rehabilitation hospital. Again, the staff were very loving, but they also let us down. They loved mum, and we felt that that was partly because mum is a proud, undemanding and polite woman. She was in Biggleswade for eight weeks and, again, we did not dare to not have somebody present to visit for a substantial part of the day.

Mum had pneumonia, along with the stroke, and after a couple of weeks at Biggleswade, she did not seem very well to us. We had to tell the staff that, despite the fact that she was getting close personal care at this time, mum was not well. They took her temperature and, yes, she had a chest infection. Treatment was good, but why was it us—she was in hospital—who had to raise the alarm? Mum was losing weight—she ended up losing 3 stone during this period. She was supposed to have protein drinks, but the drink only ever turned up on one day. Mum came to absolutely hate meal times at Biggleswade.

The second major incident was equally frightening for us. Mum had bumpers put on the side of her bed, to prevent her paralysed leg from getting caught in the bars. One night the bumpers were not put on and her leg got stuck. She, of course, did not realise this and it was only in the morning when she said that she was in extreme pain that it became apparent that this was why. Why were the bumpers not put on? Moreover, if it was a mistake, why did not somebody on their night tour know that the bumpers were not there? It is an 18-bed hospital, not an enormous one with hundreds of beds. Why, indeed, did the nurse in charge not check on the patients throughout the night? When we went in, mum’s leg was hugely swollen. The sole of her foot was purple. We are not medics—we did not know what was the matter—but we thought that something was wrong, so we raised the alarm again.

I want to tell this story because I think it is typical of other people’s experiences. Mum needed close personal care, so why did the carers, who were putting her in a hoist and changing her clothes and pad, not raise concerns about her leg being three times the size of the other one? The unit at Biggleswade is nurse-led, so a GP was called. He thought that she had a deep vein thrombosis and tried to get a scan the next day. He did not think that she should wait 36 hours, which was the time we would have had to wait for the appointment on offer. He thought that he had succeeded in getting a scan for her the next day, but, sadly, he had not, so we had a desperate day of trying to get mum scanned. We asked whether there was any other hospital that she could go to, and—remember that I am a good socialist, Labour MP—I even asked, “Can I pay?” I am grateful to mum’s MP, the hon. Member for South West Bedfordshire (Andrew Selous), who also helped and pulled out all the stops to try to get mum a scan, but we only managed to get her in the next day.

I asked to see the matron to see whether anything else could be done. Although I remained at the hospital all day, I was told that they had seen a posh car drive away from the hospital and had therefore decided that I had left—I am not too sure why they thought I drove a posh car—so the matron had left the site without seeing me. The medics were not too concerned, because they said that they had started treatment—a treatment that we were later told should not have been started before mum had had a brain scan, because she had had a hemorrhagic stroke.

I also discovered that there are only four slots for GP referral scans at Bedford hospital. The hospital serves many thousands of patients, so why are there only four slots for that huge population? We went to the hospital and another chapter of problems started. I will not bore everyone with the full details, but suffice it to say that there was a lack of communication, which resulted in mum missing her slot to be scanned, and a full day of a woman, frightened and in pain, sitting around in a hospital.

The overwhelming feeling was that everybody blamed everybody else. It was said that the day ward at Biggleswade should have sent her on a trolley. Somebody else should always have done something, but very few people said, “I will do something.” Mum was diagnosed with a DVT from toes to groin and was in the ambulance about to go back to Biggleswade while I was still in the hospital demanding answers from the doctors and asking questions. Fortunately, the consultant appeared at that point—I am not sure whether he turned up or was asked to come—and said that, because of the medication that mum was on, she should stay in and they should not send her home. That was the turning point in mum’s journey—good care and good treatment in Bedford hospital. She started to eat.

After two and a half weeks at Luton and Dunstable hospital, eight weeks at Biggleswade and one week at Bedford hospital, mum went into respite care in Swiss Cottage care home in her home town. What a difference. She is eating well, has started to put on weight and is starting to walk. She is making amazing progress and we hope that she will go home soon.

There has been only one bad incident in the care home. It asked a GP to visit and the one who was on duty—it was not her GP—refused to come, because he did not know her case, even though all the information had been sent to the GP. He referred her to Stoke Mandeville hospital for another scan—another day of pain and distress for this woman. They said, “She’s got a DVT,” but we knew that. That seems to be another failure.

I am grateful for the opportunity to tell my mum’s story, because, sadly, it seems typical of that of so many older people. It seems that if people have something that is wrong and treatable, they get good service from the NHS, but if they are older and just need care, the results are not so good. There also seems to be little consideration given to who that older person is or was; they just become “an old person.” Yes, she is 86, but my mum was a working 86-year-old, teaching yoga and apparently fitter than me—she was not just an old lady.

A GP in Biggleswade told me that my mother is lucky to have a family who have been fighting for her. It should not be that way. Every older person deserves to be treated with respect and care. I am grateful for this opportunity and I hope that, through all of our efforts, a real difference will be made to the treatment of older people.