Elderly People: Abuse

Lord Mawson Excerpts

Wednesday 14th May 2014 Lords Chamber

[Lord Mawson (CB)]

My Lords, I, too, thank the noble Baroness, Lady Cumberlege, for introducing this debate. Three months ago, my 95 year-old mother, living alone, had a heart attack early one morning at home in Bradford. The ambulance was called and the paramedic saved her life by deciding to take her by blue light the 15 miles to a hospital in Leeds because he feared the local hospital in Bradford, serving half a million people, was not up to the job. That paramedic’s good judgment saved her life and now she is back home and, amazingly, recovering well.

My mother has fortunately lived a well and independent life and so has not often had to use the health and social care system, so this was all quite new and a fresh experience for her as she became catapulted into the NHS institution. As a person who was now totally dependent on others, at this point she felt that she had a good experience of the system and was treated well by many of the NHS staff. Those of us in the family, however, less dependent and observing the system close up, were left with a few questions to ask. Abuse of the elderly can be subtle, and large, well-meaning government-facing institutions with a tick-box culture can be very inhumane and impersonal, with the best will in the world.

First, on visiting my mother in hospital after the incident, I was greeted by more than 71 notices either side of the door of the ward telling me what to do as well as to wash my hands. If we are the environments we live in, then McDonald’s has a more welcoming environment and clear communication with the customer than this. It is all very amateur and confusing for visitors and patient alike.

Secondly, why did the initial meeting with the social worker not include a person from the health service? It was held in the hospital. Why was a plan that was agreed to by the family then totally ignored and not taken forward when my mother reached the community hospital nearer home? The health people down the line knew nothing about it. Personal communication is essential if vulnerable elderly people are to feel secure. Why are these basics still so difficult in the age of the internet?

Thirdly, why were staff in the local cottage hospital telling us confidently that they did not normally speak with social services—“Nothing to do with us, love”? Why was there no evidence to us that health and social care were partners? At one point, when they did meet, they had an argument in front of the patient. If it is all about working in partnership at a basic level, they still did not seem to get it. My family’s experience of the system was that, despite all the rhetoric about a seamless service, in reality health and social services still seemed to work in separate universes.

Fourthly, why was my mother not given a bath at the new cottage hospital in the four-week period that she was there but had just hand-washing? Is this not rather basic care for a 95 year-old? She wanted a bath. Why when she came home did the social worker then tell my brother, a retired experienced nurse, that he could not arrange a bath at home either until she was given a “bath assessment” at the end of May, weeks later? And we are still waiting. Why did he tell us that the policy was that he could help my mother out of a bath at home but not help her into it? It was health and safety, we were told. Members of the family did the business, but it is all very confusing for sane people.

Finally, why when an assessor comes around to visit my mother at home is this professional not allowed to use her common sense and good judgment? My mother told me she arrived with a pen and piece of paper in her hand, and asked my mother if she knew how to make a cup of tea. “Sit down, love”, my mother said. “I’ve been making tea for 90 years. If I haven’t mastered it by now, there is something seriously wrong”. Treating elderly people like children for the sake of a form that keeps civil servants happy up the tree is abusive, makes the elderly people cross and, by the way, often tells us little about the reality on the ground. My questions to the Minister are: when will these systems receive some innovation and when will we learn—as the noble Lord, Lord Griffiths, rightly said—what caring communities are all about?