26 Mayıs 2014 Pazartesi

Clinicians, not bed movement, need to dictate discharges

In addition to this, most new hospitals built under PFI (private finance initiatives) have, on average, 30 per cent fewer beds, principally because the companies that run the hospitals are keen to cut costs. This has added further pressure to the remaining accommodation. Most hospitals in Britain currently operate at about 100 per cent occupancy rate. In contrast, most hospitals in Europe operate at 80 per cent.


It’s easy to see why, if the hospital is full and there are sick people waiting, you have to operate a one-in, one-out system. The only option is to turf someone less sick out of their bed and send them home, regardless of the time of night. Meanwhile, rates of the superbug MRSA and the infection Clostridium difficile, which causes vomiting and diarrhoea, are more than 40 per cent higher in hospitals with 90 per cent bed occupancy than in those with less than 85 per cent. And of course an outbreak in a crowded hospital, can result in whole wards being closed. Thus there is further pressure on the remaining beds.


If we stop late-night discharges, there will be a corresponding backlog of patients in A&E. But equally, sending vulnerable people home late at night when there is no guarantee that the social care they need is in place or their families are ready to step in is unacceptable. This needs some clear, sensible direction from those in charge of the health service. I, along with doctors, nurses and countless patients and their relatives, hope that they find a way to put a stop to this practice. Then we can all rest easy in our beds.


Bad news for fraudsters who con the elderly


I’m delighted to hear that the Sentencing Council is introducing guidelines that will see tougher jail sentences handed out to fraudsters who target the elderly and vulnerable.


While working in dementia care and with people with learning disabilities, I have come across heartbreaking cases of people being conned out of their entire life savings. But as the Sentencing Council acknowledges, sometimes even relatively small sums of money can have a devastating impact on the victims.


The guidelines coming into force on October 1 mean that at last judges will now be able to take into account the extent of the victim’s suffering – not just the size of the sums of money involved – when deciding the punishment. About time, too.


Don’t ignore anorexia


It often surprises people to learn that of all the psychiatric conditions, the most deadly is anorexia. Despite high‑profile deaths, such as that of the singer Karen Carpenter, the public still struggles to understand the seriousness of eating disorders.


Although the risks associated with anorexia have long been known, research by Oxford University published last week illustrated the extent of the danger. Life expectancy for those with the condition is worse than for those who smoke 20 cigarettes a day. It’s estimated that between 5 and 20 per cent of sufferers will eventually die from it.


It’s an area I feel passionately about because of the lack of sympathy it garners from other people, including some doctors. There is a sense that – more than with any other mental health condition – sufferers should pull their socks up. Everyone else can eat normally, so why can’t they?


It is more than 20 years since the late Diana, Princess of Wales spoke out about her own eating disorder. More recently, the actress Christina Ricci has followed suit. And yet the level of ignorance is astounding. It’s not simply that sufferers want to be thin, as though it’s some perverse form of vanity; it is a desperate, unconscious attempt to deal with deep-seated emotional problems.


Ensuring that there are adequate services and provision to help these people should be an absolute priority.


Max Pemberton’s latest book, ‘The Doctor Will See You Now’, published by Hodder, is available from Telegraph Books for £8.99 plus £1.10 p&p. To order, call 0844 871 1515 or go to books.telegraph.co.uk



Clinicians, not bed movement, need to dictate discharges

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