Stress Points

Between Christmas and New Year, Mad Trevor went to A&E at the Royal Surrey Hospital. He had a very low-level, if painful, medical problem which anyone else would have lived with, but because he has essentially a child's impulsiveness and lack of perspective which magnifies any misfortune into a cosmic calamity (I am not exaggerating) and any pain into the worst suffering anyone has ever had, he had to have something done about it. It would have taken a while to see his GP, so he took himself to the hospital. Once there, and seen by a nurse, he was told it would then take a few hours before he could consult a doctor who might attend to him; he was besieged by his usual obsessional and paranoid thoughts which made sitting in a waiting room absolutely impossible, so he came home without any treatment, and had to live with his problem the way an average person might have done anyway.

I don't know whether poor Trevor's visit to A&E would have made it into the figures, figures which show the NHS straining to meet its targets and obligations. He does reveal some interesting themes, though. I remember a few months ago talking about the state of the health service to a local GP who was barely able to conceal his resentment at the resources being poured into general hospitals rather than the lower tiers of healthcare where they might prevent patients having to get as far as hospital. Trevor needed to see a GP, or someone at a GP practice, rather than go to hospital. He needs to have his mental illnesses treated more imaginatively than by a kaleidoscope of drugs which are all more or less ineffective. He needs, perhaps most of all, to have people around him, perhaps even in some sort of residential setting, who can respond to his obsessional thinking and remind him of what's reasonable and sensible, to introduce the degree of perspective which he isn't capable of providing for himself. Along the lines of the support workers the local council used to provide for a couple of years, who took him out for coffee and shopping and helped him tidy his flat; until the council decided they couldn't fund that anymore, and he had to pay for them himself with money he hasn't got, partly because the mental disabilities the support workers were intended to alleviate mean he can't manage his money in the first place.

Put more resources into those aspects of health and social care and it would go some way to alleviating the pressure on acute health care. I'm hearing some voices on the radio today suggesting this, but I doubt it will happen. Instead more money, if more money there is to be, will be directed towards hospitals, towards the aspects of health care that TV dramas are made about, and more and more patient time will inevitably be sucked towards them. The stress points will simply become more and more sore if that happens.