Care in the Community - Been There - Got Nothing

The sudden burst of posts might lead you to think that I have suddenly become more agitated of late but you'd be wrong. It's just that the year end in public accounting is when we all get inundated with requests for "stuff" - I won't bore you with the trivia that is much of my working day. The worst of the storm has passed, so I can attempt to benefit from the catharsis from shouting at the world-wide webosphere.

The current DH obsession with "moving secondary care into a community setting" brings back both some sad memories from my own childhood and also my own view of the last time we heard "care in the community". This was a dominant mantra of the Thatcher years. Why sad?

Well, my elder sister was born brain-damaged and remained a young child for the twenty one years she spent on the planet. At the age of twelve, in the early fifties, she was sectioned and sent to St Lawrence's Hospital in Caterham. She wasn't a danger to herself or to anyone. It was simply because my parents couldn't care for her due to my mother's failing health. Every other Sunday, we visited for two hours (having to queue outside the main gate until precisely 2pm). The journey was bus, train and then bus again and it took two hours each way. The wards were crowded and the nurses were amazing. Most of the inmates were there because that was the only structure in place at the time to provide such care. Once admitted, the "patients' " chances of leaving alive were almost nil since there was no rehabilitation; just detention. You might think then that I would be "Care in the Community's" greatest fan? If only!

The reality was different to the hype. Who can argue that my sister and most of the other 2,499 prisoners would have been better off if the vision of Care had been delivered?

Instead, the whole strategy was used by central and local government to leech money from the system to meet their short-term financial imperatives. St. Lawrence's was closed the government pocketed the proceeds of selling prime Surrey commuter belt development land. Local authorities were left with inadequate budgets and insufficient experience to absorb a wholesale shift to them of people who had spent their lives in such institutions with complex health needs and no clue of how to even help in their own care. It was ten shameful years of waste, unnecessary bewilderment and confusion.

The problem was not the intention. it was its implementation. If I could lay my hands on the mandarin that executed this appalling act, I would cheerfully throttle him.