The ‘accidental politician’ – the case for Brecon Day Hospital

It's less about how we pay for health care, and more about how we deliver it

PEOPLE often ask me why I became a county councillor. It wasn’t for the money. At £12,500 per annum, I could do a lot better for my family stacking shelves or picking up bins or indeed virtually anything. In a nutshell, I did it for my wife.

Nine years ago we had everything – a successful restaurant, nice house, beautiful daughter, and a new baby on the way. We had moved to God’s own country two years previously and everything was perfect . We thought nothing could go wrong, but it did. Within months of my wife’s accident in October 2001, we lost everything. I found myself broke, unemployed, a “single parent” of two kids with my wife in a coma, and a carer for my Chinese 83-year-old mother in law. It changed me – it changed all of us – and pushed me towards attempting to changing the system. I became an “accidental politician”.

It’s a very long story that some literary agents still push me for, and my new partner is adamant that I write down. But for this article you need to know solely two excerpts from what is a horrific tale. Firstly, there were the doctors who told me for years that my wife possibly had a brain injury but couldn’t tell me what type, how, why or if she’d recover and that she should be in an institution. And secondly, there was the social worker who asked if I wanted to put my son up for adoption 15 minutes after my wife gave birth to him in a coma in the Heath in Cardiff. She was, I believe, the first woman in Wales ever to do so.

No one can prepare you for a loved one who contracts a long term degenerative illness, who won’t get better, who will over time get worse or contract other illnesses. It’s a sad fact, but I’ll say it. The bureaucracy within the current NHS system and social services doesn’t just fail to assist carers. It actually hinders them. For years I’ve heard the same words from the hundreds of carers I’ve come across: “It’s a battle to even get a handrail for a bath”; or,  more commonly: “Sometimes I feel like like I’ve been fighting my own private war for years and years”.

Why do virtually all carers of loved ones feel this way? Simply, there’s far too many people involved in the process – carers, doctors, nurses, occupational therapists, reablement teams, work and pensions staff, charities, respite homes, social workers – all doing their jobs proficiently, all with rivers of red tape, and few communicating with each other. Many forgetting that, as one carer aptly put it: “It’s about the patient, stupid”.

As an ex-business person, I believe the current economic crisis shouldn’t be viewed as a disaster for local authorities and health boards, but as a golden opportunity. An opportunity to put the customer, resident or patient at the centre and to reduce the cost and increase the service delivery via integration and closer working in order to provide a cheaper, better and smarter service.

I’m fortunate in that I’m an observer of the proposed merger between Powys County Council and the Health Board and I am beginning to see the green shoots of what a truly integrated service could really offer and how we could as a combined entity possibly spot issues that affect our most vulnerable – adults and children – prior to their admission to hospital.

Brecon Day Hospital, which used to provide a twice weekly monitoring and rehabilitation service for my wife and her colleagues, could be the perfect example in mid Wales of how this could work. At a meeting on July 16, 32 patients arrived with their carers, wheelchairs and ancillary medical equipment to discuss the issue with Roger Williams MP and Andrew Cottom, the Chief Executive of Powys Local Health Board. Never before had so many people with long term degenerative illnesses convened to protest about the possible closure, the lack of a consultation process and the inept assessment that determined that all were no longer in need of day hospital or monitoring facilities.

None of us carers or ex-carers are medically trained. None of us can spot symptoms of the variety of afflictions that may affect our loved ones as they stay at home 24/7 if the day hospital does close. We would have to rely on social workers, doctors, the emergency services to assist us – and since January this year we have had to do. Six patients have had long term stays in the hospital at a cost of £4,800 per person per week, doctors have been called out (another cost), social workers (yet another cost) , respite care paid (and another…) . If I was to guess-timate the closure of the Day Hospital in labour and medical time, it may have cost Powys and the the health authority £150,000 – costs that could have been minimised.

So by making an “efficiency”, the health board may have actually increased the real cost. Our plan, which we will be presenting to Mr Cottom and Mr Williams today is relatively simple: by opening the day hospital two days a week, four hours each day, with two-part time staff, costs can be reduced, our loved ones will be monitored and any issues spotted. They will be able to socialise and their carers, for a few hours a week, will receive some respite – all without any cost. It’s a win-win situation for all concerned and we would hope that the health board will come around to our out-of-the-box thinking rather than following the rule book.

It’s thinking smarter, cheaper and better in difficult times – and ironically it’s coming from a group of vulnerable adults and their carers who have never protested before .

Perhaps there’s a lesson there for all of us in these troubled times: let’s listen to the real stakeholders.