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 | You and Yours聽- Transcript 成人论坛 Radio 4 |
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| TX: 01.08.03 - Brain injury |
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PRESENTER: WINIFRED ROBINSON ROBINSON There is a desperate shortage in the United Kingdom of specialist services for people with brain injuries. So when the charity Leonard Cheshire opened a dedicated unit in Goole in East Yorkshire 18 months ago the expectation was that patients would be referred there from far and wide. It hasn't happened. Only two of the unit's 12 beds are occupied and as a result the charity's losing 拢50,000 a month. If this situation continues, they say, this unit will have to close. It's estimated that 33 people suffer a serious brain injury in the UK every single day so there should be no shortage of patients. Ray Scott says his son Darren, who was seriously hurt in a motorbike accident, is still in a general hospital five months after he applied to go to the Leonard Cheshire unit, which is called Bridgehead House. SCOTT We feel at the moment that he's in an ordinary general ward in a hospital where he sits in his bed for 22 hours a day. This isn't rehabilitation at all. And we are strongly of the opinion that he needs to go to Bridgehead View in Goole, which is a specialist unit. I mean in that sort of an atmosphere people can relearn the domestic skills that they need in order to live an independent or a semi-independent life. On top of that of course they've got occupational therapists, speech therapists, physiotherapists there, as well as the nursing staff, the patient ratio is a lot better than where he is at the moment and they can concentrate on the particular areas of his particular need. We have made applications to the consultant concerned and we've had four changes of mind - first of all he said he couldn't go because he felt that he'd plateaued neurologically and then he said he could go for a trial period of two months and then after that the team met and said he couldn't go again and then soon after that, for some reason that I've not had an explanation for, he said he could go again. But sadly now we've got permission for him to go the decision's been now made to close the facility. So unfortunately it seems like he won't be going there anyway. ROBINSON Ray Scott. Well Bryan Dutton is the director general of Leonard Cheshire and he's here. Why aren't the primary care trusts referring their patients to you? DUTTON I would like to make it clear that in one part of the area the primary care trusts are using us and using us to the full extent and we have a very good working relationship and they are very complementary indeed with the rehabilitation that's been achieved. I'm sad and frustrated and I think the whole of Leonard Cheshire and certainly our staff and the parents of - and the individuals who would have benefited from this service are frustrated and I'm still hopeful that there will be a positive outcome of a further meeting we're having next week. ROBINSON Some of them are suggesting that your admission rules are too strict and the suggestion is that if you would be willing to take people who are recovering from stroke then they might be able to use you? DUTTON Well I think there's various points there. The first point is that one part of this area, the smaller part, south of the river, is not finding any trouble at all with our admission criteria and is working very well with us and therefore that rather refutes that suggestion. Secondly I'm aware of 17 individuals who were sent to us over the last year from north of the river and who we assessed and said yes we could help and they met our criteria and none of those have been referred to us from the north, so that again I'm afraid doesn't stack up. ROBINSON But are you willing to take people who've had a stroke? DUTTON Yes because that is a brain injury but this is a specialist unit for people with acute needs, it's - as you've just heard described by a parent - it's for intensive therapy on a daily basis designed to ensure that people return to their lives with the maximum degree of rehabilitation - social, personal, psychological rehabilitation - achieved possible. ROBINSON This must be a total disaster for you having built this unit, then to be suggesting that you're going to close it only 18 months on. Surely if you had done your research properly you wouldn't be in this situation? DUTTON That's a fair point but we were approached five years ago by the health service that existed there then, by the specialists in this area, saying that there was a shortcoming in their rehabilitation and that this was needed. And we've developed this in partnership with the health services in this area and as I say again one-third of them are making it work very well but unfortunately the more populous two-thirds for reasons which are within their own control are not making it work and I do hope that we can resolve this. ROBINSON You say you hope you'll resolve it, is this a serious threat that it will close or is it really, what they call in the medical business, a bit of shroud waving in order to put some pressure on? DUTTON No not at all, we have been in serious correspondence with everybody there for some nine months now saying this is the reality, I'm afraid we have given notice to our staff for the 22nd August that we will close. ROBINSON Well Peter McCabe is here, he's chief executive of Headway. How unusual a situation is this for a charity to be offering to sell the NHS a specialist service? MCCABE I think it's fairly common. There's a range of provision and our view is that it doesn't really matter who it is that's running the service providing it's a quality service, that's the most important thing. ROBINSON How much is this service needed in this area? MCCABE Well I believe that in this area and indeed throughout the country there's a need for services and they're patchy across the country, there's some areas where there's really very little, other areas where there's a decent level of provision and it's just so unequal, it really does boil down to your postcode. ROBINSON We invited the primary care trust on to the programme, as you'd expect, and they declined to come on but they did provide us with this statement suggesting that the admission criteria might be too strict but they also said that it is for the trust, the primary care trust, to make local decisions locally and that in that sense this is the trust working exactly as they should? MCCABE Yes and I think that's a problem that we've identified and not just in this part of the world but elsewhere because the changes in the health service have meant that decisions are taken at local level and sometimes that means that our clients fall down between stalls and you really do need to get the PCTs - the primary care trusts - working together and working in collaboration with the voluntary and independent sector where it exists. ROBINSON The government is increasingly hoping that it will use the charitable sector to provide healthcare, this seems to be an example, though, of how horribly wrong it can go, do you think there's a case for asking the charities and the trusts to share the risks so you couldn't be left with a unit that costs a lot of money and find that you can't generate enough income from it? MCCABE I think it's absolutely vital that they work together and consult throughout and that means consult beforehand and have a good working relationship which ensures that the service is provided into the future. ROBINSON But in this case it would seem there was consultation five years ago, has been overtaken now by reorganisation with the charity left to bear all the risk. MCCABE That's certainly a problem within the health service and within the changes because people that you are now negotiating with don't necessarily recognise the discussions that took place previously. ROBINSON Peter McCabe, Bryan Dutton thank you both. Back to the You and Yours homepage The 成人论坛 is not responsible for external websites |
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