The majority of what the people in the article need is care, not nursing. Perhaps the overdraft of childhood care should be paid off with elderly care within the family, where possible.

IMO this is down to two things: nurses/staff and money.

Nursing used to be a vocation and involved excellent patient care, making sure their needs were met. If a patient was unable to feed themselves, the nurses would do it. Doctors in the mean time, would draw up drugs, administer them, administer IV fluids etc. To make the doctors' lives easier, nurses started to do this more and more, to the point that it's routine for nurses to give what doctors have prescribed. Then nursing entailed a degree and became a profession. Many became more than just nurses - nurse managers, nurse consultants, nurse practitioners - the latter two taking over more roles of what doctors traditionally used to do. Consequently, there's fewer nurses actually nursing. Hence, healthcare assistants are brought in to support the nurses and are now having to do more and more of what was traditionally nursing.

Doctors in the meantime are just too expensive to train and pay. Blair tried to push lots of medical students through so there were more doctors, so demand reduced and so did pay. There's competition between doctors and nurse practitioners to the point where it's doctors who are losing out in terms of training. Partly this is down to some consultants supporting this development. Feck knows why. But the net result is that nurses will do things that normally doctors would do but generally at a lower pay.

The future trend (IMO) is that you'll have maybe one or two doctors, supported by nurses in various forms (advanced clinical practitioner, physician's assistants, nurse pracitioners, nurse consultants etc) doing traditionally doctors' jobs. HCAs will be doing the nurses' old jobs. And the general public will do the HCA's job.

I am not at all bitter and twisted at the age of 30.

Nurses used to be the carers. Now that they have all had climbed the qualification ladder they have abandoned one of their key remits. As you say the pay or numbers of doctors will now have to be cut to pay for nursing assistants to do the jobs that nurses used to do. A few dead patients as a consequence of neglect will only exacerbate things. The public paid for the care in hospital via taxes and if hospitals fail to provide that care then lawyers will force them to do that and strip them of millions of pounds to pay penalties and legal bills. I seriously doubt that the Big Society can provide the care for people in old age.

I think you're correct and the rather mercenary premise upon which this debate will take place is infuriating. However, as usual, I also think there's another side of this.

One question I would ask is why shouldn't families be involved? The Daily Heil contends that having volunteers staffing wards is going back to the Dark Ages; this is, of course, pure bullsh!t. The Mail is writing to a portion of society for whom parents exist merely to provide an inheritance. However, that expectation neither is true for the majority at present nor was it true for the majority in times past. Up until the last few decades, the vast majority died without leaving any inheritance and would expect to live with their families in their dotage.

The thought of leaving anybody, let alone my mum, to rot in a hospital bed is an idea so abhorrent to me, my wife and my family that the moment my mum retired we had "the chat". When my mum gets too old to look after herself, we expect her to come and live with one of her children. After all, this is the woman who refused to give up on me even when I was a drug-riddled wreck - the woman that wiped my ar*e for years until I was old enough to do it myself. As such, she is worthy of a little more respect than 2 visits a week and a bottle of Lucozade. Only in the event that she needs specialist care would we even dream of putting her in a home.

So frankly, if the Daily Fail or any part of our (so-called) society thinks that families should bear no burden of care for their elderly, they can pucker up and kiss my rusty metal ar*e.

(P.S. Sorry for the tone but this issue really makes my p*ss boil!)

^This.

Though not the drug-addled bit in my case.

Good post Jim.

Ta muchly.

Sorry again for ranting. It's just that this issue touches a very raw nerve and is liable to induce fits of rage on my part.

Tbh, I'm rather pleased that I managed to remain lucid. Normally I get a headache and attempt to shout the bottom row of my keyboard.

"ZXCVBNM,./!"

i believe too many people have been promoted
you will always need the underdog or dogs body

but if the underdog or dogs body has been promoted
then 'they' will need new underdogs and dogs bodies

so the circle goes, management i fcuking despise 'em

but the world still goes round, ho humm ...

You can easily argue from a moral point about family involement. But when you start to look at the practicalities it's almost unworkable.
Some don't have children, some have many.
People have other job and family commitments.
Some live great distances away etc.
There are a million and one variables that you can't account for.

Indeed. It's not the system allowing for relatives to provide some care that's scaring people, it's the fact that at some point the system will rely on relatives providing some care. And you can pretty much bet that as soon as people start doing it, the system will become reliant on them doing it. And at that point anyone who doesn't have an available relative to provide that function will be f!cked.

Yes, the person's family have a duty of care to them. But so does the NHS. We all pay our taxes (well, most of us do) on the premise that systems like the NHS operate for the common good - we all pay into them regardless of immediate need but we all get them when we need them regardless of how much we earn. That's the bargain. That's the basis on which the NHS was created. The elderly have, mostly, payed many years of taxes and contributed to the upkeep of the NHS system for decades. They have a valid expectation that the NHS will provide the same service to them as they paid to be provided to other people in previous years.

Fundamentally, the NHS as an organisation doesn't have the option of saying 'this thing isn't our job any more'. The people who need it have already paid for it. The NHS has an obligation to provide care and it shouldn't shirk it just because someone has a shiny new job title.

Jon

Not just relatives. The old lady across the road from my parents went into hospital. As her neighbour offered some of his time to look after her in the past, they're dumping it on him again even though he has no biological or legal ties to her.

Ditto, though I would use every legal measure to ensure that they got the care that they deserved. Not just for my parents but everyone. Care is a vital part of the process of recovery. If a person is not helped with that they just end up getting weaker and weaker and bed blocking.

I accept this. I realise it's not as black and white as it might appear.

Personally, I don't have kids. There will probably be no close family member around to look after me should I need it. However, I am fully prepared that I might have to look after one or both of my parents should the need arise.

I'm not sure how I shall deal with my dotage. I have a retirement plan that involves becoming an itinerant traveller, seeing the land of my birth while I'm still able to enjoy it. What happens if I become infirm remains to be resolved. I just hope I can remain as fit and as active as possible for as long as possible, I suppose.

IMO, I don't mind relatives helping out - it reinforces family care, helps with patients who are "difficult"/confused. I've seen families help feed their relative and help them get dressed etc. Where I draw the line is when it's the family doing work that the nurses/HCA should do. Feck, despite being a doctor, I've helped a little old lady drink her tea, I've helped people sit more upright or adjust their drip so they can walk. If I can do this despite being busy as feck in a hospital, I don't see why nurses or HCAs can't.

I hope we don't go to a system where families are left to fend for their loved one. One of my mate's friend's dad went to India, involved in RTC, was in intensive care. The son basically had to give him the medication, wash, dress and feed him. The nurses just sat around doing nothing. Money was a big driving factor in getting things done. Sounds like this is the way things are going!