Friday, 25 May 2018

Non-NHS care on the NHS and political sloganising

Yesterday afternoon I spent four hours at the QMC Hospital’s privately owned Treatment Centre having a inguinal hernia repaired under a general anaesthetic.

I visited my GP on 9 April (six weeks ago) about a problem first diagnosed in June 2016 but at the time I was waiting to have open heart surgery, so the surgeon wasn't keen, for understandable reasons, to operate on my hernia until 18 months after my heart op. In the event this pushed back the hernia op until August 2018. The solution was to wear a support belt during the day, but most days began with me pushing my inguinal hernia back inside, usually more than once. By the beginning of this year (2018) it had become quite painful at times, so I started to keep a hernia log and decided to visit my GP sooner rather than later on the basis that I wanted to have my hernia op at the first opportunity.

The private Treatment Centre adjacent to the QMC Hospital saw me on 18 April and I had my pre-op assessment the next morning, thanks to the fact that the 8.30 a.m. appointment is difficult to fill. My hernia didn’t stop me walking or exercising, so I walked from Beeston to the Centre each time. At the end of last week I was offered a cancellation for yesterday at 2.30 p.m. which I willingly accepted. So here I am at home 12 hours later recovering, feeling fine and taking it easy, doing this post. Tomorrow I plan to walk into Beeston, then home after a coffee.

The Treatment Centre treated me like royalty from beginning to end, mirroring the heart and lung care and support I have been receiving from Nottingham City Hospital for the past three years. With my hernia fixed I hope I am now at the beginning of a long Indian summer. I’m 74 and never felt better in so many ways, but I am not complacent. I have to stay active and I am enjoying exercise now more than I ever have. I feel more creative. From where I am sitting writing this I can see my runner beans growing and the last of the blue bells, the garden has been awash with them this year.

Now back to the point of this post. Circle Health says of itself if you visit their website: The Circle Nottingham NHS Treatment Centre is the largest day-case centre in Europe. It operates under a Standard Acute Contract, providing a wide range of outpatient, inpatient, diagnostic and therapeutic services. It is the only independent sector facility in the UK to offer teaching and research, including pre- and post-graduate medical, nursing and AHP training. Its surgery has been rated "outstanding" by the Care Quality Commission.

It is also a private company listed at Companies House and has had its moments in the media. I am politically opposed to any public service / utility being in the private or voluntary sector with the exception of mutuals in which users and workers are joint owners. I feel able to say this having worked first as a Family Planning Association (FPA) clinic volunteer over 50 years ago, then 12 years with the British Pregnancy Advisory Service (BPAS) followed by 21 years with Advance Housing & Support, all charities providing healthcare related services local government and the NHS failed to provide in large swathes of England. All these organisations budgeted to make surpluses but not to pay shareholders directly. However all of them took out bank loans on which they paid interest and, therefore contributes to 'profits'.

Labour politicians have actively encouraged private healthcare so we have to be cautious when condemning private healthcare. At the point of treatment, in my experience, there is no distinction between public, private or private. Many charities are now led by managers paid a 'market-led wage' little different to the private sector.

I have long favoured the issuing of bonds offering a fixed annual return for a fixed period of time as a way of enable small savers to invest in public services and utilities, so that their need to borrow from banks can be minimised.

At the end of the day it is easy to sloganise when it comes to healthcare and public services if you give little thought to the consequences, then there taxes on our income, purchases, property and wealth!

Taken altogether, this is why I believe we need to arrive at a cross-party bipartisan agreement — something I have blogged about before — when it comes to the NHS, welfare and housing (and I'm pleased to say that our MP Anna Soubry agrees with me on the NHS, but struts like a Tory when it comes to housing).

I managed to live 71 years before needing to draw down on 47 years of National Insurance payments (money which was not ring-fenced). It annoys when the media and politicians talk about our 'rising older population' and ignore the fact that as a percentage so is the working age population.

What concerns me is the quality of all lives and this is not simply about age, it is about income and wellbeing, and I know for a fact that even at 74 on a relatively low income I am one of the lucky ones!

Tony Blair had a plan to improve the lot of working people and it failed big time, but I do not doubt his intent.

Tuesday, 22 May 2018

Enjoying life, ice cream, Dale Abbey, Municipal Dreams and Five leaves Bookshop — what a way to spend a birthday!

I had a 74th birthday last week and chose to begin it at the Blue Bell Ice Cream Factory on the edge of Spondon, on the Nottingham side of Derby, in the company of Susan and close friends. I think it fair to say a good time was had by all, especially me.

More cards than a man of my age expects, and all from ladies I love. Susan chose one that I have since turned into my 'Old Age Passport', which will go everywhere with me from now on.

Susan and I met in the summer of 1975 and took off like a rocket. She was then Curator of Mansfield Museum & Art Gallery and I was Chair of the Midlands Area Museum Service. She 24, me 31. We were buying a house together within three weeks. I was also a Birmingham City Councillor working as the records and development officers (yes, two jobs) for a then high profile charity, the British Pregnancy Advisory Service, and often found myself being asked to comment on this or that —which I did. Susan soon said of me that I was a typical politician, 'Able to speak with a confidence born of nothing but ignorance'.

She was right. I could happily be outrageous, making friends where I wasn't expected to. Called a 'Maverick' more than once, it remains a branding I am proud off.

Last week's ice cream adventure was fun and delicious — honeycomb, rhubarb and strawberries & cream, all yummy.

I even got to go two laps on a pedal go-kart. I could have done more. It was a great birthday. After this the day slowed down and we all went off to Dale Abbey to look at the ruins and the second smallest parish church in England, now part of a farmhouse which began life as monastic hospital.

Dale Abbey village is set on a road going only to church and a few houses. Off this road is what remains of Dale Abbey. How this much managed to survive is beyond me, set on the edge of a field it is actually the back wall to a small paddock. A public footpath runs through the field. 

It actually looks quite dramatic as my photograph shows.

One of my fellow ice cream eaters, Rosie (who also got me into blogging in 2007), took this pic of me snapping the ruin.

From the footpath you can see down the road to the church and the farmhouse of which it is part.

The church begins by the little door and goes to the left.

Up close the door looks suitably mediaeval. Having said that I'm not sure it is.

On the side elevation is this simple window. The church was locked and the farmhouse doesn't have a key, so we'll have to plan our next visit a little better.

In the small graveyard a friend spotted this gravestone. It mentions someone called Annie 'of Beeston House, Beeston, Notts'.

The wall around the church graveyard is made of blocks of dressed stone. The may well have come from Dale Abbey, but if it did I'm amazed most of it wasn't taken for use in new buildings following the Abbey's destruction.

It's isolation is somewhat illusory given how it sits between Derby and Nottingham, on the edgelands of two conurbations fast becoming one. Dale Abbey's Wikipedia page is a good place to start learning more. We will be going back with a key of that I am certain.

I finished the day in the ballroom of the Mechanics Institute in Nottingham city centre at a fantastic talk organised by Five Leaves Bookshop. 'Municipal Dreams' by John Boughton, who has a blog of the same name, long one of my favourites. The focus of his talk was council housing and it past, present and future. It was a lot to pack into 90 minutes but John did impressively well.

John was on BBC-TV's BookTalk programme a couple of weeks ago promoting his new book, Municipal Dreams (which you can buy in Five Leaves Bookshop, where I bought my copy).

Ross Bradshaw and his colleagues at the Bookshop were fair bursting with pride, having won the Independent Bookshop of the Year Award a couple of nights before. A well deserved honour. It appears on all my Nottingham city centre maps and I buy booksthere regularly.
I sat with Richard, another Beeston blogger who I know well and we came back to Beeston together on a 36 bus, both of us preferring the bus to the tram. His blog, NG and Beyond, is another of my favourites. His prose is close to poetry. He relies almost exclusively on words to describe the land and townscapes he explores in and around Nottingham. His writing is something I want to hold, to feel the page in my hand — he really is that good!

It was a good way to end my birthday.

Beeston Worm Map update

I have it in mind to extend my worm map to include the University and QMC Hospital bus and tram links. As a first step I have updated my original Beeston Worm Map dated 2016. You can see both maps on my Beeston Warm Map page to which you can find a link in the right-hand column.

Friday, 18 May 2018

Beeston Speed Map coming soon — comments welcome

I will let the new Beeston Speed Map talk for itself. If it needs explaining then it's a failure. At this stage I have a few names to enter and icons to create and add. I will also get the Middle street Resource centre and its cafe on. Each map is part of a jigsaw and they can all be joined together to create one large map if I had the money to print it A2 size (as many such maps are).

No map is ever finished.

I now have to take a copy out with me and check it for accuracy as at 31 May 2018. That is going to be my cutoff date for final corrections and editing.

Tuesday, 15 May 2018

The sheer joy of discovering a Sandiacre gem

I have walked the full length of the Erewash Canal in bits, all of it twice, some sections several times, and always wanted to divert to the church on the hill outside what we know today as Sandiacre, as you head north towards Cotmanhay and Langley Mill. Last week we finally made it and my oh my, what a church! By the far the best hereabouts. St Giles' Church is everything a parish church should be — simple, unadorned, old (part-Saxon and mentioned in the Domesday Book of 1086), and full of peace and tranquility; a place for everyone regardless of faith or, in my case, a humanist who likes to think of himself as a pagan, at home with nature and the seasons of life.

The approach is along and up a gully with no clue as to what is at the top.

The Church noticeboard at the top to the right gives a hint of what you will find, but is still nothing to see.

A 180º turn brings St Giles' Church into view and it looks impressive and its middle section offers a clue as to its Saxon origins. Simple and solid. This view is looking east.

Round to south side is the entrance. 

Steps lead down to a crypt. 

The small door dates from the 14th century and was to allow priests to enter and leave the church.

The view to the south from a gate which looks unused.

Inside the church your gaze is drawn to the right and towards the chancel. The dividing wall and window are Saxon, pre-dating the Norman nave, which 'probably dates from the 14th century' according a leaflet available inside the church.

Turn around 180º and there behind you is this very impressive organ, large enough for a cathedral yet here it is in this perfectly formed small parish church.

What stained glass there is is equally impressive.

This modern stain glass commemorates the RAF. The small window to the left at the top is Saxon in origin.

You would be hard put to anything better anywhere.

The can can be said for this three seat sedilla also dating from the 14th century.

This is the priests' door we saw earlier from then the outside. The heads on either side are Edward III and Queen Phillippa.

A view from the chancel towards the organ and the Saxon window.

The fonts also dates from the 14th century.

This close-up shows the font's fine carving.

The local dead of two world wars are remembered on these two plaques. Some surnames appear on both: Carrington and Wood. There may be others I haven't noticed.

This photograph reveals so much about the church and how it has changed. The roof was raised in the 14th century and the windows lengthened. A few diamonds of coloured glass can achieve so much.

When we left I took one look back at this remarkable church, certainly the church I would take visitors to see before any other.

Outside you can see a grass pathway that you can follow to avoid walking down the gully. It brings you out at the bottom and once you know it is there can use it to walk both up and down.

St Giles' Church is on Beeston's doorstep. The Trent-Barton i4 bus route stops very near by. It deserves to be on any Greater Nottingham visitors' map. It is, of course, also in Derbyshire whilst being very much part of Nottingham. Search it out. You won't be disappointed I promise.

Sunday, 13 May 2018

My lungs — Little miracles can happen with a little help from yourself

Three years ago almost to the day I was diagnosed with what was first described on the x-ray report to my GP as 'established fibrosis of the lungs'. I had the  x-ray at Nottingham QMC Hospital on 8 May 2015. By August 2015, after tests and scans, it had become Ideopathic Pulmonary Disease — 'ideopathic' meaning the cause of my lung fibrosis (also described as scarring of the lungs) is unknown, since I have never smoked nor, knowingly, worked with asbestos or the like. 

From 15 to 18 I worked as a trainee animal technician at the Chester Beatty (cancer) Research Institute, then in South Kensington, London, and among my responsibilities was looking after rats I put into smoking machines for varying periods of time with different numbers of cigarettes five days a week in a large shed on the roof of the building. I inhaled a lot of tobacco smoke during those years, plus what you picked up at work, on a bus, cinemas and the like. No smoking areas were few, but I avoided it the best I could: travelling downstairs on buses; in the one non-smoking carriage then on each London Underground train; going into the little room set aside in a few pubs for non-smokers.

In truth it was as good as impossible to avoid tobacco smoke and the awful smell of nicotine, it was in our homes, on our clothes (not that the latter has changed). Back in 1959 millions smoked, despite the evidence (I also killed the rats after different periods of time, pinned them out and exposed their internal organs before removing them in the presence of a lab technician to be weighed and dissected. I wish I could say that I left for ethical reasons, but I didn't despite having reached the conclusion that what we were doing was cruel to animals). Sadly all too many people still ignore the evidence about both smoking and animal experimentation. The point of telling you this story is because my lung scarring might date from my first job.

Susan would also mention my catching whooping cough in 1977, which wasn't diagnosed immediately and I ended up being ill for five months. On a good few occasions then, when every breath of air was being fought for, I thought I was breathing my last. It was the closest I ever felt to death until the second night after my open heart surgery at the end of February last year when I had some kind of post-operative infection and four people stood at the end of my bed and I wondered which one of them was going to take me, but I was in no pain, the morphine saw to that, and I felt 'other worldly', outside of myself looking on. It was a surreal experience and by mid-day, eight hours later, it was all as if it had never been. And my open heart surgery was a direct result of being diagnosed with fibrosis of the lungs — had I not had that x-ray I may have had a heart attack and died. I have a lot to thank the thoracic team at Nottingham City Hosital for).

I made the point in my first post about my condition on 21 May 2015 that having lung disease was going to be part of my life – NOT my life. There have been a few posts since about my heart condition (which it turned out I was born with and could have killed me had I been a runner, a footballer etc. and unlucky). In the event my second post about my lungs didn't appear until earlier this year when tests in January showed that my lung capacity was down to 81% and I could be prescribed NICE restricted medication for a year at first to see if the medication stabilised my condition. Last Thursday I went to the City Hospital to find out which of the medications I would be getting — the one which causes diarrhoea or the one which makes your skin sensitive to sunlight (the small booklets I was given to read about each medication seem to suggest the chances of either happening were c.10%)

On arrival at the City Hospital I was sent for a chest x-ray and a couple of breathing tests, (my last previous tests having been in January this year), followed by a brisk walk with my thoracic consultant. What I was not expecting in a million years when a few minutes later he came and collected me from the waiting room was the significance of the sheet of A4 paper he was holding. 'Good news, remarkable though not unusual. Your lung capacity has increased by 20%, so you need no medication'. He then went on the show me the test results and to give me copies of my first tests in 2015 and Thursday's tests, plus showing me my x-rays over the past three years, one after my open heart surgery showed how my chest had been wired to together, now disappearing from view. 'As you can see little difference between now and when we first saw you, really good'. We had a long chat. Good news can be as overwhelming as bad news. My consultant puts the improvement down to my exercising, lifestyle and positive attitude and the rest of the day passed in a haze. I was overwhelmed.

In three months my lung capacity has recovered from 81% to 94% — actually 1% better than I was at the time of my first tests in June 2015!

Back then the prognosis wasn't good and I fall into the camp that wants to know. In my last blog I wrote about a British Lung Foundation report about my condition and how it could be detected earlier using x-rays and I discussed this with my consultant on Thursday. Lung disease is not curable like some cancers. The most those diagnosed young enough can hope for is a lung transplant when the condition gets bad enough. You can live with it , dormant / stable for years, then a chest infection or other problems can cause it to flare up and it can quickly become terminal. My own condition declined prior to my open heart operation from 93% to 90%, then five months after the op I was at 86%. A chest infection in November laid me low for close on a month and this was reflected in my January 2018 test results, when my lung capacity was down to 81% — which why I qualified for the NICE controlled medication. Now, thanks to a little miracle in which I played a part, my lung capacity as at Thursday was measured at 94%! A fact I am still struggling to come to terms with three days later, but the fact is my good news doesn't alter the original prognosis one iota!

In fact it spurs me on to continue attending my weekly Breathing Matters exercise group every Thursday morning in The Pearson Centre on Nether Street, Beeston, a ten minute walk from where I live. Since the end of January I have walked at least 30 minutes every day* (missing a few I admit) and have been doing some after breakfast exercises for many years now. I am about to add 5 minutes worth of upper body exercises every day before tea. Not a lot, but based on my experience they can make a difference.

You may wonder why I bother to blog about this and at great length. The answer is simple enough. If one person follows my example and benefits than I would make this post every day. It matters that much. Time and again when asked how I feel I always reply 'One lucky bunny'. I may have made some of my luck, but so can we all.

NOTE: * An hour working in the garden counts as a 30 minute walk in my book — which is where I'm going now.

In the January post I went on about the importance of prevention and health care. The reason why lung disease and prevention is mostly associated with smoking is because people don't want to know if they have a incurable medical condition (smokers are the one group who do know the high risk they run). The trouble with this attitude is that by the time people to find out it's too late!  The breathlessness and tiredness they have put down to old age has reached the point where they are close to needing oxygen or, because they are lower than 50% lung capacity, they can't get the NICE controlled medications which might stabilise the disease/fibrosis.

If we knew early enough (and this is where my one lucky bunny bit comes in) then you have a degree of control. You can help yourself if you listen to what you are told and take advantage of the support you are offered. For me it's been a little bit more complicated than most, but I am evidence of how it can be for some if they know soon enough and for me this means promoting a voluntary LUNG FIBROSIS SCREENING PROGRAMME — in other words choice — just like there is with some cancer and cardiac conditions.

Our healthcare services have too many Cinderella conditions and services, so I am not about to argue for lung disease to get special attention. It is a choice we have no need to make. The answer is simple and our MPs could make the decision tomorrow if they were so determined. We are a rich country. The problem rests with our financial priorities and the truth is they are not healthcare related, nor are they to help the young get a good education or to help the poor and disadvantaged. We elect far too many self-serving MPs. At the end of the day we are the architects of our own misfortune, yet there is cause to hope. The world is full of decent, caring, people and many of them are to be found in the NHS which does a fantastic job despite the best efforts of all too many in Parliament to destroy it.

Thursday, 10 May 2018

For Judy a work in progress

Report on a work in progress. Creating a new style Beeston map is always involves tweaking. Trying to include EVERY Beeston shop into one pocket map no larger than A3 takes a little time. Here are my draft workings for the second part of the map.