NHS cuts in the UK: at last, some truly realistic proposals

Here in the UK we, like many other nations, have suffered a great deal as a result of the recent recession. Despite our government assuring us that the National Health Service (NHS) - which provides free healthcare for the population – is not going to suffer serious cuts, in effect and all that, the reality may be somewhat different.

However instead of looking at cuts that could affect the delivery of cancer services along with many other vital functions, perhaps the NHS could do without the following measures to improve cost-effectiveness:

Parking control gates and pay machines: expensive technology and half of them don’t work properly. Removal of these would more than compensate for the loss of parking payment revenue. All they would need now is one security guard patrolling with a large Pitbull Terrier trained to bite anyone sneaking guiltily back to their car laden with shopping bags from Tesco, Waitrose, Sainsbury, etc.

Hand sanitizers: silly little squirty boxes used mostly these days for visitors to hang their bags on while waiting for the ward doors to open immediately prior to visiting time. Far more effective – and cheaper – is to sit visitors on those awful plastic chairs at least 2 metres away from patients to avoid infection, preferably facing away from said patients. And while we’re about it why not sit them outdoors (where appropriate, i.e. probably not outside a 17th floor ward) looking into the ward where their folks are? Easy and cheap!

Extensive male and female toilets: oblige all in-patients to have urinary catheters fitted on admission and be hooked up to wee-wee bags. OK, the infection rate might rise a bit, but toilet numbers could be reduced substantially with consequently large cost savings on cleaning, plumbing repairs, removal of graffiti, etc. – a mere bagatelle compared with the cost of NICE’s latest approved bargain-basement drugs for UTIs. Frequent visitors could be offered urinary catheterisation too, to save them using visitors’ toilets which could then be reduced to a few in a shed by the main door.

Restaurants and cafés: oh, please! Who are we trying to kid? We all know that hospital food is bland, cheap and boring. So dressing that up in cutesy bright coloured packaging and calling it “Tasty Delights from the Hospital Bistro Stinko” ain’t going to impress anyone. Let’s just call it all “sludge” and be done with it. Dispense it from the rented slot machines along with the fizzy-pop drinks, stale cakes and cheap potato snacks.

TV, radio, internet, telephone, the latest from the Starship Enterprise and messages from outer space at your bedside: half the time these fancy systems cost fortunes to use. They’re manned and monitored by nice people who sweep by every few days on the ward asking if yours is working OK, because a) it usually isn’t and b) if it is most of us don’t know how to switch it on, never mind use it. I know the NHS probably gets a kick back from the companies providing these services but at what expense of having to dust and clean the damned things? Anyway, whatever happened to good old-fashioned (and free) hospital radio?

Hospital shops manned by volunteers: OK, an opportunity to use volunteers to sell books, magazines, gifts etc. to guilty visitors when they turn up and realise they’ve forgotten to bring some sort of goody to cheer up the patient their visiting. But that’s the visitors’ problem. Tell them to go across the street and buy that stuff from a supermarket or corner store, so freeing up volunteers to make tea and coffee for the patients – and/or staff - instead.

And what about out in the community? Take the automated, screen-based check-in facilities when you come to visit your GP, for example. You tap the screen with your finger and after asking you a few brainless question the computer usually finds you and checks you in. Of course it’s too easy to say hi to the receptionist you’ve known for 20 years so she knows you’re here for your appointment? People are cheaper – and a lot friendlier.

What tips have you got to help the NHS make some truly realistic cuts in the United Kingdom? Please share them here, no matter how outrageous!

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10 reasons why I love my urostomy pouch

The other day I received my valued copy of the Urostomy Association Journal and was perusing the contents page when I spotted the title of an article. "Ha! That looks like something I might write," I said to myself. I duly turned to page 40 and saw my own face staring up at me. "Ha again!" I said to the dogs. "This explains it. I did write it."

In fairness to my senior moment it has been a few months since I wrote that but I still felt a prize idiot. So as a penance (and also to share it with you as I don't believe the Urostomy Association Journal has an online presence yet) here it is...

10 REASONS WHY I LOVE MY UROSTOMY POUCH

By Suzan St Maur

I know that many people with stomas prefer a very sensitive and private approach to dealing with them, but during my whole journey through bladder cancer (plus a short detour into unrelated breast cancer along the way) I’ve found that openness and humour have helped me – and quite a few others – to deal with the trials and tribulations.

That’s one of the reasons why back in 2005 when I had been dealing with bladder cancer for 2 years and then was diagnosed with the breast tumour, I started my online “blog,” Cancer Comic Strip.

The other reason why that came about was because around the same time a good friend of mine with metastatic colon cancer, who had been given three months to live some 5 years earlier and is still going strong today, called me to complain that there were no good cancer-related jokes on the internet so get on and provide some. Off I went and did it. Check it out if you want some chuckles! (NB: I do NOT sell advertising space, sorry stoma product retailers - it’s non-commercial.)

The Big Chop: an inevitable next step

Anyway after more or less keeping the bladder cancer under control across 7 years of TURBTs, BCG instillations, BCG and Interferon instillations etc. etc. my consultant finally said words to the effect of “let’s cut the cr*p and get your bladder our before the cancer decides to go walkabout.” I had a radical cystectomy with formation of ileal conduit in May 2010 and am now the proud wearer of a wee bag.

I remember sitting on the loo in the hospital the morning of the operation and thinking, “this is the last time I will pee in the conventional manner.” An historical milestone! At the time I was a little apprehensive of how things would work out. But now, 6 months later (as I write this) I am counting my blessings. Here’s why...

1.Having had the RC and knowing that the cancer had not even infiltrated the muscle wall, chances of it having spread beyond my bladder are pretty small.

2.As my consultant whipped out my “girlie bits” at the same time as my bladder I know that I can’t get ovarian, cervical or endometrial cancer. (Useful as I’ve had breast cancer already.)

3.The lymph nodes taken out all tested negative, and I’m assured I won’t get lymphaedema in my nether regions in the same way as I have in the mastectomy-side arm.

4.Six months post-surgery my conduit is working well and my kidneys show up as normal size on ultrasound.

5.I’ve only experienced two leaks since using a pouch – on both occasions the pouch had been applied by a stoma nurse. This is something my local stoma girls do not find in the slightest bit amusing, especially when I remind them of it.

6.Never again will I have to sit on some dubious seat in an even more dubious ladies’ room, because now I empty into the toilet bowl from a safe distance.

7.I now pee like a man, standing facing the back wall of a toilet cubicle. This is a source of much fascination for anyone weird enough to peer under the partition, seeing a lady going wee-wees with her feet pointing in the wrong direction.

8.If my pouch becomes full while I’m driving along a country lane, I merely pull over into a gateway, hide behind the car, and empty it. If I’m helping at a horse show (regular hobby) I don’t have to walk through half a mile of mud to use the horrible portable toilets; I just go behind a bush.

9.If my pouch becomes full while I’m sat in a traffic jam I know I should have a nightbag to keep in the car, but in the meantime I just use an empty Coke bottle.

10.Wearing a pouch sure beats the hell out of dealing with the pain, burning and other discomfort associated with “conservative” bladder cancer treatments.

Can anyone else add some reasons to be grateful for the wee bag? I’m sure I’ve left some out...

Suzan St Maur is a freelance writing coach & editor, as well as being the author of over 20 nonfiction books of her own on a variety of topics. You can catch up with her latest ways of helping you write better at HowToWriteBetter.net