September 2010


 


 
Ariel was glad he had written his poems.
They were of a remembered time
Or of something seen that he liked.

His self and the sun were one
And his poems, although makings of his self,
Were no less makings of the sun.

It was not important that they survive.
What mattered was that they should bear
Some lineament or character,

Some affluence, if only half-perceived,
In the poverty of their words,
Of the planet of which they were part.

from Wallace Stevens, The planet on the table

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 Patients can apply for NHS funding through the continuing care system

Vulnerable elderly people are being unfairly forced to pay for health care, the new chairman of the House of Commons health committee says.

Stephen Dorrell said patients with conditions such as dementia used to get free care in NHS geriatric hospitals.

But the number of places has fallen by nearly 80% in the UK over the past 20 years – despite the ageing population.

He said this had pushed people into the means-tested social care system where they were often charged for treatment.

In an interview with the BBC, he said the redrawing of the boundaries had been allowed to creep in without proper debate or scrutiny and urged politicians to face up to the issue.

An expert commission has already been set up by the government to look into the issue of social care funding in England.

But Mr Dorrell was speaking about a specific group of patients whom he believes the NHS has turned its back on.

Ignored

As well as dementia patients this includes people such as stroke victims and those with Parkinson’s disease who struggle to get the NHS to pay for medical treatment they receive.

Mr Dorrell, who was health secretary towards the end of John Major’s time as prime minister, said: “People are being charged for care that they would have got free from the NHS 20 or 30 years ago.

“In effect there has been a change in the definition of what constitutes NHS care and that has happened without proper debate.

“Unfortunately, it has been ignored because both politically and financially it is tricky for politicians to face up to it. But because it has not been done in a planned way there is great unfairness in the system. We see examples of cost shunting and bureaucracy that cause individuals problems.

“I would not want to see a return to the old system of geriatric hospitals – care is much better now – but you have to question whether it is fair that this group of people are being charged in this way?”

Evidence on the changes to the nursing care home and geriatric hospital sectors lend support to his view.

Figures from analysts Laing and Buisson show that the number of geriatric beds fell from more than 80,000 in 1988 to 16,300 last year.

During the same period nursing home places more than doubled from 78,300 to 179,400. On top of that there are now nearly 300,000 residential care places, although these are less likely to have patients with severe medical conditions.

NHS funding is available to people with the most severe medical needs who are in care homes or living independently under a system called continuing care.

But campaigners claim the funding is too bureaucratic and difficult to qualify for. Little over 50,000 people currently get it.

Age UK policy adviser Stephen Lowe agreed Mr Dorrell was right to highlight the issue, saying the NHS had “unilaterally retreated” from its responsibilities.

Ruth Sutherland, interim chief executive of the Alzheimer’s Society, added: “There are hundreds of thousands of people missing out on valuable financial help because they don’t ‘tick the right boxes’.

“People with dementia are some of the hardest hit by this deliberately tricky system. They have complex physical health needs which should often be covered by the NHS but arguments over funding see them denied this care.

“Instead they are forced to pay for social care which adds huge financial burden to people already under emotional and physical strain. Faced with exhaustion, they may not have the strength to challenge being turned down.”

A Department of Health spokeswoman acknowledged there had been problems with people accessing NHS funding, but said the situation was now improving following new guidance to NHS trusts.

She added that recent data showed there had been an overall increase in the numbers of people getting continuing care funding.

 

Let us return to imperfection’s school.
No longer wandering after Plato’s ghost,
Seeking the garden where all fruit is flawless,
We must at last renounce that ultimate blue
And take a walk in other kinds of weather.
 

From Adrienne Rich, Stepping backward

Merciful God,
whose servant Vincent de Paul,
by his ministry of preaching and pastoral care,
brought your love to the sick and the poor:
give to all your people a heart of compassion
that by word and action they may serve you
      in serving others in their need;
through Jesus Christ your Son our Lord,
who is alive and reigns with you,
in the unity of the Holy Spirit,
one God, now and for ever.
Amen.

Vincent de Paul was born in Gascony in about 1580, of peasant stock. He was an intelligent lad, and his father sent him off to be educated. He was ordained at twenty, and at first was interested chiefly in a successful career. But when he was thirty, he accepted a post as chaplain and tutor in the household of Philip de Gondi, Count of Joigny. This brought him into contact with the peasants on the Gondi estate, and he became concerned for their needs, physical and spiritual. A peasant who believed himself to be dying confessed to him that his previous confessions for many years had been dishonest. Vincent began to preach in the local church on confession, repentance, forgiveness, and the love of God. His sermons drew such crowds of penitents that he had to call in a group of other priests to assist him. He took on the pastorship of a neighboring church attended by a more fashionable and aristocratic crowd, and there he likewise drew many of his listeners to repentance and amendment of life. Returning to Paris, he worked among the prisoners destined for the galleys who were being held at the Conciergerie.

In 1625 he established the Congregation of the Mission (now known as the Vincentians, or the Lazarists), a community of priests who undertook to renounce all ecclesiastical advancement and devote themselves to work in the small towns and villages of France. In an age not noted for “interdenominational courtesy,” he instructed his missioners that Protestants were to be treated as brothers, with respect and love, without patronage or condescension or contentiousness. Wealthy men and women came to him, expressing a wish to amend their lives, and he organized them into a Confraternity of Charity, and set them to work caring for the poor and sick in hospitals and in home visits. In 1633 the Archbishop or Paris gave him the Priory of St Lazare as a headquarters. There he offered retreats six times a year for those who were preparing for the ministry. These lasted two weeks each, and each involved about eighty students. He then began to offer similar retreats for laypersons of all classes and widely varying backgrounds. He said (identifying Lazarus of the Parable with Lazarus of Bethany):

This house was formerly used as a retreat for lepers, and not One of them was cured. Now it is used to receive sinners, who are sick men coveed with spiritual leprosy, but are cured by the grace of God. Nay, rather, they are dead men brought back to life. What a joy it is to think that the house of St Lazare is a house of resurrection! Lazarus, after he had been four days in the tomb, came out alive, and our Lord who raised him up still gives the same grace to many who, after staying here some days as in the grave of Lazarus, come out with a new life.

Out of his Confraternity of Charity there arose an order of nuns called the Daughters (or Sisters) of Charity, devoted to nursing those who were sick and poor. He said of them, “Their convent is the sick-room, their chapel the parish church, their cloister the streets of the city.” Many babies were abandoned in Paris every year, and when Vincent saw some of them, he established an orphanage for them, and thereafter often wandered through the slums, looking in corners for abandoned babies, which he carried back to the orphanage.

He complained to the King that ecclesiastical posts were distributed simply as political favors, and that the spiritual qualifications of the appointees were simply ignored. The King responded by creating a Council of Conscience to remedy the matter, with Vincent at the head. On one occasion, a noblewoman of the court, furious with Vincent because he refused to nominate her son for a position as bishop, threw a stool at him. He left the room with a stream of blood pouring from his forehead, and said to a companion who was waiting for him, “Is it not wonderful how strong a mother’s love for her son can be?” He died 27 September 1660.

How time moves on….. although I am into the second cycle of my ministry here in the College of St George – I find it difficult to remember what the routines and rituals were last year mainly because it was all so new! Often friends and visitors ask how I am doing and even offer a criticism that my blog these days isn’t personal enough. From high up in the north side of the Castle walls ( look above and you will see number 6 The Cloisters an the left had side of the picture between the white house and the larger of the towers) I can see the trees and they are steadily turning colour. The season is turning – and the morning is sharp and even frosty. I thought I would offer some of the things that give me cause for thanks.

Some of the positive elements of this stage of my ministry

  1. The surroundings of the Castle with its historic buildings and community of hard working people serving others and especially our many hundreds of thousands of visitors. The Chapel at the heart of the College is an inspiring building, a sanctuary of the spirit, a working building dedicated to worship.
  2. The diversity of my work. I enjoy the many aspects of being the Steward of the College and the people and problems that this work brings me into contact with.
  3. The Anglican choral tradition supported by our organists, our choristers and lay clerks. Their daily energy and dedication produce some wonderful music to the glory of God.
  4. The opportunity to meet and listen to people across the community and especially our visitors.
  5. The chance to read, reflect and write.
  6. The priviledge of supporting the work of St George’s House. At the moment we are getting ready to welcome clergy for a two week course where we shall learn from each other as we reflect on how we might talk about God in the 21st Centuary.
  7. Working in a team and learning from colleagues – and in that team work being ready to learn about my own strengths and weaknesses.
  8. The discipline of prayer and contemplation. The Chapel in the early morning is a place of interdependence and inter connections.
  9. Making things happen and learning patience when they dont!
  10. My fine home in the Cloisters where I love to welcome friends and visitors.

I could go on but I hope that gives you a little flavour of the work and its inevitable ups and downs….

A final picture – ( of Canons Cloisters and my home)

As world leaders meet for the UN Millennium Development Goals Summit in New York, 20-22 September, a new report from the Institute for Public Policy Research (ippr) highlights that because of the financial crisis around 120 million more people may now be living on less than US$2 a day and 89 million more on less than US$1.25 a day.

The report shows that as a direct result of the crisis, output, exports, migrant remittances, capital inflows and aid have all been lower than expected over the last three years.

African countries will see only US$11 billion of the US$25 billion in increased aid promised for 2010 at the Gleneagles G8 and Millennium +5 meetings in 2005.

As governments struggle to live up to their MDG commitments, the Robin Hood Tax campaign is calling for banks to step into the breach they created. Taxes on financial transactions – which have become known as ‘Robin Hood’ taxes – could raise hundreds of billions a year from the financial sector and put us back on course for achieving the MDGs.

David Hillman, spokesperson of the Robin Hood Tax campaign, said: “The behaviour of the financial sector has jeopardised our chances of achieving the MDGs. Whilst banks return to record-breaking profit, for years to come, millions of people around the world will be feeling the negative effects of the financial crisis they did nothing to cause. Banks must face up to the problems they caused and pay their fair share.”

Tony Dolphin, Senior Economist at ippr, said: “The global financial crisis has had a devastating effect on emerging and developing economies. We estimate that their output over the last three years has been a cumulative US$2.5 trillion lower than it would otherwise have been.

“Although the worst of the crisis appears to be in the past, its effect on emerging and developing economies will continue well into the future.

“Lower employment rates and a lack of social safety nets mean that poverty is higher than it would otherwise have been and achieving the Millennium Development Goal of halving poverty by 2015 will be that much harder.”

The report also shows that the GDP of developing and emerging economies will be around US$1.3 trillion lower in 2010 than was expected in 2007 and the cumulative loss of output over the three years 2008 to 2010 will amount to US$2.6 trillion.

Exports will be about 20 per cent – over US$1 trillion – lower in 2010 than was being forecast before the crisis began. Remittances in 2009 and 2010 have been more than US$100 billion short of what might have been expected had there been no crisis.

An economic, moral and spiritual challenge to us all:

The costs associated with dementia will amount to more than 1% of the world’s gross domestic product this year at $604bn (£388bn), a report says.

The World Alzheimer Report says this is more than the revenue of retail giant Wal-Mart or oil firm Exxon Mobil.

The authors say dementia poses the most significant health and social crisis of the century as its global financial burden continues to escalate

They want the World Health Organization to make dementia a world priority.

 

A large part of the problem is people living longer – as life expectancy goes up around the world there will be more people who will develop dementia.

The number of people with dementia is expected to double by 2030, and more than triple by 2050.

But experts say the costs of caring for people with dementia are likely to rise even faster than the prevalence, especially in the developing world, as more formal social care systems emerge and rising incomes lead to higher opportunity costs.

Data from individual countries such as the UK suggests that dementia is already one of the costliest illnesses. 

The report brings together the best available data and the most recent insights regarding the worldwide economic cost of dementia.

It calls on the World Health Organization to declare dementia as a world health priority.

Professor Martin Prince, of the UK’s Institute of Psychiatry and who co-authored the report, urged nations to develop better plans for caring for the millions who have the disease. 

“Governments must show greater leadership, working with all stakeholders, to drive solutions to the long term care issue.”

Marc Wortmann, head of Alzheimer’s Disease International, an umbrella group of organisations, said: “The scale of this crisis cries out for global action 

“History shows that major diseases can be made manageable – and even preventable – with sufficient global awareness and the political will to make substantial investments in research and care options.”

Dementia experts say governments must lead the way in ensuring national dementia strategies are fully implemented and dementia research is given enough funding to find new tests, treatments and possibly a cure.

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