Social services are ineffective

Occasionally I come across situations which make me wish that I did not work in the NHS and a recent one made me realise the serious shortcomings in the way health and social care is now structured. The problems began a long time ago with the move called "care in the community" when there was the all out push to get patients out of long stay hospital beds and into the community because this was meant to be better for people but to the senior managers and politicians the greatest attraction was the fact it appeared cheaper than keeping the elderly and patients with chronic conditions in an NHS bed. More recent emphasis has been on eliminating waiting time and thereby reducing every patient into a financial commodity which is moved through the system as fast as posible. The idea of waiting list elimination was devloped around planned admissions for conditions with a clearly defined outcome (mainly surgical treatments) but despite this it has gradually become the overriding model adopted within NHS today even though for many conditions it is not an approprite way of addressing the problems. Now after years of "care in the community" and pushing the NHS to maximum bed turnover the idea of having facilities for residential rehabilitation seems far fetched and outdated. Out patient rehabilitation is meant to be a better alternative. However in reality it can never provide as intensive input as a residential facility which potentially can deliver therapy to one idividual for up to 8 hours per day. The out patient substitute can only provide a fraction of this. And this is why at times I wish I did not work in the NHS because I can see rehabilitation potential in patients which can never be achieved through the high turnover, "care in the community" health and social care system. The limited amount of input which can be provided in home visits, the unnecessary bureaucracy, the narrow minded and unsubstantiated assumptions of the professionals. I have met people whose health and quality of life could be turned around if only there was the chance to see them daily twice a day in an environment set up to provide rehabilitation insead of them receiving "care" in the community, where their rehabilitation potential is never reviewed and wherer Social Services would rather provide loads of expensive equipment to encourage dependence and disability rather than better use their funding on getting people better