Page 16 Daily Mail, Wednesday, August 21, 2019COMMENT
Now it’s time Brussels
showed common sense
‘THE time for bluster and political blame
games is fast running out.’
So said the EU Parliament’s unctuous
Brexit negotiator Guy Verhofstadt as Boris
Johnson sought, patiently and reasonably,
to break the interminable impasse.
He’s not wrong. But shouldn’t he direct
his self-satisfied remarks to his complacent
colleagues in Brussels?
Before travelling to meet Emmanuel
Macron and Angela Merkel, the Prime
Minister set out his stance in a letter to
European Council president Donald Tusk.
Politely, he explained that if the EU wants
a deal, it must compromise by ditching the
major roadblock – the Irish backstop, which
prevents the UK from striking its own trade
deals. Mr Johnson argues it is undemocratic.
And the pragmatic reality is that it simply
will not win support in Parliament.
True to form, Brussels responded
aggressively to the overtures. In incendiary
language, officials effectively accused him
of lying – slamming the door in his face.
Mr Johnson must now display supreme
patience, and refuse to rise to the bait. He
is adamant he wants a pact. Indeed, no one
with an iota of common sense wants a
turbulent No Deal.
But without the plausible threat to walk
away on October 31 – ‘no ifs, no buts’ – the
EU will not offer eleventh-hour concessions.
Surely its leaders, with a recession looming,
would be sensible to compromise?
Yet it is unlikely to move before knowing if
Mr Johnson can survive a confidence vote.
Reality dictates Britain must leave in the
autumn. As the finishing line appears ever
closer, the Tories must hold their nerve.
Labour’s true colours
NEVER let it be said that the Mail is shy of
bestowing praise on those who deserve it.
So today, we give Diane Abbott a hearty
round of applause for honesty. The Shadow
Home Secretary admits she would vote
Remain in a second Brexit referendum.
She joins John McDonnell and a host of
other Labour MPs in campaigning to stay in
the EU – casually sticking up two fingers to
millions of the party’s Leave supporters.
Despite promising to implement Brexit in
their general election manifesto, they have
shamefully welched on their word.
Meanwhile, Jeremy Corbyn (a lifelong
Eurosceptic) risibly continues to bury his
head, ostrich-like, in the sand.
It is blindingly obvious Labour is now a
Remain party. When will one of the deluded
Marxist’s cabal dare to tell him?
A future up in smoke
THAT the number of children shunning
cigarettes has hit a record high is very
positive news. Only one in six under-16s have
tried them – down from half in 1996.
A crackdown on selling tobacco, plus a
growing awareness of smoking’s serious
health hazards, are persuading youngsters
to stub out the harmful habit.
Yet a cloud persists. While eschewing
cigarettes, children are increasingly
tolerant of cannabis, the insidious drug
linked to psychosis and violent behaviour.
And why shouldn’t they be? The muddle-
headed message from too many MPs, police
chiefs – and, shockingly, even parents – is
that it’s an inoffensive ‘natural’ substance.
But by normalising this devastating
narcotic, they risk sending our children’s
futures up in smoke.
n
WE know breathing in dirty air
contributes to thousands of deaths
every year. Now we learn that living in a
polluted area doubles the risk of the most
common form of blindness. Part of the
problem is diesel cars. Labour encouraged
motorists to switch, claiming they were
cleaner. In fact, they were toxic. Isn’t this a
salutary lesson for the vociferous green
lobby? Beware the unintended consequences
of rushing for a better tomorrow – it
sometimes does more harm than good.
How can we call
ourselves a civilised
society when
dementia patients
have no option
but to go to A&E?
by Dr Max
W Pemberton
E KNEW
care in Brit-
ain was in
crisis. The
real scandal
is that it is only getting
worse, heaping new
burdens on hospitals and
bringing distress to
vulnerable patients.
Because the politicians have
failed to tackle the problem,
too many people with demen-
tia are not receiving the
support they need, so they end
up in overcrowded, under-
resourced Accident and
Emergency departments.
Yesterday, continuing its vital
campaign to address the prob-
lems caused by dementia, this
paper revealed the alarming
extent of the crisis, with the
shocking news that emergency
hospital admissions of demen-
tia sufferers have now reached
almost 1,000 a day, a dramatic
rise of a third over the past
four years.Frustration
All too often the causes of
admission lie in the inadequacy
of care in the home or
residential units, mainly
because of underfunding and
poor management.
As a doctor who has worked
in A&E, I’ve seen so many
families stand, bewildered,
panicked and disbelieving in
hospital where they’ve had to
take their elderly relative not
knowing where else to go.
They simply can’t believe
that A&E is the only solution
when a carer or a nursing home
can’t cope. I saw one elderly
woman break down because
she could no longer care for
her husband. The only option
aside from turning to A&E, she
said, would have been to kill
herself and her husband.
The frustration and distress
that patients and their families
feel is shared by the frontline
staff who have to hear the
same tragic stories over and
over again of carers at break-
ing point, with nowhere to turn
but a hospital emergency unit.
Even more disturbing is that
so many dementia patients
deteriorate quickly once they
are admitted, partly because
hospital can be a bewildering,
upsetting environment forthem. Up to half the patients
who are admitted never
actually return home.
These latest figures are a
grim indictment of government
policy. The Alzheimer’s Society
said last May that there had
been 50,000 avoidable admis-
sions of over-65s with demen-
tia to hospitals in the previous
12 months alone.
Hospitals should be there for
emergencies, not long-term
care. But because of the
present crisis in care, they have
ended up doing a job for which
they are totally unsuitable.
By 2025, it’s estimated that
more than one million people
will have dementia in the
United Kingdom.
If nothing is done, A&E,
already under siege, will simply
be swamped. This should act
as a clarion call for action by
the Government. The present
scandal cannot be allowed to
go on. We need more carers,
more NHS staff and more
hospital beds.
For years, ministers have
promised a solution to social
care, which people with demen-
tia rely on every day, but the
rhetoric has never matched
the reality, so the spiral of
decline accelerates.
We now have the appalling
situation where, according to
the Alzheimer’s Society, half of
frontline emergency staff have
to deal with dementia patients
every week and a fifth of
them every day.
Paramedics respond to end-
less calls from nursing homes
to take people suffering from
dementia into hospital.
It is utterly depressing for
them, because they know that
if the care system had been
working half decently, the
problems those patients are
suffering from would have been
spotted earlier and treated.
One paramedic even talked
of the ‘torture of travelling to
hospital’ from nursing homes
which want people admitted
because they cannot cope.
When I was working in
dementia care a few years ago,I was asked to assess a patient
who was living in a care home.
In the two years the elderly
woman had been there, she
had started to show signs of
Alzheimer’s disease. Things
started to deteriorate quickly
and she began to wander and
become aggressive.
The staff were kind and caring
but they were not dementia
specialists. They were at their
wits’ end and had resorted to
having a carer sit with her all
the time to try to keep her safe.
Because they were so short-
staffed, this was creating prob-
lems for other residents who
weren’t getting the care they
needed. Meanwhile, the GP was
at a loss to know what to do.
I alerted social services, but
after three weeks nothing had
happened. So during one
particularly difficult night when
she had assaulted another
patient, one of the carers called
an ambulance and the elderly
lady was taken to A&E with a
letter explaining the care home
could no longer look after her.
It would be easy to criticise
the care home, but they were
out of their depth — what else
could they have done but turn
to A&E?Pressure
The fact is that this crisis
extends to all three domains of
the health system. First of all,
care in the community, where
dementia patients are looked
after in their homes either by
professional carers or their
own relatives.
It is undoubtedly the most
suitable form of care, because
those with dementia can be
comforted by familiar sur-
roundings. The problem is that
the provision of care in the
community has been under
relentless pressure, enduring
an overall cut in funding of
10 per cent in the past eight
years, at a time when the
elderly population is growing.
The second domain is nurs-
ing and residential care, which
is affected by the twin strainsof underfunding and rising
costs, leading to poor care
for patients.
The Alzheimer’s Society cite
one woman who was rushed to
hospital four times in a year
with dehydration and urinary
tract infections. This should
have been avoidable. They talk
of a man who was hospitalised
because of a pressure sore from
sitting in a chair for 24 hours
— yes, 24 hours! — a day.
And another who was hospi-
talised twice by falls when in
care, getting stuck on the
wards for months on the first
occasion and on the second,
passing away after admission.Disgrace
Once dementia sufferers get
to hospital — the third domain
in the care system — they are
again let down because of a
lack of funding. That is why
emergency doctors end up
practising ‘corridor medicine’
— the treatment of patients on
trolleys parked outside the
main hospital wards.
For people with dementia,
who are already disoriented,
that is a desperate situation.
It is a disgrace that our
advanced nation, with the fifth-
largest economy in the world,
does not provide sufficient
hospital beds or enough staff in
the NHS to cope with demand.
What is equally disturbing is
that so many emergency
admissions could be avoided if
effective care was provided in
the home or the residential
unit. That is especially true of
urinary and chest infections,
often the result of malnutrition
or dehydration.
This just shows how cutting
back on the funding for
community care is a false
saving — it only puts an
additional burden on the NHS.
Investment in front-line social
care would, in the longer-term,
reduce health service costs.
In the meantime, A&E is
inundated with dementia
sufferers who are being let down
in the community and whose
carers don’t know where else to
turn when things deteriorate.
A properly funded care
system is urgently needed to
address this scandalous
situation. The present mess
offends not just the ethos of
the NHS, but the spirit of a
civilised society.