Monday, 31 March 2008

A Denial Or Not

At last a reply from the NHS to our MSP’s letters (see here). The reply doesn’t address the main points of the MSP’s letter and we will respond fully through the MSP in due course. There is one aspect I want to highlight now: the NHS reply contains the weakest denial I have ever seen. So weak is the denial, in fact, that it doesn’t act as a denial of Mrs Carr’s claims but actually confirms them.

The MSP wrote:
I do not believe that your letter [NHS first response] addresses the main point of my letter of July 2007 [MSP’s first letter], which is that Mrs Carr is in urgent need of care. There appears to be a view that Mrs Carr's behaviour is as a direct result of the ending of the therapeutic relationship with Dr X. Mrs Carr was told by Practitioner A at assessment that her behaviour was part of a cycle of escalation to secure a response from Dr X. This view, however, doesn't seem to appear in any case notes . Mrs Carr strongly denies that this is the case. However, even if it is the case, not dealing with her behaviour, including her suicide attempts is not addressing the problem. Can you confirm whether or not clinicians, apart from Practitioner A, believe Mrs Carr is deliberately escalating the situation and is that the reason why NHS therapy is being denied totally?”

The NHS reply does not address the issues of Mrs Carr’s urgent need of care and of whether other clinicians believe Mrs Carr is deliberately escalating her behaviour but attempts to deny that Practitioner A said anything about Mrs Carr’s escalation. The attempt is so weak as to be meaningless in terms of a denial but rather it confirms what it seeks to deny.

The NHS reply states the following:

Dr Z advises, that during psychotherapy assessment and treatment that a therapist may often explore motivation behind a person's behaviour. Dr Z confirms that motivation can be conscious or unconscious i.e. within or not within the person's current awareness. Dr Z advises that during this assessment process that Practitioner A may have explored the motivation behind Mrs Carr's behaviour but does not feel it is accurate to say that she advised Mrs Carr "that her behaviour was part of a cycle of escalation to secure a response from Dr X".

Let's look a little closer at their quoted paragraph. The reply states:
Practitioner A MAY have explored the motivation behind Mrs Carr's behaviour.
Either Practitioner A did or didn’t explore.

but DOES NOT FEEL IT IS ACCURATE TO SAY that she advised Mrs Carr ‘that her behaviour was part of a cycle of escalation to secure a response from Dr X’".
Why not write “did not say”? Because she did say.

Why use a quote from the MSP’s letter? The MSP did not state that Practitioner A had actually used these words. Therefore it is much easier to deny specific words which weren’t even used …… except that it isn’t even a denial.

Why have Dr Z saying what she thinks Practitioner A may or may not have done or said or meant? Why not state what Practitioner A did and said and meant?

Instead of all these weak words a genuine denial would say something like:

“Practitioner A made no comment to Mrs Carr about escalation and believes that Mrs Carr’s behaviour was not escalation”
“Practitioner A explored the motivation behind Mrs Carr’s behaviour but made no comment to Mrs Carr about escalation and believes that Mrs Carr’s behaviour was not escalation”.

If the NHS could correctly state that Practitioner A had not suggested to Mrs Carr that she (Mrs Carr) was escalating her behaviour they would have said so very strongly. That they use weak words means that they cannot make a formal denial. Therefore, the NHS reply is not a denial; is nothing like a denial; it’s the weakest denial one could write; it’s a non-denial denial. It is confirmation that Mrs Carr and the MSP are correct!

Will Practitioner A please take the stand?

Do you promise to tell the truth, the whole truth and nothing but the truth?

Back Home

Obviously didn't make a big post before I left with the children for a few days youth hostelling near Aviemore and now I'm back and still not ready with that post. It's not as though I didn't write when we were away but rather I wrote too much.

I would like to say I was refreshed but I'm not. I don't think we were quite the family from hell but we did have our moments!! I did, however, enjoy myself.

Apart from the Easter holidays I'm buried in work: selling shares etc and making sure the money is available in the right place at the right time; talking to our lawyer regarding the conditions for the purchase of Mrs C's flat, thinking how we're going to tell the kids about the split and handling the aftermath plus the normal......

I shall get my post out .... sometime. Unfortunately time has a habit of running away from me.


Tuesday, 25 March 2008

Precursor Post: Are We The Family From Hell?

A post will follow later tonight.

[UPDATE: Tues 26 Feb - Too late 00:15. I have much to do before we can go on holiday. Posting needs to wait until we're back. With luck I'll have chance to write the post while away. Perhaps time and distance will change my thinking but doubt that anyone else's will change. Are we the family from hell or are we lepers? I know what I feel but what is an objective assessment?
Who knows? ]

I've taken this unusual step because I must blog on this subject tonight: tomorrow I'm taking the kids away for a few days .

I know the odds are that I won't find the time tonight and so I hope this precursor will stimulate me.

Are we so bad that the NHS doesn't want to touch us?

Are we winding everyone up so much?

Can we not see what all the clinicians see?

Are the NHS in the right and we are the cause of our own problems or are we a family with problems whom the NHS has unjustifiably labelled as difficult and, therefore, to be denied treatment.

Much more tonight if I can find the time. Once started there'll be a splurge of words.

Sunday, 23 March 2008

Scoop! Internal NHS Advice Discovered?

We always felt as though the NHS considered us to be a problem to be discarded and now we understand why Mrs Carr and others have been treated so shabbily. What appears to be an internal NHS document describes how to handle patients whom, for some reason, they don't want to treat. The advice is:

Of course, you wouldn't expect us to do anything else but

I know that you know that this isn't really from an NHS document although it could have been. I saw this sign in the food court of a shopping centre.

Saturday, 15 March 2008

How Long Does It Take To Answer A Letter?

This isn't a riddle but it is a puzzle!!

On 5th July 2007 our MSP wrote a detailed letter to NHS Lothian.

On 19th August 2007 NHS Lothian replied but did not address any of the questions / major points raised but rather questioned some of the background information included by our MSP.

On 21st September 2007, our MSP wrote again.

On 21st November 2007, our MSP wrote again chasing a reply.

During January 2008 our MSP's office phoned repeatedly but in their words, "We were given the run around."

On the 25th January 2008, NHS Lothian told the MSP's office that they would have a letter issued by early the next week.

We arranged to meet the MSP on 11th February but this was cancelled because there was no letter.

We arranged to meet the MSP on 22nd February.

The phonecalls continued into early February but no letter arrived.

On 22nd February - the day of our meetig with the MSP - NHS Lothian send the MSP an email stating that Mrs Carr was receiving treatment for her eating disorder and that her GP was monitoring her general health. They hoped to finalise a letter that day. The email did not address any of our MSP's points.

Today, 15th March there has been no reply!!!

In 1 more week we will have waited 6 MONTHS for a reply to our MSP's second letter.

We have already waited 8 MONTHS for answers to the issues raised in the MSP's first letter.

Do you think NHS Lothian are simply inefficient; have they decided that they are not going to reply or do they think we will go away?

But more importantly, why should NHS Lothian be so unwilling to reply?

Sunday, 9 March 2008

Priorities Must Change

Apologies for the lack of recent posts: I couldn't be bothered but tonight I decided that I was going to publish regardless of what was there.

Life moves on apace.

Mrs C is likely to buy a very small flat in a small village 15 mies or so from where we are now. Fortunately I think we can afford to buy the flat without selling our current home but it means selling all of the shares I earned / saved whilst working. With most of my / our financial safety net gone I will have to work again. I don't really mind this as long as I can find a job which is interesting but I'm under no illusions though: finding such a job wil be difficult. Doing a "Tesco" job would be an absolutely last resort.

I think we'll know this week if the flat purchase is going ahead. If it does, life for us all will be very different.

Mrs C will be able to see the children whenever but I don't think she's nearly ready to be able to spend much, if any, time alone with them. Although I've done almost all the parenting for more than a year they'll miss their Mum terribly: she's always been here even if not parenting. I think Mrs C will miss them although they are a major source of stress. Obviously I'll miss Mrs C terribly but I've got to come to terms with the fact that this is how life is going to be.

My responsibilities will reduce. The house, the kids will remain with me but I won't have any responsibility for Mrs C. I'll be concerned, I'll care but I'll not be in a position to influence events. Others will have to take on that role. I'll still do whatever I can to ensure that Mrs C gets the treatment she needs - if that's what Mrs C wants - but my priorities will be the children and me. This is how life is going to be for some time and I need to plan for this ... now.

The one drawback of not selling the our house now is that this will have to happen sometime - a year or two or three or whatever.
At least if we sold the house now - which I don't want to do - we'd be totally financially independent of each other (in terms of capital) and I could then develop and live my life. By not selling now, I'll always know that this is hanging over me and I think I'll find it hard to move on.

I really should think much more about this but I know I won't because I don't want to go through the disruption until it can't be avoided. Silly, I know, but that's me.

The last week or so has seen a slight - well, marginal - improvement in me. It coincides with the anti-depressants kicking in but also with some self-help I'm doing. I bought a book by Paul McKenna, the stage hypnotist - don't laugh or sigh now! Interestingly the book doesn't mention his career as a hypnotist but it does say that he is now a Dr although where his degree comes from is not stated. Anyway, I bought one of his book and it comes with a cd which I'm sure uses hypnosis. I don't care what techniques it uses if I find it beneficial. I guess I should mention to the bank to stop any money transfer from my accounts to Paul McKenna. Can you imagine a hypnosis cd which got hypnotised fools to empty their accounts? No, neither can I but it's an interesting thought.

I'm not back to normal blogging nor normal visiting but i'll do what I can. Please bear with me.