THE LAST DITCH An Englishman returned after twenty years abroad blogs about liberty in Britain
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Doctor Dalrymple's insights

The Pleasure of Apparatchiks > Theodore Dalrymple.

Theodore Dalrymple is the nom de plume of Anthony Daniels, formerly a physician/psychiatrist at Winson Green Prison but now better known for his writings. Wikipedia describes him as a cultural critic. He's certainly one of the best commentators on the culture of modern Britain. He's clear-sighted, thoughtful, tolerant and articulate. He's everything I would hope our society's leaders would be yet spends most of his life quietly documenting how little like him they sadly are. 
 
The linked article recounts his experiences pitching an idea for a television series; a series of interviews with deposed dictators. It would have been fascinating but the TV executives were not buying it in either sense of that expression.  
... the experience was valuable, in a way. It gave me an insight into the pleasure experienced by apparatchiks obstructing the creative and imaginative, such power to do so being a kind of consolation prize for being without original ideas of one’s own...
In my current circumstances – negotiating my father's future with apparatchiks – this rings very true. Their tone  signals the pleasure they take in their position. We're not allowed near him to assess his health or state of mind ourselves. One look in his eyes would tell us all we need to know, but that's forbidden. It seems to annoy them that we press for more details. We have been incredibly polite throughout (our loved one is at their mercy, why would we risk being rude?) but still their lips purse when we don't meekly walk away. 
 
We are concerned about reports of elderly patients languishing for weeks in wards unnecessarily – and at present denied all visitors. We were told there were 150 patients in that position at this particular hospital because of a waiting list for home support; known in the inelegant jargon as re-ablement.
 
Both parents were frail before this latest episode. My sisters and I decided they now need carers at home and found a company to do two visits a day. We have also discussed with them stepping up that care temporarily when Dad is discharged.
 
Yesterday I called the "Discharge Liaison Nurse." She said Dad was not on her professional horizon because he was "not medically fit". Nor was there any discussion of moving him to a rehabilitation ward. I pointed out his consultant had told me he was now "medically well" but in need of physio and that the staff nurse had told me last week they were looking at moving him to rehab. She was unimpressed until I also mentioned the magic words "private care". She said she would talk to the ward staff and have someone call me.
 
In the afternoon I went to pick up laundry etc. and asked to speak to a nurse. She said they'd heard we had private care so we could take him home on Friday. I pointed out the care didn't start until Monday (and we'd have to discuss whether the company could step it up to cope with Dad) so she said "fine, Monday then". I asked about evaluating his needs for care and she said "that's for when social services are going to provide it. If you're doing it yourselves that's up to you."
 
In a few short hours we'd gone from "not fit to be moved to a rehab ward" to "take him home now". 
 
The good news is Dad made it and his discharge is under discussion. The less good news is that the NHS and authorities charged with elder care really don't seem to play nicely together. I worry about the 150 patients on that local waiting list who must be atrophying literally and figuratively on hospital wards while the state apparatus "cares" for them and keeps them away from their loving families. I worry that people always insulated from market forces and – during COVID times – now also insulated from concerned families are quietly enjoying their irresponsible power.

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