The Royal College of Nursing’s suggestion that hospital visiting hours should be extended so visitors can tend to the needs of hospital patients, particularly older people, highlights, yet again, the inadequacy of UK care. With an ageing population and a woefully underfunded system of care, we are heading for a major crisis if we do not wake up to the challenges that are already upon us. When it comes to care for older people, a fortune is spent on the health service, but care is considered very much the poor relation.

Yet inadequate care of elderly patients can be just as life-threatening as inadequate attention to their medical needs. We read about pensioners dying of malnutrition in hospitals and of nursing staff so overstretched that they neglect the basic care needs of the elderly. This is a result of years of underfunding for care.

Asking relatives to care for elderly hospital patients if nurses do not feel they have time may sound appealing to some, but it is not an adequate solution. Visitors are not trained nurses; they cannot carry out care duties reliably without proper training and extending visiting hours could be even be harmful to patients – when in hospital, people often need rest and having visitors can be stressful. Furthermore, in a ward, those who have many visitors are often disturbing or upsetting those without any, and a restriction of visiting hours is sensible.

I believe this astonishing suggestion signifies something seriously wrong with our health service. If patients are in hospital then surely hospital staff have a duty of care to look after their needs, such as feeding and cleaning them. If they do not need to be in hospital, then others will be expected to help.

Too many older people end up in acute hospital beds when they should be cared for elsewhere. However, in our current healthcare system the NHS is the default safety net that looks after people when no other care setting is in place. A greater use of publicly funded domiciliary care for those without acute medical problems would be a much better way to deal with this problem, saving the NHS money while also improving quality of life for older people – and reducing the burden on nursing staff.

We see many examples of wonderful, dedicated nursing staff who look after older patients marvellously, but clearly there are strains within our system. The sooner we recognise the need to properly reform social care and integrate this with the heath service, the better. We need to ensure better public and private funding for care – reform is long overdue. Andrew Dilnot has offered part of the solution, and the government must get on with integration and reform as soon as poss

ible.

http://www.guardian.co.uk/commentisfree/