Why I’m hoping for fewer cards this Christmas

I don’t think Which? was endeavouring to bench-test care homes. What it has done is show up the fact that the Care Quality Commission hasn’t been doing its job adequately. Merely opening the lid on some operations and activities is a good start. The fact that it cannot do everything some people might want is not necessarily a failure. Which? relies on private individuals’ subscriptions and purchases for its income – it’s not there to duplicate the work of the publicly-funded authorities [apart from anything else, it wouldn’t necesarily reflect the members’ expenditure priorities].

That’s it in a nutshell, John. In many cases, Which? uncovers possible problems, discusses them with the relevant organisations and let’s us have brief details of their responses.

I would love Which? to devote more resources into things that interest me and report in much more depth, but recognise that others have different priorities. I place a lower priority on product testing than many of the current activities of Which? but recognise that this is their core activity and what most subscribers are looking for.

It would be good if Which? occasionally used their Connect surveys to find out about what we feel is most important.

Gerald, I understand your concerns about public vs private sector. However I don’t think exposing any malpractice should be condemned as biassed just because the investigation took place in one small area – it is bad and something that needs dealing with.
My concern, a little like yours perhaps, is that scratching the surface and then hoping someone else picks up the case is not very productive. The wish of big organisations to protect themselves and their staff launches huge defence mechanisms, so you really need a robust case in my view for it not to be dismissed as isolated cases. I’d like Which? to either look properly in depth at a topic or work with an organisation that can put thoroughly constructed and convincing cases together to, hopefully, force action (other than “lessons will be learned” of course).

The Which? investigation may have been superficial but like similar reports, it helped make me aware of a potential problem. From speaking to friends with family members in private care/nursing homes I have learned that there is a considerable reluctance to report poor practice. I don’t know whether this is simply embarrassment (which I can understand) or fear that the person in the home might be affected in some way. I offered to report an incident when I visited an old man who had been left bleeding on the floor for hours after a fall, and no-one attended, but his daughter did not want me to do this or take action herself. That was at a private home with a glowing report. I had helped my friend choose the care home for her father on the basis of the most recent report, inspecting the room and meeting with staff.

Perhaps Which? could pick some examples of poor practice and give legal advice to the families of several people who have families receiving substandard care, but I cannot see how they can devote more resources to this specific problem.

I may need a dental implant soon and hope that Which? will do an investigation to help me understand what the complications might be. I would not expect Which? to do a detailed investigation but it’s difficult to believe that implants are as straightforward as the advertising seems to suggest.

Another example of a limited but useful examination of a problem was when Which? looked at laser eye surgery earlier this year. This revealed malpractice and through comments on Which? Conversation, there is obviously much to be concerned about.

I read the laser eye surgery report – something I had considered briefly but discounted as eyes are too precious to risk scarring or worse. however the report was pretty mild in its warnings – it was not until the conversation that the many horror stories emerged, particularly of the attitudes of the High Street providers (and even Moorfields).
I think this is an example of the cart before the horse. It would have been much better, in my view, to seek the information as given in the conversation first, discussed with professionals and then put a complete story together.
Whether the conversation gives a complete and fair picture is questionable; I suspect the bulk of people who had satisfactory results may not contribute. But the consequences experienced by many were horrific and should have added balance to the original report.

I expect that if Which? looks into laser eye surgery again they will approach it differently. Everyone I know has been satisfied with laser eye surgery, so it would be good to have some statistics about how often problems occur and their severity, as you would with elective surgery. I don’t like the high street approach for something that could result in permanent problems, even if they are uncommon. We only have one pair of eyes.

It’s a difficult balance. With hindsight I feel that the report should have been more critical but don’t forget how much criticism Which? attracts for being too critical.

wavechange – “dental implant”. I see this as another very specialist area – not something for Which?’s limited resources or expertise. Maybe a subject for a conversation though. Something to get our teeth into.

Best discussed with your dentist I’d suggest. A friend of mine had a successful one a couple of years ago and is in process of having another done by a specialist dentisit. It takes time though.

I had a gap that was filled by a porcelain tooth with a metal wing that was glued to the back of the adjacent tooth. Despite taking the strain of a bite it has held up remarkably well for about 15 years – without having my jaw drilled. Incredible what glue can do.

My dentist thinks I’m OK with the missing molar and the only problem is with whole hazelnuts getting stuck in the gap at Christmas. 🙁 But I realise that having a missing tooth puts more strain on adjacent teeth, and my dentist has told me that fitting a bridge would be worse in this respect.

I had a crown since my early 20s and never had a problem until a private dentist fitted another crown facing it. When he realised that it was too large, he ground away my existing crown rather than the one he fitted. The old crown, now weakened, started to disintegrate some months later and to cut a long story short I lost the tooth.

I agree that a Conversation on implants would be a good start and have suggested this a couple of times.

Which? should ask us to do a risk assessment before putting coins in our Christmas pudding to avoid the need for dental treatment. I still have three silver sixpences from when I was a child.

Gerald, my perception of those who run big organisations – public or private – is they seem immune from the normal consequences of incompetency. Health, banking, auditors, FSA, social services – the reward for failure is often a substantial pay-off and pension contribution followed by a high-power appointment somewhere else.
The way the world works sometimes perplexes my simple mind. You have to wonder whether being honest, diligent and responsible is a good career strategy.

It was a very superficial wound but messy because the chap in his 90s was nearly blind and had struggled to get back into his chair, which is where I found him. From the dried-up blood I presume that he had been left for hours. He said he had used the emergency call but I don’t know if that was the case, since he seemed confused. I did express my concern at the time but left it to his daughter to decide whether to file a report. She did not want to and there was no lasting damage.

If we are discussing NHS hospitals I can provide some worrying anecdotes. I don’t think it’s useful to compare the private and public sector, and we should do our best to address problems wherever they occur.

Gerald – As I see it, Which? tends to focus on areas where we have choice or money is involved. I’m not defending or criticising that approach, but I’m glad they are doing a lot more than product testing these days.

I made my comment as an illustration that not all is well in the world of private care homes and to make the point that people are sometimes reluctant to complain. The only real criticism was that no-one had discovered that the old chap had had an accident. He was unsteady on his feet and if my memory serves me correctly, he was due to be inspected regularly. There was also a delay in getting someone to attend after I reported the problem. The staff who were chatting at reception were responsible for a different wing of the building, so I had to wait. I did express my concern at the time but left it to my friend to pursue, but she decided not to. I don’t ignore what happens in the public sector, and if you read my posts on other Conversations you will find some of my criticism of the NHS.

Wavechange: I discussed the pros and cons of dental implants with my dentist a while ago and he advised me to search the internet where you can learn all about the procedure. Having done that I decided it was definitely not an option for me personally but obviously its a question of choice and whether you are a suitable candidate.

Thanks Beryl. I will certainly look into this very carefully if I decide to go ahead. My experience of straightforward dentistry has demonstrated both good and bad. Most of the advice available is from those involved and I would certainly appreciate some unbiased information from Which? I’m sorry you were not a candidate for treatment and that’s a complication I’m very well aware of.