Price of care

Lessons must be learned from the recent collapse of a British nursing-home giant writes Maurice Gueret, as he catches up on some good reading at the dentist

Ailing homes

Things are looking decidedly wintry at Four Seasons Healthcare. The privately owned care-homes giant that operates more than 300 nursing homes, including many in Northern Ireland, has collapsed into administration. Debts are averaging £2m per home, and interest payments would appear to have crippled the operation. With 17,000 residents and 22,000 staff, the sums just aren’t adding up. And it’s little surprise. Crunching the figures, it seems as if the average income for nursing-home care in the UK is about £6 an hour per resident. When you consider that an overnight stay in a quite modest hotel from evening to morning, without breakfast, could easily earn the owner €8-10 an hour, you see how the care sector might struggle. Politicians are brimming with ideas these days when it come to making childcare better and more affordable. But with two salaries necessary now to pay most mortgages, time to mind ailing relatives is short. It’s at this end of our spectrum where the real problems are coming.

Nobbling neuralgia

Shingles is a nasty dose with a painful blistering rash. It affects people who had chickenpox in their younger days. The virus remains dormant in the nervous system, reactivating in later life in about 25pc of us. Common rash sites are one side of the torso or one side of the face. It can be a malevolent episode, especially if the eye is affected or nerve pain (neuralgia) remains in residence after the rash has cleared. A shingles vaccine called Zostvax was introduced a few years ago, but uptake in Ireland was poor. It wasn’t made available free of charge to older people, as childhood vaccines are to infants. At the end of March, a new improved vaccine was approved by European Medicines Agency for use across the EU. It’s known as Shingrix and a large controlled study of more than 15,000 patients showed it to be highly effective at preventing both shingles and post-shingles neuralgia in adults over 50, for at least four years after vaccination. I made enquiries, but no date has yet been set for its availability in Ireland. It will be interesting to see if the State makes this jab available free to senior citizens, seeing as they failed to give them the last one.

Magazine heaven

I have visited a few specialist dental clinics in recent times and am always amazed at the care they take to keep reading material in their waiting rooms up to date. Whether it’s the endodontist, prosthodontist, periodontist or orthodontist, the magazines are so good I’d happily wait all day for an injection. I noted that some of them subscribe to a service called DLT Magazines, which replenishes their monthly supply with a specialist Dental Pack every few weeks. This gives them 14 titles a month, including some excellent mags from golf to history, Wi-Fi to wildlife. There are separate offerings for opticians, hairdressers and car dealers. And I noted a general one for healthcare, but I couldn’t find a specialist Doctor Magazine Pack. Perhaps somebody is missing a trick here? The service only costs about a euro a day and sure beats looking at a Golden Pages from the 1990s or a sleepy goldfish.

Bottom surgery

The wordsmiths at Dictionary company Merriam-Webster introduced more than 600 new word meanings or phrases to their lexicon in April. A snowflake is somebody who is over-sensitive. And if there is a lot of fuss about an issue it can now be described as buzzy. I have been scanning new entries that emanate from healthcare. Traumatology is one, but it’s hardly new as it has been used in medicine for many years to describe the work of orthopaedic and other surgeons who study or treat people who are injured in accidents or violent attacks. Other new words are to do with gender-reassignment surgery. Top surgery is an operation on the breasts whilst bottom surgery is work that involves changes to the genitalia. Salutogenesis is certainly a new word to me. Pathogenesis is the old medical term for the chain of events that leads to a particular disease. Salutogenesis is a new approach focusing on factors that support good health, rather than factors that cause disease. I’m not sure that I quite understand it, or that there is a need for such a word. I’m even less convinced that it will catch on. But if you see a new hospital corridor sign saying Department of Salutogenesis, safe to assume it’s more of a buzzy wellness thing, and not the place that will be doing your tests.