Carers with stopwatches

I spent half an hour with F. The two carers who had helped him bathe were just leaving. His small maisonette living room is piled with a variety of meagre belongings; black plastic bags with unknown contents; family photos and mementoes; books; old newspapers. On the window sill a much younger F with his wife beam out from their wedding photos; he tall and military in bearing; she dark and attractive; they are kissing in the lych gate of a pretty church. A boy with a mass of fair hair smiles out from another photo; F’s thirteen year old son, now being cared for by his sister on the other side of the country. I listen to F talk slowly, and with long pauses while he gathers thoughts and forms words and sentences, telling of his military career and exploits, his former life, home and family. His eyes fill up when he talks of the son he sees two or three times a year. This man fought in Bosnia, jumped out of planes, then flew a desk for the foreign office. He’s not much older than me. Now two carers come in to help him with his bath. There's a story here, if I have time to listen to it. Maybe I will over the coming weeks.

Back home, there's an item on the radio, about the costs of care. Local authorities are beginning to log care time in minutes and charge clients by the minutes for care received. This means that if it is estimated that it takes 28 minutes to bath someone, then 28 minutes, not 27 or 29, is what will be charged for and paid. There is no time for a conversation, no time for a special word for someone recently bereaved, no ten minutes extra to listen to someone who is feeling a bit low that day. It must all be factored in, and electronically logged. I reacted, as they say, with shock and disbelief. Carers are quitting in droves. Where's the sense in this?

I remember a hospital I used to visit regularly, where there was a tea room, with a large jolly lady with a teapot. She would talk to people and crack jokes with all these folks who were waiting for appointments and treatment. Then one day she was gone – replaced by a dispensing machine. I sat beside that machine with the silent patients in the waiting room. I never heard it tell a joke once. Nowadays, in older hospitals some of these cafes are still open, but run by Friends groups of volunteers. In the bright new private finance health palaces Costa Coffee has the franchise; young people with baseball caps dispense cappuchinos without a smile. The NHS does not pay for cheeriness. Its results cannot be quantified and put on charts. Carers with stopwatches are the end result of this process. Truly we know the cost of everything and the value of nothing.