A Norfolk hospital has recently been forced to take legal action against one of its own patients in order to make him leave – after a stay of over two years. Adriano Guedes was admitted to James Paget Hospital in 2014 and was later declared fit to be discharged. However, when presented with suitable housing offers in order to re-join the outside word, he reportedly refused them on multiple occasions. Hospital staff say legal action was a last resort, with Guedes eventually being evicted on 10 January.
At first glance this may seem simple enough but, of course, there are two sides to every story. Two weeks after his eventual eviction BBC News reported that Guedes had not wanted to stay in hospital, and had in fact “tried to get out of there”.
Mr Guedes suffered paralysis after a stroke in 2008 and as such has very specific accommodation requirements. He says that he requested wheelchair-friendly housing but was repeatedly presented with non-suitable arrangements by social work staff. Guedes also stated that had he been capable he would have left the hospital by his own means, but his paralysis means that he must rely on his local authority for accommodation and care.
Upon leaving the hospital the 63 year-old Portuguese national was placed in an unfurnished council flat in Suffolk without functioning central heating, curtains or a carpet. He is virtually isolated and miles from the spinal specialist he needs to see in London. Guedes is now on hunger strike, and has refused to eat since the date of his eviction.
Bed-blocking is a serious issue for the already stretched NHS at the moment. The Department of Health estimates the average daily cost of a hospital bed to be around £400 (using this figure Guedes’s stay would be valued at roughly £340,000), so if this really is a widespread issue it could be draining money from the healthcare service at a time when funding is already lacking.
In 2010 delayed discharges in England sat at around 58,000. Since then this figure has doubled, with last year seeing 134,000. In Scotland the numbers are significantly more steady, with an increase of only around three per cent being seen in the last four years. Scottish figures for December have not yet been released but in November alone we know that 45,639 days were spent in hospital by those who had already been declared fit for discharge. Using the same estimate provided by the Department of Health this means that NHS Scotland spent £18,255,600 on care that was not really required in November of last year alone.
So what is causing the hold up? Between July and November of last year, ‘health and social reasons’ were consistently blamed as the main cause of delayed discharge and were three times more likely to be so than any other factor. However, the NHS fails to elaborate much on the precise nature of ‘health and social reasons’. There must be cases just like that of Adriano Guedes around the country (although perhaps less extreme), where the care needs of vulnerable members of society cannot be met, and as a result they end up stuck in hospitals where they, and hospital staff, do not want them to be.
This therefore raises the difficult question of: what is to be done? A funding increase for the NHS seems unlikely in the current climate. Can increased community awareness provide a solution? Perhaps local authorities need to take a more preventative approach to the needs of their residents so that they can tackle these kinds of problems before they escalate and become crises, as happened in the case of Mr Guedes.