My office is a 3 story building and for the last year or so I have inhabited a desk on the first floor. Well I say A desk, actually about 3 months ago I was moved about 3 rows and a large cupboard forward to make way for smoking cessation, now that was an interesting team, who have since moved onto the 3rd floor. I did say it was strange! The world of the UK primary care trust is an odd one, and they do say that hot desks are the new black or something so it should come as no surprise that I will shortly have to move my desk again. Meanwhile, today children’s services moved out and I was left there as one of three people in the whole large, open planned office and my other two colleagues were out. When I was stressed and in an ultra busy job, I craved silence, but this is still a new job, I am still making the work happen and lets face it everyone else in the whole world is taking a holiday! So from 12 midday I saw and spoke to no one in the office. I went out to the shops and bought myself some new books to read, and spoke to the assistant, other than that……..nothing.

Home, and hubby is doing a strange form of nights, more like afternoon and night times 4 so since I got home I have spoken to no one (as I said yesterday teen son is away in France). I know hubby will ring later, and it is lovely to get some time to yourself, but I think singing along to your ipod, while you power walk the fields of rural England as your only method of knowing if you can still speak is rather extreme. In the coming months when I can get no peace, when I am back in a busy office, when the work is piling up, when my family are wanting something from me at all times, remind me of today, the day I wasn’t sure I liked the silence!

My teenage son (an only child as those of you who read this stuff regularly will know) is away in France with his cousin staying with some friends who are currently renovating a house. He is no doubt having a great time, and is hopefully learning that work is a good thing, but he is less than communicative. He has a roof over his head, food (and lots of it if I know him) and a beach complete with sea outside the front door to go and have fun in. So apparently he doesn’t need to speak to me other than exchange the odd text. When I asked him if I should ring him his answer was No: Why? What more can be said?

I of course encouraged him to go on this trip and am glad he is doing something constructive with his long summer. He has also done well to escape the English weather on a year which has seen the wettest July in history. But of course I am missing him and I am finding it mighty strange not to have his music blaring out, not to have his dry wit and acid comments when I say something out of turn. It is strange not to have to buy a continuous stream of pizzas and other fast and unhealthy foods to fill his skinny body with. He will be back in a week or so, and has only been away from us for just over a week since we left him in France, but it is mighty odd and I guess a precursor to what we will need to expect when he goes off to college in a couple of years. No one prepares you for parent hood, and nothing can quite prepare you for this feeling either. Mind you, his bedroom is at least staying tidy!

The PCT continues to be reorganised; this is pretty much the longest period of sustained change I have witnessed in my 20 odd years of NHS service and to my mind the fall out continues. Every week now, I hear of people taking early retirement or leaving to go to a new job, colleagues are wondering if a job in M&S or Waitrose (this is an upmarket supermarket and they are upmarket people) would be a viable and more pleasant alternative to nursing or nursing management I(and they are only half joking). Morale in the provider arm of the PCT seems to have dipped so low it can now barely be seen. Managers have had their power and authority removed, and can no longer sign off invoices, the decision for recruitment rests at the highest level and staff not surprisingly are leaving. What then does the PCT do? It decides to employ some external consultants of course and those consultants will we working on change management with staff (give me strength!) plus there is to be a programme of culture change (whatever that will involve!). The higher management tell us they want to listen to us, they tell us they value us, but I wonder what your average nurse, doctor or indeed manager will be saying as they read the latest email telling them of change management consultants and culture change when staff are exhausted beyond belief and morale no longer exists.

Having said all of the above, I am actually ‘all right jack’. I am working for the commissioning part of the PCT and most of the current changes are about the provider part. I guess this doesn’t prevent me having to have my culture changed, and having to watch as others have to go through the uncertainty that I have been through myself during the CaPLNHS process but I do consider that I have had a lucky escape because quite honestly my sanity is beginning to suffer from all of this!

It all started pretty well, and got better. My keys went to hubby’s work with him, so 8am saw me hunting the spare car key and taking the back door key (spare front door keys are 1) with my parents 20 miles away and 2) next day and the neighbours left for Australia yesterday. I have their key, but don’t know where they keep mine). Work was essentially fine, as it often is on the first day back as generally I try to maintain my holiday attitude to life and not let anything worry me. There were plenty of emails, things to read and gossip to catch up on, after all we all need to know what is happening in the world of the office. About 2pm though my work PC died; just went off and when you tried to switch it on again it emitted a loud beeping noise. I reported the demise to the IT department who asked me questions like, what happens when you restart it? I held the phone close to the PC for them to hear. My call has been logged and now we wait. I used someone else’s PC for a while, but found I couldn’t follow links from emails to the internet as ‘access was denied’. So I decided instead to go home and get myself to the supermarket; there are only so many days you can live with basic provisions in the fridge!

So that’s my first day back, but it is only right to finish off with some pictures of where I would rather have been!

This first picture is of the Yellow Train in the Pyrenees and the second the Etang (inland sea) near our beach house.

After a 2 week break for the recharging of batteries, the eating of good food and the consumption of fine wines, life in the NHS is back. What I mean by this is that I am back and tomorrow the NHS will welcome me to work; something I can obviously hardly wait for. My time away has been put to reasonable use as when not doing the above I have been considering the kinds of great blog posts I might come up with in the near future and you will be glad to hear I do have some reasonable ideas. I intend to start these tomorrow, because tonight I am still hanging by a thread to the whole holiday idea despite the bizarre and surreal day spent today attending the funeral of an uncle in law (if it is possible to have one of those). I intend to kick off today therefore with some thoughts about that and move on tomorrow to some holiday related and hopefully NHS / Work related stuff.

My own family (I mean relatives rather than my husband and son) is generated mainly through my mums side and the numerous brothers and sisters my maternal grandparents had. This means that any family occasion, including funerals tends to be large. They have pretty much without exception been cremated rather than buried. It was strange then today to attend a funeral attended by no more than 13 people, which was a burial. These people were all related in some way (directly or by marriage) to the person who had died, and my first thought and concern was that you could live for 77 years and have no friend or acquaintance left in the world who wanted or could attend your funeral. The family are not well off as such and a burial is not cheap, but I personally wouldn’t like the idea of being stored in the ground either below, or on top of others in a communal grave. My final observation on this matter was that sometimes peoples complex lives, and the fact that their wife has a child from another marriage can cast strange effects on the whole proceedings. Perhaps the talk of getting the home of the person valued, even before they have been placed in their communal grave is a little premature and leads to the wrong kinds of thing being discussed at the wake afterwards. As my husband said, it was extremely unpleasant to hear people discussing property and money when they should have been discussing memories of the brother, step father and uncle who had died. Also perhaps spare a thought for the elderly lady who has lost her husband and the love of her life. So that was how I spent the last day of my 2 week holiday. More tomorrow!

In the eyes of the Conservative politicians it is because they want to fix it. Apparently for the sake of about £20 per week in extra child benefit more people will get married, those marriages will produce children and one parent will stay home to care for the children and then that family will stay together and fix society! Well thats alright then, all problems solved! I have a sneaking suspicion that the problems, where they lie are slightly more significant than that. Poorly parented children may become poor parents who have not themselves perhaps reached their own potential educationally or in terms of the kinds of jobs they do. Will they then get married and then spend the £20 per week extra on healthy food, and activities for the family or will they be making other choices? Is society actually broken?

I live on the edge of a medium sized town. It has its problems, its deprived areas, its teenage pregnancy problem, its crime, its drug problems. But as I walk around areas of town and encounter people going about their business I don’t get the sense of something awful something that is caused by the breakdown of the family, something in essence broken. Things are not perfect, my own life is not perfect but I am both puzzled and concerned by the image such policy promotes. The idea that something broken can be fixed with £20 per week.

Yesterday I attended an event run by our local Children’s Trust. Now this is kind of a virtual organisation. It is a way of bringing together services for children with a common aim of making the lives of all children, whatever their particular needs better, making services better joined up, making communication better. We heard about organisations running schemes for disadvantaged children and teenagers, to get them off of the streets and doing activities they enjoy doing. Of projects which help children who have struggled to fit in at school to continue their education and to move on to work or further education. We heard of schemes for young families, parenting, learning how to choose, prepare and cook food, toy libraries for children with special needs. The work to fix society if it is broken is already going on out there. People are working hard to make it happen for themselves and each other. Money helps, but money alone is not the answer!

Many of us that are parents would like to believe that our children have no need of sex education until, well until they are at least 18 and that is despite the knowledge we might have of our own teenage years. It is a fact that children are exposed to more information from many sources at an earlier age about what used to be known as ‘the facts of life’. It is also a fact that there are actually more facts of life to know about than there might have been 30 years ago when I was a teenager. A couple of things have brought this home to me recently, firstly that someone wrote to our local paper to complain that her 13 year old daughter had received education about HIV / AIDS without being specifically asked permission. This had resulted in the decision to remove the child from that school. The second event was closer to home, and involves my sister in law discovering that my niece has had sex with her boyfriend at the age of 14! This young lady has always told her mum that she would not be doing anything like that, but then a boy arrived on the scene and suddenly it had happened.

I don’t necessarily think it is right for such a thing to have happened, and it is certainly illegal (the boy is also underage) but denying such things happen is not going to stop them. Pretending that unprotected sex cannot cause pregnancy or infect someone with HIV or some other infection is naive in the extreme. Of course we need to teach our children to wait to experience sex, but removing them from school does not seem to be the answer.

Sometimes things just go quiet. Life just happens and you find yourself just carrying on, and that is really how it is for me right now. Finishing my masters gave me a renewed enthusiasm fired by a greater feeling of energy for my new job and I got on with things that had been pending but which I had put on the back burner while I finished my dissertation. But generally I do feel extremely weary and that feeling is fueled by the knowledge that I am off on holiday in less than a week.

Yesterday I attended a meeting where a group of people who need to implement a government ‘must do’ spent an hour listing reasons why they wouldn’t be able to do it. Now money is a big factor, and I completely agree that the government is often naive in the extreme when implementing new things. Start up costs are often available, but little thought is given to how it will be sustained. But sometimes people’s negativity just begins to get on my nerves.  It took 55 minutes of moaning, which thankfully was followed by 5 minutes of a suggestion of how doing one part of the equation differently might save enough money to actually pay for it to reach a conclusion. All of this on a Friday afternoon.

People working in management in the NHS have got into the habit of putting up barriers, they are ground down by the financial situation that many have found themselves in. But sometimes I think they ought to sit and listen to themselves and wonder how others might see them. I guess one of my problems is that I tend to try to see the bright side, to look for positive alternatives and often I am in the minority doing that. Maybe this particular change is going to be more expensive than the unit would like, maybe it is going to mean many of them have to work differently, maybe they are all weary from being NHS managers but put yourself in my position or the position of another person from outside and wonder what exactly you are coming across like to others!

This post was difficult, and might not make sense, this is because if I go into specifics about the meeting etc. then I think I will be recognisable, and whats more will be breaching confidentiality.  You  might think that if you don’t work directly with patients that it would be easy to blog about work without breaching confidentiality, but my current job is so specialised that if anything it is getting more, not less difficult!

When I was at school there was no such thing as a school prom, the idea hadn’t yet arrived and anyway as children of the 70s we were more comfortable dancing to the music of Saturday Night Fever at a disco (yes I am showing my age here). Earlier in the year when my son first brought home the letter giving details about the prom he first of all said it wasn’t his scene then swiftly moved on to the thought that he wasn’t a suit type of person and why couldn’t he wear jeans? Since then thankfully (though jeans might have been cheaper) he has thrown himself into the whole prom idea, and here is the result. A pretty handsome lad even if I do say so myself!

The event was held at the conferencing facility of a local stately home, so they had a great setting and luckily for once we had good weather so they were able to enjoy time outside in the grounds. What else he and his friends got up to is not really for me to know, but apparently a great time was had by all. So that is the end of year 11, now we just have to wait for the exam results in August.

Interesting article in the Guardian G2 magazine today, about care homes versus say living on a cruise ship or at a health farm. Michele Hanson was suggesting that the costs are similar, and at least you have plenty to do, plenty of people to get to have fun with and good food on a ship or at a health farm. Of course it is not quite so simple, but it certainly makes you think about the way we treat our elderly doesn’t it?

The whole welfare state / old age debate is currently being discussed over on NHS Blogdoc and for once I have to agree with Dr Crippen. Far too many people seem to think that the state is there to look after our elderly once they are too old to completely manage on their own. I have had first hand experience of this, living and previously working as a District Nurse in a ‘new town’ specifically built for the people bombed out of London. I have met people who have felt that they don’t need to be able to give their own insulin injections on account of the fact a nurse can do it for you and they have paid their ’stamp’; I kid you not!

I have come across elderly people who have ‘given’ their homes to their families and then been moved into one room to live, and I have had to deal with relatives who are forever on the phone complaining but who actually never seem to visit their elderly relatives. On the other hand coping with your infirm parents can be really hard work, both physically and emotionally. Luckily I have not yet had to cope with either my parents or in laws getting to infirm to manage their lives or their bodily functions and it is easy to criticise. But it is a sad fact of live, we cannot assume that the homes they live in are our inheritance until they are actually dead because if they need some form of care that will not be provided by the state. If it was I think the rest of us who continue to pay taxes would quickly find ourselves paying massive amounts to the state. Personally I want to keep at least some of my savings and perhaps plan to spend my retirement sailing around the world misbehaving on a cruise ship!

I had cause to visit one of the smaller London airports on Saturday shortly after the would be suicide bomber drove into the front of Glasgow airport. Not surprising then that there were armed police everywhere and my plan to meet my parents in the drop down / pick up zone was thwarted. Having said that, I would rather be safe, and pay £5.20 for an hours parking than allow terrorism to win. My parents who although only in their late 60’s seem to be unable to keep up with the rules around air travel had their supply of wine confiscated at the French airport as they had failed to recognise that wine is a liquid. I am off on my own holiday next week, and I am beginning to wonder about the whole airport air travel experience. I suspect it won’t be global warming and my carbon footprint that stops me flying but the rules and regulations, the waiting and the uncertainty that will get to me.

My other thought in this whole matter is what would make people who are meant to be caring, who are meant to do no harm become terrorists? At the time of writing, all we know is that at least two doctors are suspects. They have not been charged with anything, much less been to court for a trial. But the whole concept goes against our beliefs about what a doctor would and should do. The war in Iraq is complex, the mess that has been left behind after it is meant to be over is nothing short of terrible. I can understand how some people would want to exact revenge on those of us in the west. But why would a couple of doctors, who a few days ago might have been providing medical care to people be part of this whole set up? I guess I have no answers to all of this, just questions.