Community care is struggling, a hundred factors winding into each other like weeds in an overgrown garden.
Where do you start?
No-one would argue against the need for rationalisation. There’s a great deal of overlap between departments, which is a waste of resource and confusing as hell. A single point of contact for community referrals is a good idea. The work can be sensibly triaged, assigned, case-managed. So long as there’s adequate administrative support, and enough clinical staff in the field, it can only be an improvement. But at the moment the whole thing is shaking out more like a managerial putsch disguised as an initiative. Staff are leaving in distressing numbers; nurses and carers and managers with years of experience and local knowledge. The garden needs attention, sure; lately it feels as if the gardener is so fixated on The Plan everything’s getting ripped up and thrown on the bonfire.
Out in the community, though, the air’s a lot clearer. Metaphorically, at least.
There’s a mouldy loaf on Rosa’s kitchen table, subsiding organically into the general muddle of biscuit wrappers, unopened letters, wildly scribbled notes, remote controls, random junk; the table a model for the rest of the house, of course. We’re picking our way through it all to see if Rosa’s actually there. We hardly need to. It’s odd how a house so filled with junk can feel so empty. Despite all the cuddly toys in yellowing cellophane, bookcases and shelving cluttered up with years of bric-a-brac, little walkways through all the junk in each room like rabbit runs in a field of grass, there’s a distinct feeling of absence.
‘Maybe she’s in the garden?’
‘I don’t think so. The door’s bolted from the inside.’
‘Let’s check anyway, in case she went round the back.’
She’s not there either. Instead there’s a large tortoise, walking in that awkward, drag-stepping way they have, like the whole shell thing was maybe not such a great idea after all. But it’s making progress, from its little lean-to under the lilac tree to the dense vegetation on the other side.
The neighbour comes out and talks to us over the fence. Apparently Rosa went in to hospital by ambulance sometime this morning. A good thing too, he says. We’ve been trying for years to get her some help but she just keeps turning it down.
‘Are you okay to look after the tortoise?’
‘Hank? Sure! Hank’s no bother.’
We all watch him. And whether it’s because he senses the attention, or whether it’s because he’s realised he’s left his wallet back in the hut, he stops, cranes his head round, and stares. It seems to last a long time, but eventually, with an odd, gacky little snap of his beak, he looks forward again, and after gathering himself, sets off on his long, slow progress across the garden.