28th October, Monday to 2nd November, Saturday 2013
The first week of my trip, I stayed in London. Most of the visits to specialists and organizations related to our research on home nursing were in Hatfield, a beautiful country area 30 minutes north from London by train, but had also good times in London in the evenings.
One significant characteristics of UK’s health system is that medical service, provided by NHS basically for free and social service, provided mainly by local authority are clearly divided. Home care, especially for elderly care is a point where both sector come across and contact the same person, an individual who live in their own home and community, and have various needs based on their daily life, which includes both medical services and domestic/personal services (bathing, cooking, washing etc.). Since our main focus was a nursing service, we visited related professionals and organizations, but at the same time, I had always paid attentions to other sectors and comprehensive systems, though it was too complicated. We met faculties of the University of Hertfordshire, and NHS hospitals/community services, the Royal College of Nursing (trade union for nurses), and the Queen’s Nursing Institute, a organization for support and advocate of home nursing. As I mentioned, there is a fragmentation of the overall health system in UK, and varieties across local districts, so even for specialists or organizations in UK, it was difficult to gain figures or materials of all the necessary information such as workforce, service delivery. Thus, it was important to know what is missing pieces and how to infer that. …Still my brain is storming after lots of visits and additional documents, I try to grasp the overall picture and build our final report to client.
Anyway, despite fragmentation of the system, and huge decrease in budgets and workforce, especially for district nurse, a key player of home care in community, I was impressed with lots of efforts by practitioners and organizations. A district nurse, with whom I visited several homes of local residents, who had various diseases and needs, showed me how she communicated with each of them, and also their relatives and other actors such as social workers. Her caseloads looked very large, and it sounded partly because of recently decrease in human resources (but still she worked so hard every day every week). The Queen’s Nursing Institute impressed me with how they made research by themselves such as surveys to practitioners, and advocate to policy makers to approach problems in the field. The quality of their reports and pamphlets were so high, and that told me their professionalism to fight to realize their goal, not just criticizing the government.
In the evening, though half of time I fell down asleep after back to the hotel, I could met my friends living and studying in UK. It was so happy for me, cos they showed me parts of their daily life here, what they see, what they love, how they feel and do, while walking around the town with them. Not only here, I always feel myself a foreigner, or drifter. I never imagine, so far now, to settle in one place for long time, say 5, 10, or 20 years. So wherever and whenever I visit some town, I look and walk around the town with an eye of observer, never a inhabitant. My thoughts and feelings tend to float, and that’s why I respect each of you, who settle in a community, keep your own rhythm and tempo of your life and work, and warmly welcome me, with happy smiles telling me what you love in our town. Though short stay every time, I never forget your kindness. Thanks a lot, and hope to see you someday somewhere again.