All you need is....follow through!

Here in New Zealand we have our General Election tomorrow.
There are a lot of issues on the table for us all to consider and, of course, a lot of promises have been made by politicians.

But one thing which, it strikes me as having been a problem here for a very long time, is nowhere to be seen.
It stands at the heart of so many of the issues affecting the country, the systems, us all.
And that is - follow through.

There largely seems to be none at all and where it does chance to happen it's usually due to other factors forcing it to occur.

On a nationwide scale - it doesn't matter what side of the argument you are on with regard to National Standards (a new assessment tool here). The major, underpinning flaw is they funded the implementation so finally we (as parents) have a clearer picture of our children's achievement but not any remedial help for those identified as failing.
Follow through people??


They introduced a 'developmental' check for 4 and a bit year olds to try and identify issues before they started school. But the vast majority of 'assessors' are simply Plunket nurses picking up an extra string to their bow but, in my and anecdotal experience, many have very little knowledge on which to base their assessments eg the Plunket nurse who told me - and wrote in W's book - that he was meeting all milestones even though she also wrote down he was getting Early Intervention help at the time. He'd qualified for OT and physio help because he wasn't meeting milestones!
This system has been put into place as a crude screening tool and then concerns are referred on to experts - but the experts are under-funded anyway and thanks to the surge in possible referrals the wait is now around 18 months in our town. Since that'd take a kid to nearly 6 years old the whole 'before school' thing sort of gets lost...      Where's the follow through?

We have a horrible record for child abuse in this country. I'm not sure of the current stats but we'd have over 100 kids die each year due to child abuse.
There was a case recently where our Child Protection people knew of issues with a family and were actually trying to remove a child from the family's 'care'. However, somewhere along the way they 'lost' the family and couldn't find the kid. They couldn't find it, until it turned up in a hospital with brain injuries and later died.
Where's the follow through on that?

Some people will know my vehement view that if we are going to have good neonatal care in this country then we also have to have extra funding for Early Intervention, special education, extra health needs and so on. If we are going to spend the money on the babies then we have to follow through and spend the money on the children they grow into. Hopefully if we spend the money on the children they grow into then we won't need to follow through and spend so much money on the adults he children grow into.
This is particularly so for those moderately and mildly premature children who, with a smaller, less intenvsive or at least less prolonged hand can streak on past or round their roadblocks. These are the kids where there is never a debate about giving them the NICU care in the first place and so they, and their parents, always have to carry the can.

We had a discussion with the kids' surgeon about N and how his eating and formula volumes are a large part of what's holding him back from school. One of the things that was thrown about was that it's unethical to do something for the child just because another system won't be flexible enough for him.
Actually, I feel what's unethical is the fact that so much money was spent keeping his brain in a good state in the NICU, supporting him as a baby, keeping him alive when he wound up in the ICU at 6 months old, giving him some Early Intervention when he needed it and now we run into roadblocks trying to get him to school and a suitable education for that brain to use, grow, develop and actually do something with!
Again - follow through?

And on a much smaller scale - T was getting SLT when he was littler. Due to the vagaries of the system he had to have a hearing test, then go on a waiting list to be assessed to see if he'd qualify for SLT and if so then join the next waiting list to actually get therapy. So I duly did the hearing test - quite a mission it was too! Then I got a letter saying we hadn't shown up for the appointment! Since we'd been there for over an hour and seen two audiologists in the end I wrote a strongly worded letter to the hospital and asked for a copy of the results to be sent to me as well as the GP. If  I didn't have the report when the SLT came then they wouldn't do the initial assessment. So I got the report just in the nick of time for T's assessment which I refused to miss because the hospital couldn't organise itself as we'd waited over 6 months to get to that point.
T qualified and 3 months later started therapy. The therapist left but did a good handover to the next one. She was often sick and then disappeared. We later got a letter saying she'd quit and as T had had over 6 months of therapy he would go to the bottom of the waiting list again. We rang and complained that actually he'd been on the books for 6 months but had only had about 6 sessions due to illnesses/cancelled appointments and had already been nearly 2 months without therapy and we didn't want him to go to the bottom of the list again. They checked their records and confirmed what we'd said and as soon as they appointed someone T re-started therapy.

But again it's the lack of follow through. It shouldn't have been up to the parent to keep records, keep on top of things and events and appointments. They have records too and they should have checked before sending out letter dumping kids.

Things are fragmented. I'm sure they are in every system really.
But follow through seems to be hugely lacking here - and would make the systems work so much better with very little extra effort. Those who are employed to keep track of the people ought to do it not just cross their fingers and hope for the best. The funding needs to be there for the systems to actually work - not just put half a process in and hope.

What this country needs - is follow through!