The ongoing NHS scandal

Published in The Spectator (October 13th, 2011)

Shock! Horror! Another report reveals the shameful care given to the elderly in British hospitals. People in the twilight of their life reduced to begging for food and rattling the bars of their beds in a desperate attempt to get the attention of medical staff paid to care for them. The findings came in reports of random inspections by the Care Quality Commission watchdog that found concerns in 55 of the 100 hospitals visited, with 20 of them — one in five — breaking the law in its levels of neglect. They found patients starved of food, denied water, spoken to rudely or simply ignored.

It is sickening stuff. But what is so disgusting, so shameful, is that this is just the latest in a series of reports into the way our sacred National Health Service treats elderly and disabled patients. The Patients Association has heroically drawn attention to scores of similar cases of horrific neglect. And it is only three years since the discovery that hundreds of people died in the most squalid and obscene circumstances in the mid-Staffordshire hospital scandal. Meanwhile, two of the people overseeing the hospitals involved have been promoted to the two top jobs in the health service.

Yet still the vast majority of people in Britain sanctify the National Health Service. As the parent of a child with profound disabilities, the scales fell from my eyes after seeing too many blunders and too much insensitivity to the needs of vulnerable patients. Now I watch politicians bicker about minor modifications to the system and, at the slightest opposition, bow to the demands of the producers rather than placing themselves totally on the side of patients. They should recognise that our needs sometimes differ from the demands of doctors and nurses determined to always defend their comfortable status quo.

The simple truth is the NHS is an outdated institution. As the former NHS chief executive Nigel Crisp has said, the system is designed for the past century when it fought infectious diseases, industrial injuries and infant mortality. It is built around big hospitals filled with platoons of highly-trained professionals and all the latest hi-tech equipment. Meanwhile, our needs have changed, with an ageing society leading to more long-term conditions such as cancer, dementia, depression and diabetes. And there are growing numbers of people with disabilities, partly thanks to medical advances.

We urgently need four major reforms. First, to break the stranglehold of consultants who restrict the number of entrants to their hallowed and well-paid circle, thereby producing bottlenecks in hospitals. Second, to re-examine the relentless focus on graduate nurses. Third, to stop being so squeamish about competition, which is an essential motor of change as shown so uncontroversially in Europe. And, finally, to remould the health service to cope with the long-term needs of people with highly-complex conditions, often requiring a multi-agency response and based in the home and community as much as in hospitals. This leads to the painful conclusion that some hospitals must close.

Sadly, none of this will happen while politicians pander to the professionals and the public remains in thrall to the myth of the NHS. Costs will continue to rise until the whole antiquated edifice comes crashing down. In the meantime, more elderly people will end their days begging for a drink from medical staff who don’t give a damn about their needs.

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