Health

Why can't the NHS get basic care right?

  • 22 November 2012
  • From the section Health
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Reading the 53-page dossier on poor patient care put together by the Patients Association, you cannot help but be moved by the harrowing stories.

There is the case of a man placed in a dementia-friendly ward with staff, who were given strict instructions to check on him because he had a history of going walkabout, but was able to escape and subsequently drowned in a nearby river.

There are tales of patients left in soiled sheets, their dignity stripped from them, and others being left for hours in pain, their cries for help ignored.

It is not the first time we have heard such accounts - and probably not the last.

Of course, in an organisation the size of the NHS - it sees 1m people every 36 hours - there will always be cases where standards have slipped.

But what is clear from this report - and others that have been published previously - is that it is still happening far too often.

Organisations, including professional bodies and the government, have been quick to call on staff within the NHS to blow the whistle on poor practice.

'Suffering'

But it begs the question: why is it allowed to happen in the first place?

Some have argued the move to degree-level training for nurses - from next year all nurses entering training will have to complete a three-year course - has meant they have lost some of the ability to empathise and show compassion.

But this theory was rejected by the Willis Commission in its comprehensive report a few weeks ago.

Others have said resources are being stretched too thinly. But how much time does it take to place a glass of water within reach?

I recently asked a senior nurse working in a large hospital what she thought had gone wrong.

Her answer was quite clear. She told me: "We have had to become immune, desensitised, to cope with what we do. Every day we see suffering and we can't always help.

"That does not explain or excuse some of the clear examples of neglect we have heard about. But it has created a culture that means these things can happen."

She went on to say that at the heart of the problem was the fact that there were many people in hospital that should not be there.

It is an often-quoted fact that two-thirds of emergency admissions are among people with long-term conditions, which covers everything from heart disease to dementia.

With better care and support in the community, many of these could be avoided.

But that requires a re-think in how the NHS - and the social care provided by councils - is organised.

Mike Farrar, the chief executive of the NHS Confederation, has perhaps put it most succinctly in the talks he has given on the topic.

He describes it as a refocusing of what the health service is there for, saying the NHS of the future "will need to move from a medicinal service with a care dimension to a care service with a medicinal dimension".