Saturday, 7 January 2012

Why the PM is having to order nurses not to let patients starve to death

I don’t know why I get so exercised about nursing standards. I haven’t spent much time in hospital over the years, and I know that most people have pretty decent experiences when dealing with the NHS. I suppose it’s because I grew up in that era where all nurses were considered “angels” who would do their very best to relieve our anxiety when we were at our most vulnerable, by being cheerful, respectful, kind and consoling.

Up to about ten years ago, the NHS was about the one area of the public sector in which I wholeheartedly believed. It had done a pretty good job of looking after me, my family and my friends over the years. (The treatment my mother received when she was dying of cancer was exemplary – the hospice where she stayed for a few weeks struck me as a wonderful example of imaginative, practical compassion: what a superb system.)

Because I developed a fairly serious long-term medical condition in my thirties, I’ve never really been able to afford private medical insurance, so I’ve had to maintain faith in the NHS and the basic decency of the people who work in it. But now I live in terror of having to be admitted to an NHS hospital – superbugs, Third World levels of cleanliness, doctors evidently unable to speak English, and nurses whose treatment of their patients would have ensured them a place on Dr Mengele's team. Isn’t being in hospital bad enough without the staff torturing you? 

Liberals don’t half enjoy banging on about people without medical insurance being turned away to die in the streets by American hospitals. But, given that many old people apparently die in British hospitals of starvation and/or dehydration, having been left to lie in their own filth, and having been treated by nursing staff as an unwanted irrelevance, those attacks on the US system are wearing a bit thin. Motes and beams, after all.

Yesterday’s announcement by the Prime Minister that nurses will from now on be instructed to check patients on an hourly basis and to make sure they’ve been watered and fed, in return for which their paperwork will be reduced by 25% got me wondering just how, in the name of God, we managed to get ourselves into this sorry state. We used to be so proud of our nurses. When did they morph from Florence Nightingale into Irma Grese?

So where did it all go wrong? After all, we’ve known for years that people were living longer and would need to be looked after – so the number of confused oldsters blocking beds can’t have come as a complete surprise. No doubt the flood of immigrants pouring into this country throughout the recent Labour Terror has put a terrible strain on the system. And huge increases in nurses’ pay and treating them as if they were pseudo-doctors has no doubt led them to regard their traditional duties as degrading. After all, they’ve got degrees!

But I think a clue as to the real root problem is to be found in the following chilling statistics: between 2003 and 2007, the amount of money spent on NHS administration rose from £6.2Bn per annum to £12.6Bn. Between 2008 and 2009, the number of NHS nurses rose by 1.9% - the number of managers rose by 11.9%. And all, one suspects, in order to feed the Labour government with statistics to show just how brilliantly the NHS was doing - despite an increasing weight of anecdotal evidence suggesting otherwise.

The one thing administrators love above all else is paperwork. By introducing complex systems that require a massive increase in the number of forms people who used to do real work – like policing or nursing or running companies – have to fill out, the more vital it becomes to increase the number of bureaucrats to supervise the endless paper chase.  Eventually – and inevitably – the bureaucracy which was somehow supposed to make the system more efficient becomes its very raison d’être: this eventually happens in every large organisation. (The institutions of the EU are slightly different – they only exist to fund extremely well-paid employment for thousands of over-educated, left-wing paper-pushers.) When this stage has been reached, the institution in question has essentially become autistic – it’s locked inside its own skull, carrying out meaningless rituals designed to make its members feel safe, speaking a private language, and unable to see itself as others see it: the people who use the organisation's services are no longer its focus.

I’m not sure how, but I’m convinced that if one were to dig deep enough, the malign effects of an arrogant and largely pointless bureaucracy would explain  why the fully-qualified doctor son of a close friend of mine can’t get a proper job in the NHS, despite our taxes having been invested in his training, and despite the fact that the system seems to be stuffed with doctors who can’t speak the lingo. And I'm sure it would explain why so many members of a profession which was once a by-word for compassion now behave with a degree of inhuman callousness that would have shamed the staff of a Ceaucescu-era Romanian mental hospital.

The government needs to announce plans to cut NHS spending by 25%, most of it to be funded by sacking 50% of all administrative staff – do that, and 75% of the paperwork would instantly disappear.

And any nurse who allows one of her patients to die of neglect should be locked in a room for a week without food or drink or access to a toilet, so that they can see what it feels like. After that, toss a dozen administrators into the same room – but don’t bother ever unlocking the door: that should help them realise how ultimately useless paper is.


  1. Can't argue with any of this. An instructive post.

    Since the DHSS started in 1988 there have been, I think, 11 health Secretaries [including such towering figures as Frank Dobson and Patricia Hewitt and, of course, our obligatory Scottish friend]. They seem to be in post for about two years and then move on so none of the politicos ever master their brief. Lansley will be gone by the summer. The sinister Whitehall mafia are firmly in control.

    As they are at the MoD. There are very strong parallels between the two ministries. They have both been bent into assymetrical shape. The MoD continues to gear itself for a Russian attack through the Fulda Gap in spite of fighting desert wars and the NHS has not quite twigged that British Society has moved on from the 50s/60s. Instead of looking after the nation's defences and health they are vast job creation schemes and sources of great profit for the defence industry and pharmaceutical and medical supply industries.

    In fact, they have both fallen into the classic trap of substituting strategy with tactics because of a total lack of political leadership. "Complete buggeration" as Denis Thatcher used to say.


  2. Ditto, SDG - I agree with every word you say!

    Our politcal system has many strengths, but the ability to turn round failing institutions isn't one of them. Because the NHS is run and staffed almost exclusively by left-wingers who like it just the way it is (and I expect any right-wingers would just want to hold on to their jobs - understandably), and because politicians believe - wrongly - that the electorate won't wear any changes to the system, any Health Secretary who wants to improve the system is doomed to failure. Same with the Ministry of Defence, which employs 86,000 civilians - that's one for every two people in uniform. And I bet the vast majority of them vote Labour, and are doing their very best to resist meaningful change while fighting units and weaponry are sacrificed instead.