Episodes of appalling lack of care in the NHS have surfaced in the media over many years and now the report on the Stafford hospital is distressing reading for all and perhaps especially those who have spent a lifetime working in the NHS. The changes that have occurred in my experience since 1947 are enormous, especially in terms of new drugs and new technology. Inevitably this has necessitated structural change so that now an extraordinary dedication to care and expertise can still be found in most intensive care and highly specialised units. All those involved are aware of the extreme importance of attention to detail, but in addition they are dedicated to comforting frightened patients and relatives as part of their vocation and they are recognised as an essential part of the treatment that may determine the recovery of a patient in grave danger. These units still have an hierarchical system of discipline and attention to detail.
In the Armed Services and civilian transport by road, train and the safe sailing of a ship, the participants are acutely aware that their focussed obedience to superiors and the rules are essential for the best chance of safety of their own lives and those under their care. In a passenger aircraft the crew in attendance would endanger everyone on board if the hierarchical discipline was abandoned. Unfortunately in the NHS the “Cinderella” wards, especially those taking care of the elderly, have in many cases lost the traditional caring culture and often discipline would appear to have been abandoned completely. Some so-called carers regard the physically incapacitated and demented as scarcely human and in general a nuisance to be dealt with minimal human compassion and kindness, in some cases withholding food, drink and clean bedclothes. The patients are regarded as a disposable commodity and therefore the grave responsibility that is natural in the military and land sea and air transport is not a natural self-preserving instinct. But with a little reflection would show that this is incorrect, as the carers in turn will become old and they should dread to be treated with the same lack of respect. A complete change in culture is necessary but the almost politically incorrect word ‘discipline’ should be part of the process of reform so that those recruited to work will have a pride in their vocation. Of course the work conditions and pay must be commensurate with the responsibilities. The restoration of individuals with the status of matron and ward sister, to whom respect is deserved and automatic, would help to recover the traditional culture of caring throughout the health service.
Rapid Response:
Re: Who knew what, and when, at Mid Staffs?
Letter to the Editor
Episodes of appalling lack of care in the NHS have surfaced in the media over many years and now the report on the Stafford hospital is distressing reading for all and perhaps especially those who have spent a lifetime working in the NHS. The changes that have occurred in my experience since 1947 are enormous, especially in terms of new drugs and new technology. Inevitably this has necessitated structural change so that now an extraordinary dedication to care and expertise can still be found in most intensive care and highly specialised units. All those involved are aware of the extreme importance of attention to detail, but in addition they are dedicated to comforting frightened patients and relatives as part of their vocation and they are recognised as an essential part of the treatment that may determine the recovery of a patient in grave danger. These units still have an hierarchical system of discipline and attention to detail.
In the Armed Services and civilian transport by road, train and the safe sailing of a ship, the participants are acutely aware that their focussed obedience to superiors and the rules are essential for the best chance of safety of their own lives and those under their care. In a passenger aircraft the crew in attendance would endanger everyone on board if the hierarchical discipline was abandoned. Unfortunately in the NHS the “Cinderella” wards, especially those taking care of the elderly, have in many cases lost the traditional caring culture and often discipline would appear to have been abandoned completely. Some so-called carers regard the physically incapacitated and demented as scarcely human and in general a nuisance to be dealt with minimal human compassion and kindness, in some cases withholding food, drink and clean bedclothes. The patients are regarded as a disposable commodity and therefore the grave responsibility that is natural in the military and land sea and air transport is not a natural self-preserving instinct. But with a little reflection would show that this is incorrect, as the carers in turn will become old and they should dread to be treated with the same lack of respect. A complete change in culture is necessary but the almost politically incorrect word ‘discipline’ should be part of the process of reform so that those recruited to work will have a pride in their vocation. Of course the work conditions and pay must be commensurate with the responsibilities. The restoration of individuals with the status of matron and ward sister, to whom respect is deserved and automatic, would help to recover the traditional culture of caring throughout the health service.
Sir Roy Calne, FRS.
Competing interests: No competing interests