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September 27, 2007

NHS fails the elderly

The Telegraph reports a study by the Healthcare Commission today showing a shocking series of failures in the NHS' treatment of older people:

"• Only five hospital trusts out of 23 met all of its standards on dignity in care

• 23 per cent of elderly patients said they had to share a room or bay with someone of the opposite sex

• Only 16 per cent said they had all the help they needed to eat

• 25 per cent of recorded patient safety incidents involving food and drink either caused patients harm or put them at risk

• 94 per cent of elderly patients claimed they were never asked their views of their care while in hospital."

The government response is limited to lame assurances that it takes the issue seriously and will make it a priority.  While there are broader questions that we should be asking as a society about how vulnerable older people are looked after that isn't the problem here.  This is another case of institutional carelessness in the NHS.

A system focussed on responding to political priorities instead of answering to patients is almost pathologically unable to think of the little things.  The NHS is too large for anyone, particularly inexperienced politicians, to really understand.  To get around that problem politicians use simple statistics.  These can't capture intangible basics like patient dignity and care.

Institutional carelessness leads to 84% of staff failing to wash their hands even after contact with an MRSA patient and 99 out of 394 NHS trusts failing to take basic steps to tackle infections like decontaminating reusable medical equipment.  This failure to ensure cleanliness kills thousands each year.  Now we learn that it leads to negligence, starving patients who need help to eat, and to abuse, the Healthcare Commission found patients are being left in soiled clothes or "forced to use lavatories or bedpans in front of other people".

It is becoming clearer and clearer that the NHS is institutionally careless to the point of real brutality.  Reform which puts real power in the hands of patients, rather than more political targets as promised by Brown and his Ministers at the Labour party conference should be an absolute priority.

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Comments

An elderly friend of mine now sadly deceased was suffering from a blood infection and in a delirious state he fell from a hospital bed due to the lack of side rails. The nurses tried to play it down but eventually the doctor saw the extensive bruising. When asked why he didn't report the incident he said he was afraid it would anger the nurses concerned. You may possibly scoff at this, but many elderly people feel intimidated by some hospital staff.

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