How We Treat the Sick

Citation

Weeks, S. (2012), "How We Treat the Sick", Working with Older People, Vol. 16 No. 4, pp. 190-190. https://doi.org/10.1108/13663661211286729

Readers will welcome this paperback's subtitle – “Neglect and Abuse in Our Health Services”, which offers a candid pointer towards the contents. Long‐designated as a political hot‐potato, the NHS is now raising more concerns than ever before. It is clear that the NHS is under increasing pressures to meet external demands. However, reading about systemic failure is less heart‐breaking than actually witnessing it first‐hand.

Tellingly, Mandelstam chose to dedicate his book to a hospital which provided excellent care, which was achieved:

“without outcomes, targets, indicators, priorities, excessive gathering of statistics, unceasing structural change – in fact, without all these hallmarks of the modern health service”.

This dedication concludes with a salient point that for years that establishment was “continually threatened by bureaucrats and accountants”.

The 26 chapters cover a range of issues pertinent to this journals readership, encompassing topics such as diet, activities of daily living, human rights and negligence. Chapter 12 addresses the contentious subject of older people as “the Unwanted”. Those 21 pages make grim reading, but also prove worthy of concentrated study, as scenarios are unpicked, and some parallels are made with nineteenth century workhouses – “at least Oliver Twist was able to eat some gruel and then ask for more … ” (emphasis in italics added by author) (p. 176).

Something is not right with the care as prescribed by management within the NHS: for an organisation that prides itself on inner‐hierarchies, where those who are identified as leaders are promoted through the ranks, the end results do not necessarily reflect well on that system. Bullying within the NHS is becoming more widely documented, and this publication identifies the huge anomaly where a caring profession is affected by a bullying culture (p. 237).

Other negative cultures exist within the NHS, and can have a further detrimental effect for those faced with a hospital admission. Having negative expectations of the level of anticipated care may ultimately hinder recovery. By unpicking the factors involved in this unseemly mess, conclusions are reached indicating a systemic blight where a lack of accountability allows corner‐cutting in care and an erosion of compassion, dignity and basic humanity.

Recently David Cameron expressed his hope that extra funding towards dementia research will make the UK a world leader in the field – sadly, if this book is indicative of present day NHS failings, management might need to be addressing more basic concerns.

This review should perhaps conclude with a declaration of interest: having trained and worked in the NHS for 21 years makes me more supportive of former colleagues than ever before: the system, Mandelstam argues, is at fault, not any individuals. Collective responsibility should be accepted collectively. Having visited my mother over the last 41 days of her life, and witnessed her being moved between wards and bays and beds, inevitably – some might charitably say – personal items were lost. Unfortunately, those losses (of dentures, hearing aid and walking stick) detrimentally impaired her digestion, hearing and mobility, and ultimately added to her distress.