They're just dead bodies

Aneurin Bevan famously remarked that he designed the National Health Service so that, when a bedpan was dropped in a hospital corridor, the sound would echo through Whitehall. Now, through Whitehall, Westminster and Fleet Street, we hear the squeak of a faulty door hinge - this, apparently, being responsible for Bedford Hospital's decision to stop using its temporary mortuary and to dump dead bodies in the chapel instead, as revealed in a newspaper photograph last weekend. Press and politicians duly worked themselves into another of their fits of contrived outrage. "Third world conditions" in our hospitals had been exposed. It was "a national scandal", insisted Dr Liam Fox, the Conservative health spokesman. "Shockwaves" had been sent through Bedfordshire, announced one MP; relatives would need "counselling", warned another. The hospital's chief executive resigned, to near-universal acclaim. ("Modern NHS managers," droned the Times, "like many others in positions of authority, are not known for their enthusiasm to fall on their swords when they make mistakes" - thus prompting us to rack our memories for the last time that an editor of the Times, or any other newspaper, resigned over "mistakes".) The Health Secretary, Alan Milburn, reassured MPs that dead bodies had not escaped new Labour control and direction: "guidelines" had been issued last May, sent out again in November and were now going out again. Hospital trusts would be expected "to adhere precisely to the letter of that guidance", he said, thus betraying new Labour's idiosyncratic interpretation of what guidance is supposed to be.

Our attitudes to dead bodies are peculiar. To be thrown into a mass paupers' grave was felt to be shameful, degrading. But to whom exactly? A strictly rational person would argue that what happens to the body is of no consequence after life has left it. You are as dead in a gilded casket as you are in an unmarked grave. Yet we all worry about our posthumous reputations, about how we shall be remembered, about how many people will attend our funeral. We accept the mortality of our bodies, but crave at least a smidgen of immortality in the minds of those left behind. But do we give any thought to the precise arrangements that a busy hospital adopts between death and funeral? Would the Sunday Times, in the Good Hospital Guide that it published last weekend, have thought of including procedures for the disposal of bodies in the information offered to patients who want the best?

If there was indignity in the death of 77-year-old Basil Riches, whose relatives claim to have recognised him from the news-papers, it lay in the taking and publication of the photograph. That was the real insult to Mr Riches, who will now be remembered as a corpse with his feet exposed. The press, in all its preening self-righteousness, in its anxiety to hunt down scapegoats, guilty men and defective parts, would never pause to think that it, too, had made "mistakes". Thus politicians and press collude to distort and infantilise public debate. Some remarks in the Commons debate on Tuesday went beyond parody. Dr Fox was apparently outraged that the government gave a higher priority to bringing down waiting lists than to "improving pathology facilities". Peter Brand, the MP for the Isle of Wight, seemed to criticise (perhaps some nuance is lost in the Hansard report) an order of priorities that puts investment in children's wards before investment in mortuaries.

The brutal truth is that we make quite preposterous demands of the NHS. It is a collectivised public service, free at the point of use, and to expect from it high standards of individual attention or customer choice or fastidiousness about dead bodies is absurd, just as it was absurd to expect gourmet meals from a Soviet restaurant. Once, 77-year-olds usually died at home; now, most people would feel uncomfortable with a dead body in their front room, and expect hospitals to deal with it. They then demand a bespoke service, which treats the body of their loved one with the special respect that they themselves would give, but they do not expect to pay higher taxes for it. Newspapers rail about "third world hospitals", but criticise Labour for the few taxes it has dared to raise. Ministers throw up their hands in horror while they discuss another pledge not to raise income tax. The Bedford case may, as Mr Milburn insists, have nothing to do with resources. But it has everything to do with our inflated expectations of the NHS and the childish lack of proportion that characterises our public debate.

This article first appeared in Iraq: the great cover-up

2001-01-22