The politics column - Martin Bright
The public will judge this government not by how bold it was in challenging left-liberal shibboleths
Forget lavish loans and billionaires: this government will, in the end, be judged in more everyday terms. A new report by three healthcare watchdogs, on the treatment of older people, reflects a malaise that will register with voters, if not with the political classes.
After nearly nine years of Labour control of the National Health Service, the report, Living Well in Later Life - by the Healthcare Commission, the Audit Commission and the Commission for Social Care Inspection - concluded that older patients were treated as second-class citizens within the NHS because of "deep-rooted cultural attitudes to ageing", and that institutions charged with caring for the elderly were "patronising and thoughtless".
The continuing indignity of mixed-sex wards, food removed after staff leave trays out of hungry patients' reach, wards smelling of urine from unemptied bottles, people left on trolleys: these are all horribly familiar to me. In September 1997 I helped launch a campaign to improve the treatment of older people in hospital. I complacently assumed that things might have improved as a result. Help the Aged's Dignity on the Ward campaign began with an article I wrote about the near-torture that my 88-year-old grandmother, Irene Emmings, endured at Bath's Royal United Hospital after having a stroke.
Waiting over a long weekend for a speech therapist to come on duty to assess whether she could swallow, Irene became dehydrated and malnourished without food or drink. Staff at the hospital were so demoralised they had forgotten the basics of care; my elderly relative was left for hours in soiled sheets and deprived of drugs for her diabetes and glaucoma, because no one had bothered to look at her medical history.
She fought against her mistreatment throughout her ordeal. Paralysed down her right side, she continued writing secret notes with her left, which she hid from staff and passed to relatives when they visited: "The telephone rings and they don't answer," she wrote and "please help me".
I wrote that such neglect was unacceptable under a Labour government. Ministers agreed. Frank Dobson, the then health secretary, reacted swiftly, saying he owed a debt of gratitude to the wartime generation which had voted for and financed the NHS. He commissioned an investigation by the Health Advisory Service, which concluded that, even though there were some excellent examples of well-run, properly resourced geriatric wards, there were also too many instances of neglect.
The report was published in November 1998. In the introduction Dobson wrote: "No older person should go without the fundamental care that contributes to recovery - to be helped to eat and drink; to lie in a clean, dry bed; and to be treated with respect." I had hoped that the Dignity on the Ward campaign would be a lasting legacy to the fighting spirit of my grandmother, that others would not suffer as she had done.
Eight years on, it is just another reminder of how little has changed. I wrote that the treatment of my grandmother shook my faith in the Labour government, but this was premature. Although Gordon Brown's commitment to matching Tory spending plans for two years meant the health secretary's options were limited, it was, I insisted, unfair to blame Labour for the state of Britain's hospitals. It isn't now. Dobson's successors, Alan Milburn, John Reid and Patricia Hewitt, have been zealous proponents of the reforms driven by Blairite market fundamentalism and they must each, in their way, bear responsibility for the failure to deliver for the older people who make up the vast bulk of patients in the NHS.
Dobson has now lent his voice to the Keep Our NHS Public campaign against the reforms. He has suggested ministers should suspend further change and concentrate on improving patient care.
A separate report into the future of social care by the former NatWest chief executive Derek Wanless found "very serious shortcomings" in provision and funding. Wanless has estimated that the £10bn spent on the elderly will need to more than double, to £24bn, to cope with the ageing population. This will have serious implications. The banker's solution is to scrap means testing and recognise that, while the government will have to increase its contribution to care for the elderly, individuals will have to match that commitment by sharing the costs of their own care and that of their relatives.
Perhaps this is true. It may also be the case that the government's health reforms are necessary to inject business-style dynamism into moribund structures within the NHS. The Treasury will certainly argue that the private finance initiative is the only way to provide the modern hospitals the system needs to function in the 21st century.
In the end, the creation of pseudo-markets in public health is a new Labour sideshow. The public will judge this government not by how bold it was in challenging left-liberal shibboleths, but by whether its grandmothers were treated with decency and respect when in hospital.