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15 February 2011

Why are we so sentimental about the National Health Service?

It is a paradox to save the life of a patient and then give that person shoddy aftercare.

By Olly Grender

Why on earth are we so sentimental about the NHS? How does a Twitter craze like “I love the NHS” become so prolific, when the reality for many remains the experiences described in the Health Ombudsman’s report today?

How did my late father-in-law – a kind man who never spoke an angry word to his children all his life and who revered his GPs – reach a point of total fury with the care in a hospital ward while in recovery from a serious condition, to the point where he made us promise to him that he would never go back? It is a paradox to save the life of a patient and then give that person shoddy aftercare.

There is a critical problem of attitude from some within the system. A friend recently asked a nurse to “please explain to me why you are being so rude to that patient”. It happens at the most junior admin level (“I wasn’t told to call you about that letter”). Only when the consultant sweeps in and apologises are you so slavishly grateful that your fury subsides.

When I worked, a long time ago, as a temporary medical secretary at a hospital, people thought I was an oddity because I worked late to clear all the correspondence. I hadn’t become institutionalised, and thought that the patients might just as easily be my mum or my grandmother. But what switch is it that flicks for people working there, so that their patients become case studies and not human beings?

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When the Tories said they would ring-fence expenditure on the NHS, I thought they were crazy. I feared it was a signal that the NHS would remain separate from reforms. Don’t get me wrong – the Lansley reforms are a massive gamble, and they worry me and almost every Lib Dem. There are already rumours about a rebellion at the forthcoming spring conference. This is in contrast to one Lib Dem cabinet member I spoke to recently, who believes that the health reforms will be the success story of this parliament.

I also fundamentally believe that the issue within the NHS is one of attitude rather than structure, and therefore don’t entirely believe that restructuring the service is the answer.

Yes, there are thousands of exceptions and individual moments of care and kindness. But the monolithic institutional attitude remains.

The NHS has much to commend it, but it is not helped by people ignoring the areas where it does have a cultural and attitudinal problem. No other reforming organisation would be treated in this way.