Helen Martin: Sickness cutting to heart of NHS

Hard to see how that can happen when one in ten patients is left without help to feed themselves; one in 12 has been refused help to wash or dress; and the same number cannot get to the toilet because there is no-one to take them.

When you get right back to basics, washing may be optional – providing wounds are clean. But hunger, possible malnutrition, the risk of urine infections and soiled beds don’t sound like a recipe for recovery.

The statistics come from the Scottish Government’s annual Scottish Inpatient Patient Experience Survey – and whoever thought up that snappy title should be first to walk the plank. They have, perhaps with good reason, been linked to the fact that three nursing jobs in our hospitals are going every day.

Recession and staff shortages go hand-in-hand, a marriage made in hell. We have little choice but to accept our own jobs hang by a thread and just as individuals are having to manage on less, so are businesses.

But the NHS is not a business,  however hard some politicians have tried to make it so. Its current decline probably owes a great deal to too many disparate managers setting conflicting targets and throwing their non- medical weight around, so it’s good news that their number is to be cut by 25 per cent within the next three years.

The Government holds its hand up to a policy of directing more nurses and midwives to work in the community – perhaps too many, robbing Peter to pay Paul.

Whatever the cause of neglect – for that is what it is – of patients, it ultimately comes down to a lack of man or woman power on the wards, and not necessarily qualified nurses, many of whom nowadays are so highly qualified to degree level that their job is no longer about helping someone to the toilet, wiping bottoms or spooning food.

We need care assistants and auxiliary nurses to be 21st century “angels”, the ones who really care hands-on for patients, their comfort and general wellbeing, rather than attending to what are often referred to as their “clinical needs” (although one in 20 patients also complained of being left waiting for pain relief and medication).

Last week an elderly man  complained that his 50-year-old son had been left cold and shivering beneath blood-stained sheets because there were no blankets available  and claimed a man in the next bed with terminal cancer was in the same sorry state. This was in a new  £174 million wing of the Victoria  Hospital in Kirkcaldy. He was told  bed linen was being “rationed” and cleaners wouldn’t tidy up the filthy floor for fear they would catch an infection.

We all have stories, some going back years. A few years ago a friend of mine was admitted to the ERI for a knee operation. He was also on dialysis waiting for a kidney transplant so he was alarmed to discover there was no dialysis machine for him. When one was eventually found, it was dodgy and there was no-one available to set it up and operate it when he needed it – because he was on an orthopaedic ward.

The elderly are most at risk, like my late mother-in-law who was in for an emergency hip pinning in the ERI and was blue with cold. I asked for a blanket to be told there were none. Witheringly, I asked for a dry towel, a coat, anything to wrap round her until we could bring in something more  substantial.

What most of us cannot understand is how a nurse, any nurse, can see someone shivering, unable to eat, or desperately in need of the toilet  and do nothing. Surely responding  to that need is a simple human  compulsion no matter how busy  they are?

But Scottish Tory health spokesman Jackson Carlaw offers a clue. Of the patients’ survey, he said: “There is no excuse for patients not to be helped with food or assisted to the toilet. Fortunately the vast majority of people are satisfied with the important thing – the quality of clinical treatment they receive.”

It’s not far from that old chestnut: “The operation was a success, but the patient died”.

If that attitude, that clinical treatment is “the important thing”, is reflected throughout the NHS in  Scotland, it explains why things are going so badly wrong on the wards and why many doctors will say that unless a patient needs life-saving treatment or surgery, the healthiest option is to keep them out of hospital altogether. Even being there is a health risk.

Feeding, toileting, providing  comfort and warmth are every bit as important as clinical care, indeed  they are crucial elements of it. They are not separate services which  hospitals might or might not provide as they choose. Delivering them  inevitably means employing more people at a cost. But without  them, regardless of clinical or surgical advances and perceived “excellence”, Scotland’s NHS deserves no more than a third-world rating.