« October 2006 | Home | December 2006 »
Filth and shame in an NHS hospital
Twenty-four hours to save the NHS! I wonder how often that promise comes back to haunt Tony Blair 10 years later. Week after week reliable reports and the government’s own figures tell a disgraceful story of incompetence, debt, misery and filth in the National Health Service. That story is supported, week after week, by heart-rending personal accounts of horrors on the wards.
The broken new Labour promise that caught most public attention last week was the failure to abolish mixed-sex wards. Janet Street-Porter, the ferocious media personality, wrote about the misery of her sister when dying of cancer in a mixed-sex NHS ward. Plenty of other people have tried to draw attention to this disgrace and Baroness Knight, the Conservative peer, has been campaigning about it for years but — such is the spirit of the times — it takes a loud-mouth celebrity to get public attention.
The same thing happened when Lord Winston made a fuss about the dreadful treatment that his elderly mother received in hospital. Only then did the government stop denying that there was anything wrong.
Street-Porter published extracts last week of the diary of Patricia Balsom, her dying sister. They were horrifying. Among the miseries she endured was lying neglected in a mixed ward, where she was woken more than once to see a naked male patient masturbating opposite her bed. Her shocking stories prompted a flood of others.
The late Eileen Fahey, for instance, dying of cancer, was put onto a mixed geriatric ward where confused people wandered about without supervision. One man with dementia regularly masturbated at the nurses’ station and tried to get into women patients’ beds; he was a threat to them all but staff took no notice, according to her daughter Maureen. Other patients have to give answers to intimate questions in the hearing of other patients. One deaf old man was repeatedly asked when he last had an erection, until tears ran down his cheeks.
A former midwife described eloquently on Radio 4 the indignities of being in a 24-bed mixed-sex ward, stripped of all dignity and intimidated. Bedlam was the word she used, and it applies even more accurately to the secure psychiatric mixed ward in London endured by Susan Craig last year, after a breakdown. She suffered regular sexual harassment, with mentally ill men groping her and exposing themselves. The nurses disbelieved her and told her husband she was “flaunting herself”.
If so (I don’t believe them), their job was to protect a patient from her own folly. Instead they chose, in modern cant, to blame the victim.
Sexual harassment is only a small part of the problem. Many people, both men and women, feel their modesty is violated by such closeness to random members of the opposite sex, even when they are not threatened.
Patients lie naked, half washed and forgotten, their sick and ageing flesh exposed to everyone, while nurses rush elsewhere. It is commonplace to have to walk to filthy mixed lavatories with gowns wide open at the back. At a time of sickness and anxiety many people are profoundly embarrassed to be surrounded by a clutter of bed pans, colostomy bags, nakedness, cries of pain and sweat, blood and tears — their own and other people’s.
All this is much worse, for many, when they are surrounded by members of the opposite sex; shame and anxiety are not the best bedfellows of hope and healing.
Much has been written about the rape of modesty and the death of shame. However, it is still true in this weary country that most men and women prefer to perform private bodily functions alone if possible, and among their own sex only, if not. That’s why we have separate public lavatories and separate changing rooms in shops and clubs and pubs. That’s why people put up towels on the beach. That’s why women give birth in female wards, not in mixed wards or not — I hope — so far.
Admittedly there are some who believe that mixed wards are not a problem, but our prime minister is not one. “Is it really beyond the collective wits of the government and health administrators to deal with the problem?” he demanded in 1996, flying high on vectors of dizzying youthful indignation as leader of the opposition. “It’s not just a question of money,” he went on. “It’s a question of political will.” Well, he said it and he promised to end mixed-sex wards by 2002.
What we have come to expect of new Labour promises, following failure, changing the goalposts, more failure and exposure, is denial. Sure enough Patricia Hewitt, the health secretary, was sent onto the Today programme in denial mode last week.
Although the Healthcare Commission watchdog found that on average 22% of patients have to stay in mixed-sex wards, rising to 60% in some hospitals, Hewitt’s officials at the Department of Health say
the government has achieved its target of abolishing mixed-sex wards, with 99% of trusts providing single-sex accommodation.
It is not difficult to spot the problem with that claim. It is not the same as saying 99% of patients get single-sex accommodation; it may be “provided” for very few. There has been the usual goalpost shifting: hospitals can claim they are providing single-sex accommodation by putting screens between beds in mixed-sex wards. Brilliant.
Hewitt admits there was a problem of perception; she even admitted that there was a “clear gap” between patients’ experiences and figures provided by hospital trusts to the Department of Health. One does tend to have a problem of perception, I find, if one is being misled.
My feeling is that mixed-sex wards are not the worst of NHS hospitals’ problems, although they demonstrate them. They demonstrate the incompetence and deviousness of hospital management in general, and they also show something worse. In all the stories I’ve come across what stands out is the ignorance, incompetence, laziness and heartlessness of all too many nurses, who are allowed to neglect and insult their patients without supervision and without sanction — in single-sex wards just as much as mixed.
Blair did not just promise to abolish mixed-sex wards, he also promised to save the entire NHS. He believes in divine judgment; I wonder how he will answer.
The Sunday Times | Sunday, November 26, 2006 | Comments (0)
Hallelujah, they're standing up for Jesus
Reports of the death of Christianity in this country have been much exaggerated, by me among many others. Even the dear old Church of England is showing a few signs of revival. Some might attribute this change to the Holy Spirit, blowing where it listeth in that irritating way it supposedly has. I would attribute it to competition, pure and simple.
The example of Islam in this country, for better and for worse, has powerfully concentrated Christian minds. Confronted with Muslim convictions, Christians — and particularly Anglicans — find themselves and their own faith renewed. There is nothing like a strong consciousness of a different identity for clarifying one’s own. Years of milksop tolerance and ecumenical dither have given way, here and there, to a new conviction. The church strikes back!
“Students sue over Christian rights at colleges”: that was the front-page headline of The Times yesterday. Christians standing up for themselves! Whatever next? For years it has been obvious to anyone interested in such things that Christian and post-Christian traditions in this country have been belittled and repressed by multicultural activists concerned to promote any culture other than our indigenous one. You could call this the spirit of Winterval — after the ridiculous name chosen instead of Christmas by local councils, supposedly to avoid “causing offence” to other faiths.
Britain’s campuses have been chilled for years by the spirit of Winterval and at last Christian students are protesting. I am not a great fan of Christian student evangelists, but at least someone is beginning to stand up against the constant attacks on our common Christian culture.
Student Christian unions are now preparing to take legal action against university authorities, accusing them of driving their beliefs underground. The Christians’ grievance is that official student associations are denying them, uniquely, the usual privileges and status offered to student bodies, because of their views. They stand charged with homophobia, breaching equal opportunities rules and discriminating against those of “transgender sexuality”. In other words, in universities such as Edinburgh, Heriot-Watt, Birmingham and Exeter, Christian unions are accused of excluding non-believers from their meetings, discussing sexuality in ways that liberals dislike and expressing their disapproval of homosexuality.
At Exeter the Christian Union had the usual privileges suspended, including funding and free access to university rooms. The students’ guild took the view that the Christian Union’s core beliefs were “too exclusive”. At Edinburgh the Bible was banned from halls of residence after protests from the students’ union, and the Christian Union has been banned from teaching a course about sex and relationships following complaints that it promoted homophobia. At Heriot-Watt the Christian Union has been told it cannot join the university students’ union because its core beliefs discriminate against non-Christians and those of other faiths.
This terrible stupidity and hypocrisy leave one almost speechless. It is bad enough that university students are anxious to censor others and deny them access to proper debate. That is to undermine the very nature of a university, a place where people can think and discuss the unthinkable.
What is worse is that the repression of Christian groups is the height of hypocrisy. For the most unacceptable of what many Christian students believe is pretty much what many Muslims believe, only Muslims go much further. There are plenty of Muslim students, not least among the activists that so alarm the government that it is asking university authorities to spy on them, who believe not just that homosexuality is an abomination but also that women and infidels are inferior. Yet can anyone imagine that any student association would suspend a Muslim group for its homophobia, exclusivity, discrimination against women and infidels.
But it is an ill wind that blows no good. Things have at last got bleak enough for people to start paying attention. Several senior Anglicans have recently spoken out in a way that would have been unthinkable until recently, and certainly before 7/7.
Last week the Church of England’s secretary general stated without any of the usual emollient Anglican waffle that Prince Charles’s wish for a multi-faith coronation was unacceptable. John Sentamu, the charismatic Archbishop of York, made an impassioned protest against such things earlier this month. He accused the BBC of bias against Christianity while favouring Muslims out of fear of terrorism. And he accused this society more broadly of disliking its own culture. “This country disbelieves in itself in an amazing way,” he said, and he has lamented the destruction of Britain’s Christian heritage by the wilfulness of the chattering classes.
He is right, of course; when you throw the baby Jesus out with the bath water, you lose the cultural water along with the baby to some extent. Sentamu stands for Christian and post-Christian values in the face of competition from other cultures. So too does another Anglican bishop, the eloquent Michael Nazir-Ali, Bishop of Rochester. Both have the credibility of people who are not white natives and both have known hardship and repression.
White native Anglicans are often less impressive; our own Archbishop of Canterbury gives out mixed and muddled messages. If the trumpet gives an uncertain sound, who shall prepare himself to the battle? Fortunately there are others who are prepared to the battle — the repressed young Christian students, the Ugandan Sentamu, the Asian Nazir-Ali of Muslim antecedents. They understand conviction; they understand what we face.
They are a bizarre army to come to the defence of what’s best about faithless, post-Christian Britain; it has taken this strange collection to convince me that disestablishment of the Anglican church would be a disaster for this country; paradoxically, it would bring down the last best defence here against the evils of religion. We are lucky that there is new life in these Christian soldiers.
The Sunday Times | Sunday, November 19, 2006 | Comments (0)
Having a subversive time in Ambridge
For many years I had a guilty secret. I was an Archers addict. I had to tune in furtively, because everyone around me despised it. When I was young I, too, would laugh contemptuously if the first few detestably folksy bars of the theme tune intruded on my ears. But slowly I began to listen more to Radio 4, and The Archers seemed to coincide with vegetable peeling; I became a passive listener.
Many vegetables later, I began to feel the lack of The Archers if I missed more than a couple of episodes. My family could not understand my habit and nor could I because I knew it was dreadful. Such is the way of addiction.
These days it has become positively chic; I have heard The Archers openly discussed among people who pride themselves on their intelligence and discrimination. And last week, in an astonishing cultural shift, The Archers was treated as an interesting news story, not just some quaint relict.
The media flagged up the programme’s 15,000th episode, and otherwise sensible urban people were openly admitting how much they were looking forward to finding out whether mumsy Ruth would succumb to cowman Sam in an adulterous hotel room, and — in this age of high-tech and listen-again — several friends confessed they were staying at home to tune in.
When, as a fellow but no longer secret addict, I ask why we are so mesmerised by a programme of such awesome banality, people don’t bother to answer. Iris Murdoch loved it, they point out. So did her husband John Bayley — both A-list intellectuals, despite the fact that this programme is clearly lower middlebrow.
The answer, I suppose, is that the craving for moral uplift is no respecter of brows, however high. The most brilliant children from the most aspirational schools cannot get to grips with their quantum mechanics homework until they have their daily shot of Neighbours or Friends. Others of perfectly adequate intelligence feel emotionally deprived without regular access to Coronation Street or EastEnders.
What all these programmes have in common is their high moral tone. The moral idiom may not be high, the environment may be low, but the tone is always one of determined niceness, goodness and tolerance. It is oppressively optimistic. Nobody is quite irredeemable.
People do bad things and talk dirty (even in The Archers someone said “frigging” recently), but everyone is after goodness and happiness in the end. However crude the plot and the characters, these stories are at one level all celebrations of bourgeois values. They are sermons in soaps, particularly The Archers; these sagas of everyday folk are latter-day people’s pulpits without church or clergy. They are comfort viewing or comfort listening.
The Archers is also heritage listening, being an extended fantasy of a lost world, an unobtainable rustic idyll. Personally I find Ambridge rather sanitised and suburban; none of the blood and stink and death of farming finds its way into the listener’s imagination; there were quite a few squelching sounds during lambing this year — or was it calving? — but I think that was only Ruth and Sam stealing slurpy kisses. Clearly it evokes for many listeners the dream of a tidily green and pleasant land, with green and pleasant neighbours.
Against this hazy blue remembered background, however, the plot is distinctly didactic. The Archers began as a public information service to give practical advice to post-war farmers and though it claims to have lost this role it seems in fact to have taken on the much more ambitious one of educating the public about life in general.
It offers a constant stream of right-on propaganda, posing as infotainment, about practically everything — breast cancer, European Union regulations, foxhunting, parenting, lone parenting, agricultural depression, gay marriage, mental illness, marketing, Hungarian workers, undue pressure at school, rape, infertility, affordable housing, upper middle-class adoption, organic food and more, much more. It is one long therapy session with people compulsively sharing and caring and understanding where other people are coming from.
The Ambridge diocese has a proselytising spirit too. Last week I heard to my astonishment the sweet tones of BBC female bossiness giving listeners advice on how to listen to The Archers. You should try to let yourself in gently, she counselled, and not attempt to understand more than one plotline at first, simply relaxing through the other parts of the episode, which you ought not to trouble yourself with at first, until you begin to find it easier. I stared at our radio in disbelief. Is there no end to the paternalism, or maternalism, that surrounds us?
More mysteriously still, why is it that, despite all this, many people who loathe political correctness are hooked on The Archers. My suspicion is that they hear it as an extended postmodern joke. Its worthiness is so extreme it is subversive; the overkill is so startling, the clichés so dazzlingly predictable, the Mummerset accents so ludicrously cod, that the whole thing hovers on the edge of comedy.
Perhaps the highly sophisticated scriptwriters like playing with us from time to time and leaving little clues. For instance, I laughed until I wept when I turned on the car radio, against my son’s protests, to hear Grandpa Joe Grundy mumbling in Mummerset and tenderly crooning endearments to his son’s prize ferrets as he smashed their brains out with a hammer.
I know I was supposed to feel for poor Joe’s misery at being thrown out of his farm into a miserable urban council flat, where the ferrets weren’t even allowed to frolic on the balcony, and which understandably caused him to flip his rascally lid. I know this was a serious mental health issue, an environmental issue, a health and safety issue, a human rights issue and possibly an animal rights issue (ferrets) but I just found it wonderfully funny — a marvellous antidote to all that damn decency.
For some The Archers may be a latter-day equivalent of going to church for a comforting little moral uplift. But for others, like me, it’s uplifting in another way; it has all the appeal of a post-modern high-kitsch, subversive cult.
The Sunday Times | Sunday, November 12, 2006 | Comments (0)
Asbos don’t mend broken teenage lives
It is not easy to “love a lout”, to use Labour’s spiteful jibe at David Cameron; and to “hug a hoodie” might be positively dangerous. All the same, something has to be done about the Asbo set, especially as antisocial behaviour orders don’t seem to be working.
Half of all Asbos are breached by teenagers, who see them as a badge of honour, according to a report released last week by the Youth Justice Board. Also last week the Blairite Institute for Public Policy Research (IPPR) published research showing that British teenagers are by far the worst behaved in Europe. On every indicator — drug abuse, drunkenness, promiscuity, early sex and teenage motherhood — they come at or close to the top of the list.
So something has to be done about the Asbo set. Labour’s promise to be tough on crime and tough on the causes of crime has obviously failed. They haven’t built enough jails; their community punishment policies are lamentable; an incompetent system releases the wrong people and loses them; and violent crime among young people is rising. So it is surely worth trying to think again about hoodies and louts and how they get to be the way they are. It is the lowest of political sniping to criticise the attempt, as Labour has done. Investigating the underlying causes of delinquency is or ought to be central to Labour thinking.
Imagine that you are a boy of 15 called Kelvin. You are bright, good looking and strong and you live on a nasty inner-city council estate next to some of the richest streets in London. Your father disappeared long ago, and your mother lives with your two younger sisters in a flat on the same estate, but for some reason you and your younger brother live on your own in a separate flat.
Mum is nice enough but she has a violent temper, especially when drunk or high, and used to slap you about until you got bigger than her. She works nights in a bar, so she’s usually asleep during the day. There are no meals ready for you, almost no affection or advice, no laundry done for you and quite often no money for you. Things have been this way for almost as long as you can remember. It’s frightening sometimes, and it’s always lonely. So you hang out with your friends, looking for something to do. You see rich boys driven about in big cars by their loving mummies, sporting expensive trainers, iPods and mobiles.
At your bog standard comp, the lessons are boring, constantly disrupted, and most of the kids don’t speak English. With some of the most outgoing and energetic kids, you bully others, steal dinner money, bunk school and get suspended. You’ve been doing drugs since you were 11, and now you’ve started dealing. It can get violent, but you’ve got leadership qualities — aggression and charm — and you begin to discover the arts of enforcement by terrorising younger children. Soon you are doing a little mugging and thieving; then you’re casing rich people’s houses for older thieves, and in a year or two you will get a couple of girls pregnant. A bright, attractive, energetic boy, you are neglected, illiterate, and almost completely unsocialised. You have been formed for crime.
This is a story that could be told again and again. It is close to some stories I know personally. There are worse versions, like the fate of children in so-called care, who are moved on and on like poor Jo, the crossing sweeper in Dickens’s Bleak House, from one hardship to another, and finally dumped into the so-called community by social services when they are still teenagers. I have felt extremely sad for the few such boys I have known, even as they abused our hospitality or terrorised the little children in the communal garden, and I have even felt tempted to hug them. It is so entirely obvious that they have been deprived of the loving care that is essential to self-respect and respect for others.
I am no bleeding-heart liberal, yet I do strongly feel that punishing these children — monstrous though their behaviour may be — is rather irrelevant. To understand is not necessarily to forgive, but equally to blame is not necessarily to solve: about 66% of prisoners reoffend and they are only the ones who get caught.
Last week’s IPPR report about Britain’s monster teenagers suggested, hardly surprisingly, that their alarming behaviour can be explained by a collapse in family and community life compared with the rest of Europe. Teenagers on the Continent, as we used to say, spend significantly more time at home than British children, talking to their parents and eating family meals round a table. British children are much more likely to hang out with their friends most evenings. About a third of British parents don’t have, or make, time for their children. The result is not just life-long unhappiness; for some it is crime, and then punishment for their own disadvantages. The jails are full of people who come from dysfunctional families, who are illiterate, or who have been in so-called care, or suffer from mental illnesses or learning disabilities.
Cameron is right to talk of “tough love”, though it is unclear what that might mean in practice. It is, sadly, uncertain whether a deeply damaged teenager can be helped back into law-abiding society. Charles Murray, the distinguished inventor of the idea of an underclass, once said to me that he thought, sadly, that society should just give up on the Kelvins — because it is too late to do anything for or about them.
The IPPR report talked of the importance of parents in socialising a child and teaching the norms of society. But when a single mother has never adopted those norms, or got much out of society, she is unlikely to pass them on. You need to feel that society has invested in you to be able to invest in it yourself. If your prospects are dim, crime is a rational choice. If you get caught, you won’t do much time; and Asbos are a laugh.
Far more Asbos are breached than the government admits, according to the National Association of Prison Officers. Yesterday the association and others complained that while they are working with the official figure of 42% (for 2003), there is evidence that the real figure in some areas is closer to 70%. Yet tomorrow, against all the findings, Tony Blair will insist again on his faith in Asbos. Perhaps, like louts and hoodies, he’s beyond redemption. He’s certainly hard to love.
The Sunday Times | Sunday, November 05, 2006 | Comments (2)
