Lord Mancroft reflects on his unhappy experience of the NHS

Lord Mancroft is under fire in many of today's newspapers (see The Times and Daily Mail) for controversial remarks about certain nurses that were responsible for his care during a time he spent in hospital.  But many will sympathise with his reflections on his NHS experience.  He found the hospital very dirty and noone appeared to be in charge of his ward.  He also watches a man die alone.

In the first part of his speech Lord Mancroft talked about his horrendous experiences in one unnamed NHS hospital:

Hospital cleansiness: "When I was taken ill, I was taken to an accident and emergency department in a hospital not in London but in the West Country. I can tell your Lordships only that it is a miracle that I am still alive. It was exactly as the noble Baroness described the hospital down in Maidstone in Kent. I will not tell your Lordships which hospital I was in, but the wards were filthy. Underneath the bed next to me was a piece of dirty cotton wool, and there it remained for seven days; the ward was never cleaned. It was a gastroenterology ward, with lots of people with very unpleasant infectious diseases. The ward, the tables, the beds and the bathrooms were not cleaned. I was extremely infectious at that time and no precautions were taken with me at all. The staff were furious when my wife wanted my bed cleaned when it clearly needed cleaning. I was just lying there, a pathetic person. It was appalling."

The slipshod and lazy nurses: "The nurses, who probably are the most important people in this complex area, were what I would describe as an accurate reflection of many young women in Britain today. What do I mean by that? I shall now break your Lordships’ rules and read the next bit, because I thought very hard before I wrote it. The nurses who looked after me—not all of them; we should never generalise and there were one or two wonderful ones—were mostly grubby, with dirty fingernails and hair. They were slipshod, lazy and, worst of all, drunken and promiscuous. How do I know that? If you are a patient, lying in a bed and being nursed from either side, the nurses talk across you as if you are not there. I know exactly what they got up to the night before. I know how much they drank and what they were planning to do the next night, and it was pretty horrifying."

Noone was in charge of the ward: "My bed was next door to the nurses’ station, so you could see how the whole place was being run. Actually, you could not: I have seen lots of things being run, but after a week, I could not tell you who was in charge. I had absolutely no idea who was telling who to do what. My view is that nobody was telling anybody."

A man who died alone: "The man opposite me was dying. I imagine he died two or three days after I left. I do not know what he was dying of because he was not doing a lot of talking. But I do know that he virtually died alone. The nurses thought that he was a nuisance. They changed his bottle, gave him his pills, occasionally fed him and propped him up. But basically this man died alone in a British hospital in the 21st century, and I had to watch him do it, which was pretty unpleasant."

Lord Mancroft then moved to the Chelsea and Westminster Hospital where he had a very different experience:

"The nurses, of every nationality, size, shape and colour, were wonderful. I was discharged from the country hospital. When I arrived in London I had two operations in 24 hours. I am quite certain—as were all the staff, although they would not say it—that if I had not had them I would have died. The hospital in London was wonderful. The nurses were marvellous. I do not know how, but it worked like clockwork. It was spotlessly clean. It was everything that it should be or could be anywhere."

The Tory peer also makes strong remarks about the unnecessary complexity of dispensing and of the volume of paperwork in hospital:

Queuing at the chemist: "Dispensing drugs is really simple. You and I call it retailing. Every week when I get my drugs, I watch them doing it and it takes 40 minutes. Over the road, Waitrose, the supermarket, is doing exactly the same thing really well, so why cannot these people do it? It is a shambles. It takes 40 minutes to get a drug which you can see sitting on the shelf. Why is that?"

Endless paperwork: "Everywhere is swamped with paper. Everyone asks the same questions and fills in forms. Every department is covered in completely pointless paper. Last week, I saw one of my consultants. As I was leaving, he said, “By the way, what do you weigh”? I said, “What on earth do you mean, what do I weigh? Why do you want to know”? He said, “I do not want to know, but I’ve got to tick the box on this form or they will make you come for another appointment and weigh you. I run an outside clinic twice a week and 60 of my patients twice a week are weighed. I don’t care what they weigh. They don’t care what they weigh. But the form says that we have to weigh them”. How ridiculous is that?"

And in conclusion:

"There will always be good and bad. In Britain at the moment there is very little that is good enough and too much that is too bad. This Government came in 10 years ago to sort this situation out. It has not been sorted out. It is internationally embarrassing and humiliating that a country of this size and wealth should produce a service which is so horrible."

Original Hansard source.

Comments

[IRJMilne]

The hospital's chief executive has criticised him for not giving evidence about this. What sort of evidence is he meant to have? Was he expected to bring a hidden camera with him?

"The Royal College of Nursing said Lord Mancroft’s comments were “grossly unfair on nurses across the UK” and amounted to a “sexist insult about the behaviour of British women”", says the Times. What is sexist about them? And he was repeating his own experiences of some nurses. If people find it insulting to be told the truth about some members of their profession, that's their problem.

The Times has really got it in for the Tories at the moment, for some reason, having helped to wind up trouble over the Auschwitz business too.

"His gross generalisations" are referred to by a union boss. As he made a point of saying that one should not generalise I am sceptical about the merit that should be attached to the views of the head of a group which donates money to the Labour party.

Politicians must be able to discuss problems with public services in parliament, and if this is his experience of the NHS then he was surely right to repeat it in the House of Lords, or he would be failing in his duty to hold this wretched government to account.

I don't think his experience of nurses in the NHS tallies with my own, but if he is (as we should presume) telling the truth, then he was right to speak as he did.

[Alan S]

Lord Mancroft told the truth about too much patient care in this country.

He was on Today earlier and noted that an MP would be too frightened to say what he said.

One of the many advantages of the Lords.

[geoff]

His mistake is in not making a proper complaint to the hospital but going straight to the media and parliament.

That isnt the right way to do things. If you have a problem with a service you should tell them first

[Alan S]

Radio 4 has just reported that Cameron rebuked Mancroft in speech to Welsh Tories. He should think more carefully before opening his mouth, apparently.

[another HF]

I must say that as an NHS consultant I do recognise some parts of this description. We certainly suffer with a lack of staff and of structure in ward management, and there are (or at least have been in my recent memory) hospitals where the cleanliness was substandard.

On the other hand remember the pressure under which the hospital is almost certainly working. It is likely that the PCT is receiving significantly less per patient to provide services than the London Hospital, and devoting much less of that money to secondary care (ie hospitals).

The district hospital will be under pressure from any number of government targets and levels of trained permanent staff are almost certainly low. At night there will be very few nurses and even fewer doctors. During the day medical teams are coming and going without knowing much about their patients because the European working time directive effectively prevents any continuity in patient care.

At the bottom of all this is the Labour governments belief (apparently shared by many Conservatives)that healthcare is about providing a service which anyone can do and it is just about getting units into place. Unfortunately healthcare is also about relationships, responsibility and trust. If doctors and nurses are unable to develop relationships with their patients they will not feel responsibility for their care. Without that it is difficult to see why or how patients should or can trust their medical teams

Paradoxically this may end up driving patients back into the private sector

[john]

Labour politicians will be egging Cameron on to rebuke Mancroft. It seems he already has, which is a pity.
A great many people will sympathise with the Peer, because they know he's telling it like it is.
It's ten years since I spent two and a half weeks in Edgware General Hospital after a heart attack. It was sheer hell.
There was constant noise, particularly at three o'clock in the morning when nurses would drop in for a chat around the central table. The lavatory floor was nearly always awash with urine and cleaning in general was pathetic. If I'd known about MRSA, I'd have been terrified. As it was, I was simply depressed and angry.
There appeared to be nobody in charge. I once saw a man come in and speak to a couple of nurses. I was told he was some kind of ward manager. Needless to say, he didn't speak to any of the patients.
Two doctors made the rounds every day; they were very young and always looked absolutely knackered. I attempted to complain one morning and was told: "What do you expect in the NHS". The nurses did little "nursing". They were mostly West Indian and African. They were self-important and very much "on their dignity".
Thank God there was a lovely Irish ancillary worker who went round plumping up pillows and asking if we needed anything.(In other words, doing the nurses' job).

The Tories were in power then. Have things improved? I don't think so. I've visited many people in hospital since then. Some establishments seem to be well run, others are hopeless, particularly on hygiene. Londoners may have read the recent undercover reporting job done by the Evening Standard, whose reporter took a job as an agency cleaner. Please God, I stay healthy.

[Deborah]

I am disappointed if Cameron has "rebuked" Mancroft. Honesty is a virtue. It is refreshing for someone to tell the truth about SOME parts of the NHS.
The constant refrain that ALL nurses are angels is palpable nonsense and we need to acknowledge this if things are ever to improve.
The situation that Mancroft describes doesn't develop overnight. I expect that lots of people have made formal complaints through the proper channels and got absolutely nowhere.
The outburst from the chief executive says it all. His first response should have been concern, not a demand to "prove it". I'm glad Mancroft has raised this issue -now, hopefully, someone will have to deal with it.

[Richard Balfe]

Well done Lord Mancroft for far too long we have had this sloppy idea of nurses as "angels" etc. The truth of the matter is that the NHS is an out of control expensive juggernaut.
We need some measure of local control and accountability.

[Blanche Abrahams]

I agree with Lord Mancroft. Quite frankly some of those nurses need elocution lessons. Socilaism at its worst. Privatise.. quite simple!

[Angels?]

Lord Mancroft's bad experience is an exact, and I mean exact, description of that which we experienced in a metropolitan Essex hospital 3 years ago. For the two weeks we were there, the ward was staffed by foul-mouthed hungover nurses, who ignored any patient in too much distress to speak for himself, who talked over their very ill patients and treated us to a discourse on their sexual adventures of the previous evening, and who were under no direct supervision by anyone. At one point some civil servant came in and wandered round telling the patients "I'm the matron, you know - the modern matron" - as though this was of any service to anyone. Since the hungover and foulmouthed (and nearly 100% anglosaxon, by the way) nurses took no notice of this wundermatron, it was of no surprise that no standards in the ward improved. "Cleaning" took place once a day, when a man with a dirty bucket of dirty water pushed a dirty mop under the beds.

Lord Mancroft's views on dispensing are 100% accurate also. It took me three hours to get some bloody painkillers off the hospital staff so that my other half could come home.

I laugh now when I hear that all nurses are "angels". I snort in derision when I hear people complain about non-British people coming to the NHS to work. The contrast between the native Brit staff in that hospital - whom, frankly, I wouldn't employ to clean my bathroom - with the largely migrant & genuinely wonderful nursing staff I saw last year in the Homerton, was astonishing. Any difficulty in communicating - and then only a matter of asking patients to speak clearly - was more than overcome by the genuine care towards the patients.

Now. It has been said that Lord Mancroft should have complained at the time, and by a physician writing above that hospitals are not about economics but about trust. I am not someone who puts up with loved ones being treaten as so much rubbish, and on several occasions in that Essex hospital I spoke to whomever I could find in "charge" to complain and demand some better treatment. I'm afraid it had no effect. The consultant writing above is, I'm afraid, either working in a great place (in which case, great - no-one is claiming Lord Mancroft's experience is universal) - or is suffering from the delusion that takes hold of lots of medical people, that they are somehow gifted with a different moral sensibility and set of moral duties than the rest of us. Nursing staff who treat patients like dirt and who have no obvious line of command should be sacked; certainly it is not we who should be asked to show more "trust" in their abilities.

[Mike H]

Well done to Lord Mancroft for speaking out about his experiences. Many of us with experience of a stay in hospital or regularly visiting a patient will recognise the truths in what he says.

For the life of me, I fail to understand why he should be criticised for doing something so novel as 'telling it how it is'.

Sign of the times, I suppose.

[David Belchamber]

Geoff at 10.56:

"That isnt the right way to do things. If you have a problem with a service you should tell them first".

In principle, I agree with you but the picture Lord Mancroft paints is one I recognise from the Surrey hospital that my brother was in a few years ago. It was quite appalling, as a result of which when I had to have a routine operation I was too afraid of going into an NHS hospital that I went private.
Something is more likely to be done about the problem by publicising it in this way and, although there are excellent hospitals and excellent care, the bad ones are really bad.
Part of the problem is the way they are managed but there is no way under this government that this can improve - they just don't do efficient management!

[another HF]

"is suffering from the delusion that takes hold of lots of medical people, that they are somehow gifted with a different moral sensibility and set of moral duties than the rest of us"

No, just the same ones. I am merely pointing out that if nurses (and doctors) have no pride in their job or their place of work, then they will not nurse effectively and some will show the same lack of respect for other human beings as I'm afraid I see (with apologies for sounding like an old fart) in many other young people. What we see in our hospitals is a mirror on the rest of society, not an isolated problem. Without respect for our seniors, our traditions and our fellow men we are just a rabble whether in a hospital or a high street

[Tapestry]

This commentary on the National Health Service by the Prime Minister in waiting was published today (28th Feb)-

We are living under the illusion that healthcare in this country is free, but this is not the case. We collect huge amounts of taxes to fund this healthcare system and everyone is paying for their health from their own pockets.

We end up with a situation where we take money from people to pay for their healthcare but then tell them that they cannot choose their doctor, cannot choose their treatment and cannot choose what to be treated for. We assign them to a local doctor, medical centre or district hospital and tell them that, like it or not, they have to go there, have to wait their turn in the long queues, even if the service is rude and the treatment inadequate.

Our healthcare system has combined the worst elements of the State system and the biggest problems of a market-based healthcare system and it offers people no alternative. This is not the fault of our doctors; this is the system that the state has established.

It is absolutely clear that the state must make it possible for people to choose their own medical centre, their own doctor and insurance company. The money the state collects from citizens in the form of taxes and fees should go to doctors only through the patients, through the provision of quality service to these patients, and not through local healthcare administration officials or on the basis of funding estimates.

The legal possibility should exist for uniting all of these different sources of money coming from state and private funds into one channel. It should not matter which medical centre a person chooses — municipal, federal, private, in his home town or in some other place — what matters is that this is his money and therefore his right to choose. . . .

These words and more from Dmitri Medvedev, the Russian Prime Minister in waiting, from today's International Herald Tribune, on the subject of Russia' national health service. His comments have a strangely familiar ring to them, don't you think.

[Deborah]

Ed,
I think Tapestry's post deserves a more prominent position. It is stunning.

[Maureen Komorowski]

Dear Sir,

I would like to complain about your comments you made about nurses. It is a very hard job to do and very underpaid. If you have any genuine complaints to make about nurses whose care you dependened on you should have gone to the correct authorities and addressed the matter locally. You must have felt very aggreived to speak in the House of Lords as you did but you yourself have acted unprofessionally.
I am a nurse of many years and I can asure you I work exceedingly hard as do my colleagues.
You have done a great dis-service to nurses and I think you should publically apologise and you should also go back to the Bath Hospital and make a formal complaint so that the Cheif Executive can deal with the nurses concerned.

Yours sincerely

Maureen Komorowski

[Mat]

Many nurses do an excellent job and it would have been better that Lord Mancroft had taken his concerns to the hospital first although clearly he has every right to raise this in the House as well. That said there is an issue here and I think very many people can cite their own experiences. Obviously there are some very good hospitals and nurses but I recall an experience which wasn't that far removed from some of the problems described. The ward was filthy, there was blood and I think faeces splattered on the wall next to me and on the floor. The bathroom/toliet was so filthy you didn't want to use it. Once day someone came along in a lack lustre way with a mop but never cleaned under anything or in any proper way. An old woman (it was a mixed sex ward) appeared to be slowly dying and nobody showed much if any interest in her. The ward was incredibly hot and it was impossible to get comfortable. Nurses (yes some were nice, friendly caring when you did interact with them) seemed to appear briefly and then disappear for ages. They didn't seem to attend to patients in the way that nurses used to. Nobody seemed to be in charge in a hour by hour practical and direct way. From time to time some nurses did discuss their lives in a loud and somewhat inappropriate way and some of the nurses seemed to be slovenly with their hair not tied back etc. Nobody seemed much interested and if you weren't discharged toward the end of the week you would be stuck in the ward until the following week because the doctors didn't visit over the weekend. This must have contributed to much bed blocking. My feeling was that the system had gone into a state where the staff were not empowered to do their job and if they didn't they apparently feared no sanctions. They appeared to think their job was office based ratrher than nursing and presumably this was because the whole ethos was one of paper chasing.

[Simple Simon]

Well done Mancroft, hear, hear.

Of course nurses are dirty, slipshod and lazy. It's why I refuse to venture forth in an NHS hospital - I can't understand what the man was doing in one in the first place.

I'm sick to back teeth of reading about how nurses are angelic salt of the earth types at a time when NHS hospitals are filthy and disease-ridden. I doubt if many of their homes are much cleaner.