We ought to be much, much more angry about hospital treatment of the very elderly

By Paul Goodman
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Perhaps the most noticable difference between photographs of modern nurses and their predecessors is the disappearance or downsizing of nursing caps.  My sense is the change gathered pace at roughly the same time that nursing became a graduate profession.  The cap's origins seem to have been connected to the religious origins of hospitals.  It didn't follow that nurses had to be Christians, or that hospitals run by churches.  But the cap was a nod to the ineradicable fact that medical care in the west was shaped and sustained by a Christian ethos.

The range of care available in today's NHS would have strained the imagination of former generations of nurses.  There can be no turning-back to the age when most nurses weren't graduates.  And doubtless there was no golden age of nursing.  But would staff in any hospital, 25 years or so ago, have left a female patient unwashed for eleven weeks?  Would a male one have starved to death after being treated in a hospital for two months?  Would another man who could not feed himself have been taunted by nurses who took away his food uneaten?

We know that the catalogue of shame at the Alexandra Hospital in Redditch, which the Sunday Telegraph reports today, isn't a one-off.  The Care Quality Commission found last year that half of NHS hospitals are failing to care for the elderly.  At the root of the problem is neither management nor "resources" but culture.  I have been in and out of NHS hospitals as a patient, and my experiences have been very good ones.  It was a doctor performing an NHS operation who removed a cancerous gland from my throat.  The system was excellent in a crisis.

But then again, I am middle aged - neither so young as to be within a mother's womb, or so old as to be lingering in hospital after an operation.  And it is at these extremities of age, amidst our celebrity culture, that human life is most vulnerable.  It isn't an exercise in nostalgia to write that a quality as elusive as it is invaluable was diminished along with those vanishing nursing caps: call it respect, call it dignity, call it care - even call it love, if you will: we know it when we see it.  Oh, and pace Ed Miliband, it helps if the hospital staff speak English.

If you don't believe me, here is Janet Davies of the Royal College of Nursing: "Some of this goes beyond nursing, and is related to the overall attitude of society towards older people and their needs and dignity."  Nigel Lawson once said that the NHS is "the nearest thing the English have to a religion".  It is puzzling that this is so when the system is not that much better than other health care systems elsewhere in Europe - or, rather (let's be plain about it), when on a lot of measures it performs worse.

I suspect that most voters know this perfectly well, and that what drives their protective instinct towards the NHS is the fear that any change will be for the worse.  So it is that at the same time they recoil from the horrors of Alexandra Hospital (which has apologised to 38 families) while clinging to the system as closely as ever.  Tim Montgomerie has written that Jeremy Hunt aims to be angrier about the faliure of the NHS than any voter.  Very good.  The Health Secretary could start by asking if anyone has been sacked at Redditch.  And if not, why not?