A whiff of NHS decay

I WAS NOT quite born under the auspices of the National Health Service but, had I been given any choice in the matter, I would have been. I am devoted to its practitioners, admire its egalitarian skills and have owed my life on more than one occasion to its care.

I remember one particular dark night of the body, some six years ago, when I was desperately ill. In the low small hours a black nurse with cool hands and calm movements brought me back from utter wretchedness.

It was not a case of medical skills - a nurse's freedom to take such decisions is strictly limited - it was her kindness that was supremely consoling. She turned me from a fevered, terrified, vomiting sufferer into a patient who was soothed, refreshed and able at last to sleep.

In the last 14 years I have been admitted half a dozen times to one of London's most splendid teaching hospitals. Three weeks ago I found myself there again for a relatively minor operation. Since my last visit the hospital has become a Trust. Everything about it has deteriorated: most of all, nursing standards.

It is only when you are ill that you realise how true it is that health comes way ahead of wealth in the list of desirable attributes. Pain and suffering are a scourge, and I have always thought it outrageous that the rich should be able to pay for better care: as though anybody ever chose to be ill.

It is essential that doctors and nurses perceive all their patients equally. Stripped of the trappings of clothes and jewellery, salaries and limousines, class, looks and health by the all-levelling hospital bed; reduced, as often as not, to childish querulousness by the primitive fear of pain and death: God knows, we are all at our worst when sick. The very idea that some sick people are more deserving than others is a travesty of medical ethics.

Yet medicine is being travestied every day in the country's clinics and hospitals. The honourable notion of healing has been replaced by the efficient through- put of patients; care has been replaced by the maximisation of turnover, and nursing skills by what I can only describe as a Bunny-girl mentality.

Today the whole atmosphere on the wards has changed. Shiny wipe-clean boards announce, 'Your nurses today are . . .' followed by a couple of names and a scribbled, grinny face. Each morning 'your' nurse comes in and says, 'Hello, Mrs Lambert: I'm Joanna' - or John, for that matter: the number of male nurses has noticeably increased. 'Hello,' you say, but the nurse has already turned away to the next subject (product?) with the desultory words 'Feeling better?' trailing limp and unanswered behind them.

Unless you are very ill (and I was not), today's nurses do not turn your pillow from fevered hot side to blessed cool side. They change your bed only on alternate days, leaving the bloodstained sheet to alarm visitors and embarrass you. They no longer wash you if there is the slightest chance that you might be able to do it for yourself. They wear make-up (well, the women do) and, as often as not, perfume, whose cloying, lingering sweetness is anathema to nerves made shatteringly delicate by anxiety, boredom and pain.

They say goodnight and forget to turn the light out: which gave me 10 minutes of excruciating moral debate while I weighed the laborious, uncomfortable and possibly dangerous process of getting out of bed against the embarrassment of summoning a nurse from more important duties.

On the basis of my admittedly brief sojourn in that particular hospital, it seems that the demographic dip in the population has resulted in a decline in the standards of nursing recruits, just as predicted.

Young women - and young men - are now more likely to enter the profession because they cannot get a job elsewhere, and men simply do not make such good nurses as women. They lack that blessed quality of idealistic, generalised tenderness which used to be found, remarkably often, in girls barely out of their teens.

Men are brisker, more practical, physically stronger, emotionally more remote. They solve your immediate problem but they do not seem to care.

I am sad at this apparent decline in what used to be a great, skilled and humanitarian profession. I am sad at the collapse of a hospital that used to be one of our proud NHS flagships, now almost sunk by financial cuts and a preposterous new ethos.

Above all, I am enraged by the arrogance of successive Tory governments which think that, by repeating parrot-fashion that more money is poured into the NHS every year, they can persuade us to ignore the truth that lies starkly there before us: the National Health Service is on its deathbed, closing up its eyes.