This week has seen the publication of a report drawn up by a leading British lawyer called Robert Francis on “appalling standards of care” at a National Health Service hospital called Mid-Staffordshire. This report concluded (in the words of our Secretary of State for Health) that these problems “were also a failing of the wider NHS System”.
We have no quarrel with any of these views. What we dispute was the need for Mr Francis to spend two years and a vast amount of the British taxpayer’s money in reaching it. All he had to do was to read pages 212 to 220 of THE PURITAN GIFT, which deals with the managerial culture of hospitals.
For example, one of the failures lamented in the Francis Report is that of not feeding patients who are incapable of feeding themselves. Here is what we wrote seven years ago on this very point:
For the authors, the symbol of the new era has to be a half-eaten, dried-out meal sitting for hours by a hospital bed occupied by a semi-conscious patient. In an earlier and better-regulated age, a trained nurse would have felt obliged to feed the patient…
We also quoted what Florence Nightingale wrote on the same subject one hundred and sixty-three years ago in her “Notes on Nursing: What it is and what it is not”:
To leave the patient’s untasted food by his side . . . is simply to prevent him taking any food at all. Let the food come at the right time and be taken away, eaten or uneaten, at the right time.
Lest Americans get cockahoop about the failings of the British National Health Service as exemplified at Mid-Staffs Hospital and publicised in the Francis Report, I should add that our criticisms applied equally (and perhaps more) to the American hospital system. By way of example, we quoted a three-page article in the Chicago Tribune of September 10, 2000 which told us, among many other things, that:
Overwhelmed and inadequately trained [American] nurses kill and injure thousands of patients every year as hospitals sacrifice safety for [higher profits].
The greatest weakness in the Francis Report is that does not tell us in any detail how to achieve a better managerial culture for hospitals throughout the Anglosphere. Our book does.
Co-author, THE PURITAN GIFT