Last night’s really rather depressing Dispatches programme, on Channel 4, ended with a rousing signal to arms, a clarion call from journalist Mark Sparrow for there to be “a patients’ revolt”. Over what? Well, hospital food, now you ask. And good luck to him – and any patients who do decide to revolt over it. It’s a disgrace. But I can’t help thinking that nothing will be achieved in terms of patient care. There might well be a couple of new guidelines issued – I daresay perhaps a consultation or two launched – but what we’ll probably end up with is a new rule that every meal must be accompanied by a bread roll, or that lasagne must be served every ninth day. You know, the usual top-down, target-loving, bureaucratic rubbish.
There was a very telling moment halfway through the programme when Sparrow was talking to a ‘food consultant’. Why, he asked, was hospital food so bad across the board when everyone knows that a good diet is essential to recovery? The answer began with a few generalities about ‘cuts’ but then moved to talk about the directives that had been issued following a number of well-publicised MRSA scandals. Filthy hospitals were contributing to deadly infections and people who had gone in for routine procedures were leaving in the charge of a coroner. A disgrace. The government’s response? Centrally mandate that all hospitals be ‘deep cleaned’. In many cases, the hospitals’ response? Pay for such deep cleaning by siphoning the money away from the food being given to patients. No doubt savings could have been made elsewhere, but a bureaucracy never looks to cut itself.
Throughout the show we were invited to guess what meals we were looking at. The lasagne that looked like cold vomit, the chicken casserole that had travelled two hundred miles before being reheated in a microwave, the Hungarian beef goulash that was neither a goulash nor contained beef. It might have been blackly comic if the results weren’t often so tragic. We met the cystic fibrosis sufferer who frequently lost a great deal of weight whenever he had to go into hospital for treatment. Doctors knew that he needed a high protein, high fat diet because of his condition, but he could not get it because centrally-created regulations determined salt and fat levels in patient food. Nationwide. Regardless of circumstance. An NHS dietician lamely told us that a lack of salt might make the food taste “a bit bland”. Not quite the issue that the bag of bones on Ward C was concerned about.
Elsewhere we travelled to the midlands, to Good Hope Hospital in Sutton Coldfield (recently in the news again) where several old people had died through neglect. Food was being served to them; or, more precisely, put in front of them, where they lay too weak to sit up and feed themselves. No-one helped feed them; presumably because it was no-one’s job. And the hospital’s response to a family who had lost their grandfather in this manner? A weak apology and a promise that “systems had been put in place” to ensure that patients were now definitely fed. Saints be praised.
James Bartholomew’s seminal The Welfare State We’re In contains the chapter ‘The NHS: like a train crash every day’. It’s a provocative statement; but it’s also totally correct. The NHS falls well behind the health care systems of other developed countries in terms of mortality rates, cancer survival rates, stroke outcomes and heart disease. It also presides over huge regional health inequalities – when surely its sole remaining selling point is that it provides a universal service where “poverty must be no bar to health”. It does this because it is unwieldy, centrally-controlled, politically-directed, target-driven, and run for the benefit of those who work for it rather than those who are treated by it.
Throughout last night’s show we also met the many people working hard, on the front-line (to utilise a well-worn phrase), to improve standards for patients. We heard from Loyd Grossman, who had worked for five years, and had eventually given up in disgust, trying to improve hospital meals. It is a tragedy that the efforts of these people are wasted in the midst of a bureaucratic nightmare that, in Grossman’s words, has a “prejudice against common sense”.
So what are we to do? The programme asked us to sign a petition that will be sent to Andrew Lansley. Or we could write to Anne Milton, the “minister in charge of hospital food” we were told. And, yes, let’s do both those things if we want. They might change things a bit. Possibly.
But as free-marketeers we must do more. We must throw our energy into showing people that there is a way that things can be better. No longer must we, as a society, be wedded to the idea of centrally-run, politically-driven healthcare that is “universal” only in the sense that it is almost uniformly sub-standard. If we are going to write to Andrew Lansley, let’s tell him that we want our share of the collective pot, so that we can spend our money on the care that we want, and that we can be treated as clients and customers as opposed to afterthoughts. Let’s tell him we want the Singapore model of private accounts. Or let’s have our taxes lowered so that we can keep more of our own money and have the freedom to spend it as we wish.
Just let’s please not have all the entirely justified anger that last night’s programme will generate impotently culminate in a consultation and then a set of new directives. I simply can’t face having to eat lasagne every nine days while I wait for my stitches to heal. Not least when it looks like cold vomit.