Where do I begin? Watching Channel 4‘s recent drama about the Mid-Staffordshire NHS scandal, The Cure, was an evocative, thought-provoking and highly emotional experience. Heartbreaking, exasperating and intensely depressing in equal measure - yet, at times, strangely uplifting as the drama’s unlikely heroine courageously fights and, to an extent, though not as resoundingly as one would’ve liked, defeats powerful vested interests - The Cure is a story that, above all else, serves as a timely reminder of the things we can’t say about ‘our’ NHS, even if its employees kill our loved ones.
The story begins as Julie Bailey’s elderly mother, a bright, kindly 86-year old lady named Bella, is taken ill with complications caused by a pre-existing hernia. What should have been a routine medical response for a treatable condition, however, turned into an eight-week ordeal. Bella was subjected to the daily invective of a nurse more suited to employment as a guard at Ravensbruck and with it, cruel, almost routine levels of neglect. Much to her daughter’s dismay and confusion at the callousness of individuals ostensibly employed to help the elderly and infirm, the nurses withheld vital medication and a disinterested doctor nonchalantly informed her of her mother’s imminent and unavoidable death, contradicting a colleague who had recently described Bella’s condition as eminently treatable.
Finally, after two long nightmarish months, the hospital delivered what can only be characterised as a coup de grace. Bella was forcefully dropped onto her hospital bed and, as a consequence, died of heart failure shortly afterwards. It really was heart-wrenching.
Bella’s experience was no exception, though, as became horrifyingly apparent to her daughter both during and after her ordeal. Julie witnessed a desperate, dehydrated and disoriented patient drinking water from a vase, food left out of a neighbouring patient’s reach and later, when embarking on her campaign for justice, hundreds of victims’ families with similar stories of abuse and neglect. On a personal level, having witnessed the mistreatment of my own grandparents at the hands of a clearly failing health service, I found it particularly harrowing, memories of neglect and the daily battle for decent, humane treatment flooding back.
I’ll say it again: the NHS is failing! Its labyrinthine, impenetrable bureaucracy is impossible to navigate, as demonstrated by the endless and confusing list of agencies and acronyms that make it up. The Department of Health (DOH), General Medical Council (GMC), Nursing and Midwifery Council (NMC), the Chief Independent Health Regulator known as Monitor, the Strategic Health Authority (SHA), Primary Care Trusts (PCTs), the Patient Advisory Liaison Service (PALS) and the HCC (Independent Health Regulator Watchdog). See what I mean? This multitude of interconnected tentacles is not only impenetrable for patients, opaque and impossible to understand thus disempowering, it’s also dehumanising. The patients become mere pawns, often irritants, in the daily game played by multifarious producer interests relentlessly competing and jostling for favoured positions within the bureaucracy.
Patients become nothing more than numbers as ambitious bureaucrats obsess over data and targets. At one point in the drama, the CEO of Mid-Staffordshire NHS Trust, Martin Yeates, suggested altering the way the Trust collected data in a bid to hide the fact that its mortality rate was 40 per cent higher than the average. No concern for the patients, just a desire to save his career, an appalling trait shared by Toni Brisby, the Chair of the Trust, who, in one scene, gave grieving families just three minutes to share their experiences before abruptly cutting them off. They were clearly an inconvenience. She had better things to do with her time, like trawl through and manipulate data, one supposes.
I was left wondering whether the bureaucracy is to blame for such spiteful, insensitive behaviour. In other words, given the unique, highly charged and, yes, undermanned milieu, would we all become like Yeates, Brisby and the abusive nurses and care workers, or does it take a sociopathic personality to display such cruel indifference? I’d go with the latter. I don’t care how pressured and overworked you are, common humanity, your ability to empathise, should always inform your actions. Look at the tortured, wonderful nurse and whistleblower. She was a beacon of light in a dark dystopian cesspit of maltreatment.
The problem that the NHS faces, however, is that the wrong people are attracted to such bureaucracies. Caring, good, apolitical people have no wish to enter such a cutthroat and deeply cynical organisation. Those that do, I suspect, are either fighting against the tide or ready to give up, frustrated and demoralised. I have several friends in this latter category. In addition, and according to another friend who was an NHS manager and before that, worked in a Trust’s HR department, it’s almost impossible to sack someone for incompetence. So mediocre, sometimes highly unsuitable individuals are left to do their worst.
The most striking aspect of The Cure, however, apart from the wonderful performances of the actors, was the degree of opprobrium that Julie Bailey attracted for making public her mother’s treatment. Her shop was vandalised, her tires punctured, she was shunned by the local community and even received death threats. In the end, she had to close her business and move away. And what happened to the individuals responsible for hundreds of needless deaths? Yeates, the CEO, was suspended on full pay before resigning. That’s right, not a single prosecution was pursued. Julie may have received a well-deserved MBE but, in many ways, she endured a harsher punishment than the care workers, nurses and NHS executives. She was the one hounded out of her home.
Our politicians spent the whole General Election talking about the NHS whilst saying the sum total of nothing. It was extraordinary. You could be forgiven for thinking that everything is perfect, provided we chuck it a few more quid. This couldn’t be further from the truth. It needs root and branch reform. But incessantly calling it ‘our’ NHS as though it’s some kind of sacred, infallible institution, denouncing critics as puppets of big-pharma and the US, and intimidating into silence anyone who questions or criticises its care, is obstructing open debate, discussion and, as a result, the reforms we so desperately need.
I would urge our politicians to watch The Cure and take inspiration from Julie Bailey. If they demonstrate a tenth of her implacable courage, we really will have the best health service in the world.