LORD MANCROFT AND THE NHS

Lord Mancroft , cofounder of the Addiction Recovery Foundation in 1989 and its chairman until he became its patron in 2007, has been in the news recently due to speaking in the House of Lords about his personal experiences in the NHS. In the interest of full disclosure, we abridge an article by JENNY McCARTNEY of The Telegraph 2 March 2008.

Lord Mancroft, the 50-year-old Tory peer who startled the nation on Friday with his disparaging remarks about nurses, is evidently not a man to mince his words. He was admitted to the Royal United Hospital in Bath, last August, for the treatment of an abscess and was unimpressed with the quality of care he received.

"The nurses who looked after me were mostly grubby - we are talking about dirty fingernails and hair - and were slipshod and lazy," he said. "Worst of all, they were drunken and promiscuous. How do I know that? If you are a patient in bed and you are being nursed from either side, they talk across you as if you're not there. So I know what they got up to the night before, how much they drank and what they were planning to get up to the next night. It's pretty horrifying." Furthermore, he complained, the ward was filthy.

Lord Mancroft's speech in the House of Lords provoked a furious response at the hospital where he was treated. Francesca Thompson, the director of nursing at the Royal United, said that nurses were "devastated" by his comments. James Scott, the hospital's chief executive, challenged him to name the nurses involved, protesting that "he has made very serious allegations against a group of professionals".

Even David Cameron, the Tory leader, felt it necessary to slap down the peer. "He should think more carefully before opening his mouth," Mr Cameron said yesterday. "My experience of the NHS is 100 per cent different."

THE PUBLIC TRUTH

In 2005, a Channel 4 Dispatches programme investigated the truth of such allegations by equipping two experienced nursing assistants with hidden cameras. They spent three months at Ealing Hospital, London, and the Royal United Hospital in Bath - the hospital in which Lord Mancroft was treated. They uncovered a lack of basic precautions around patients infected with the superbug MRSA and the frequent ignoring of calls for help.

The truth is that many patients feel the same as Lord Mancroft. For many years, the public's perception of nurses was of dedicated professionals who were only slightly lower than the angels. Today, however, growing numbers of patients are complaining of a sharp difference between that nursing ideal and the shoddy, perfunctory reality that they experience on the wards.

Last month, it was announced that a course had been set up in Stockport, Manchester, to train nurses in appropriate behaviour around patients. Judith Morris, the deputy director of nursing at the Stockport NHS foundation trust, said that it was a response to numerous complaints from the public.

Some of the aspects of hospital care that patients find most frustrating are not the fault of nurses. Many wards are understaffed, leaving nurses burdened with paperwork and with less time to spend on one-to-one patient care. Frequently, too, excellent nurses find themselves demoralised by a bureaucratic and shambolic system, and colleagues with lower standards of behaviour.

One senior male nurse at a London hospital once described to me his exasperation as he watched a cleaner go into a room that had to be kept sterile, carrying a colour-coded mop meant for cleaning the filthiest of substances. His rebuke was met with a shrug.

Older nurses, who trained under a more exacting system, often express shock, when they return to the wards as patients, at the behaviour of younger nurses. Some say that the emphasis has shifted from nursing as a vocation to a job in which procedure has become more important than patient care.

Lord Mancroft's unease seemed to be as much about the manner of the nurses as their professional competence. He described their preoccupation with sex and drinking as "an accurate reflection of many young women in Britain today". It is true that it has become socially acceptable for young British women to brag about alcohol consumption and discuss sex with an openness that would have been unthinkable to their grandparents' generation.

The trouble is that many patients may be from their grandparents' generation or from a more reticent culture. That may explain why among some doctors there is a higher professional admiration for some foreign nurses than for younger British ones. "The Filipino nurses are generally really lovely to the patients," one hospital doctor I know said.

The public's sympathy with nurses is traditionally strong: but their behaviour is not always beyond reproach.

Before the outrage at Lord Mancroft's remarks reaches fever pitch, perhaps nurses should contemplate the uncomfortable fact that many more vulnerable patients would agree with him.