Christine Hunt
Age Concern England
Associations and Societies Young Thinker of the Year

I have just locked all the doors to this room. You won't have any food or water today. If you need to go to the toilet, you need to ask my permission to leave. And if I'm too busy or I'm on my lunch break, then you are just going to have to go in your pants. If it would make you feel less uncomfortable, I can give you an incontinence pad or a nappy to wear. So tell me, how dignified do you feel right now?
     What you've just experienced is a taste of what it's like to be an older patient in hospital, stripped of your dignity from the moment you enter the ward. You find yourself begging the nurses to take you to the toilet. The response is always: 'in a minute, darlin' or 'just a minute poppet'. And 'a minute' never happens. You are left to soil yourself. So I'm sick and tired of the government making pledges in its health bills, general election manifestos and countless speeches about improving dignity in care for older patients. All it does is widen the gap between the rhetoric and the reality; and the reality is that dignity in hospitals is in very short supply.
     Dignity is just a meaningless word; it has been debased by the politicians who use it glibly and never back it up with any radical reform or investment. Let me explain what I mean.
     In 2006 the government launched a Dignity in Care campaign to stamp out abuse and disrespect of older people in hospitals. It aimed to do this by raising awareness about dignity and sharing and rewarding best practice. It certainly grabbed the headlines but it had no influence. Not even a year on, we witnessed a shocking scandal at three hospitals in Kent when it was revealed that nurses were 'too busy' to take patients to the toilet. Patients were told to 'go in their beds' and were left to lie in their own excrement for hours. It was this horrible neglect that led to a superbug outbreak that killed 90 of their patients. One of those patients was Mary Hirst, aged 83. She went to the hospital with a broken hip and contracted C difficile and MRSA. Her daughter, Jackie Stewart, reported:
     'She was left in her own soiled sheets and was sobbing because nobody had cleaned her up. Her treatment was appalling. She was not fed properly, not being cleaned, and there was only one commode between six patients. She didn't die of a broken hip, she died of hospital neglect.'
     This kind of treatment is unthinkable. Politicians give us a Utopian view of what dignity should look like but they ignore the barriers standing in the way of achieving it. NHS resources are spread so thinly that hospitals are bad for your health. Eight out of 10 nurses (let me repeat that – eight out of 10 – hardly a minority) say they're unable to treat patients with the dignity they deserve because of staff shortages, a lack of specialist equipment, and unfit wards. They admit they're so overstretched that they don't even have time to deliver basic care, like helping an older patient to eat their meal. Food is just taken away untouched and thrown out. It is one of the reasons why so many older patients become malnourished during their stay. To make matters worse, older patients are still subjected to the indignity of mixed-sex wards despite an election pledge from the government to abolish them some 10 years ago, a pledge it repeated in a 2001 manifesto.
     I'd like you to imagine for a second that your beloved grandmother is in hospital and she is very sick and vulnerable. She has a skimpy privacy curtain that doesn't fully close and she has a male patient in the bed next to her. He can see everything; when the nurse changes her, when she's left on a commode, when she wears one of those night dresses with the split back that leaves her fully exposed. How does that make you feel? Spare a thought for the 94-year-old woman who woke up in the middle of the night to find a sexually-aroused male patient masturbating over her bed. So it infuriated me to hear Health Minister Lord Darzi announce earlier this year that the elimination of mixed-sex wards was 'an aspiration that cannot be met'. It's just another example of the government's shameful failure to deliver on its promises, while telling us they are doing 'everything in their power' to strive for better dignity in care. I don't question that the government has thrown a lot of money at the NHS, but it never reaches the bedside. Patient care hasn't improved. Wards are still understaffed, unfit for purpose and under-equipped. Nurses are still underpaid and demoralised. You can't deliver dignity to patients in an undignified environment. It needs radical change.
     The NHS needs a major face-lift: more staff, capital investment, strong leadership, dignity training and more patient involvement. Until then, dignity is just a cheap and meaningless buzzword overused by politicians to hide their failures. Until then, hospitals will continue to breed a culture of 'supervised neglect' that will put more vulnerable older patients at risk.
     Oh, and don't worry, the doors aren't really locked. You will be fed and watered; you can visit the loo when you need to…because you're not old. And you're not in hospital.

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