Table Of Content‘A searing condemnation of neglect and abuse of older people in our health
services, this is a must-read volume to spur us to action. We tolerate the appalling
treatment of older people in some of our institutions (by no means all) because,
as a society, we don’t think they matter. If we visited more, challenged more,
took ownership more seriously, and gave care staff, often pressurised and
underpaid, more respect, things might get better. Michael Mandelstam is to be
congratulated for drawing this to our attention. Now it is up to us to find the
solution – and that lies partly in valuing those who care for our older people
better, paying them better, and regarding care as a serious career choice.’
– Baroness Julia Neuberger
‘Successive reports on catastrophic failures in the nursing care of desperately
sick people in our hospitals have had little effect. They have failed to see the
systemic nature of the problem and, worse, have proposed box-ticking solutions
to what is often the abandonment of common humanity. Michael Mandelstam’s
documentation of a continuing scandal that touches on all of us is worth a
thousand expensive inquiries. This brilliant and impassioned book should be
mandatory reading for policymakers and all of those who care for vulnerable
people.’
– Raymond Tallis FRCP FMedSci, Emeritus Professor of Geriatric Medicine and
author of Hippocratic Oaths: Medicine and its Discontents
‘Amidst the striking advances in modern medicine stands the starkly contrasting
deterioration in the day to day care of vulnerable patients. Neglect and abuse of
elderly and incapacitated patients in our hospitals and nursing homes is not a
rare or occasional scandal picked out by the media. The picture painted in this
timely book strongly points to a much wider spread of failures of acceptable
standards of care. Despite any number of published inquiries little seems to have
changed in the last few years. This excellent book now demands action not
words from the professi ons and Government.’
– Lord Leslie Turnberg
‘How We Treat the Sick is a call for action. NHS staff have been smothered and
de-motivated by countless targets and controls. Focused regulation and more
autonomy for front line staff could transform the experience of patients.’
– Baroness Molly Meacher
‘Michael Mandelstam has provided a devastating account of some of the more
horrifying aspects of the care provided by the National Health Service. As he
points out this is not necessarily typical of all care provided, even by those
institutions mentioned in the book. It is however a sufficiently alarming book
that should be read by everyone concerned with health care in Britain, and
demands attention both from the organisations concerned and from those
responsible for the management and reorganisation of the NHS.’
– Tim Yeo MP
‘How We Treat the Sick by Michael Mandelstam considers in detail evidence of
what has been happening to some hospital patients, particularly older people,
over the past 14 years and seeks to explore the moral and legal implications of
that record. As a passionate believer in the NHS and what it stands for, and in the
prevention of elder abuse, I believe this issue deserves much greater recognition
as it has important implications for service provision across the country. Looking
forward we must not see the criticisms in the book as a threat to the NHS, but
rather as a pathway to better practice.
While the book ends on a pessimistic note, I am more hopeful that matters
could change for the better. For as the book tells us the recent past hasn’t been
a dark experience for everyone and the excellent care and attention provided
for most people by the NHS only serves to highlight the fact that, if the will
is there, it is perfectly possible to provide good quality care within the current
resource limitations.
Going forward we can, and must, do much more to improve, firstly the
health and social care of vulnerable people who cannot speak for themselves
and secondly, the training and morale of those whose job it is to care for them.
A good place to start would be immediately to begin the process of vigorously
consigning to history the bad practices so clearly highlighted in this important
book.’
– Baroness Sally Greengross OBE
How We Treat the Sick
by the same author
Betraying the NHS
Health Abandoned
ISBN 978 1 84310 482 7
Quick Guide to Community Care Practice and the Law
ISBN 978 1 84905 083 8
Community Care Practice and the Law
4th edition
ISBN 978 1 84310 691 3
Safeguarding Vulnerable Adults and the Law
ISBN 978 1 84310 692 0
Manual Handling in Health and Social Care
An A–Z of Law and Practice
ISBN 978 1 84310 041 6
Michael Mandelstam
Foreword by Lord Justice Munby
HoW We
TreaT THe
Sick
Neglect and
Abuse in Our
Health Services
Jessica Kingsley Publishers
London and Philadelphia
Crown copyright material is reproduced with the permission of the Controller of the HMSO and
the Queen’s Printer for Scotland.
Parliamentary copyright material is reproduced with the permission of The Stationery Office.
Extracts from The Guardian and The Observer are reproduced with the permission of Guardian News
& Media Ltd.
Extracts from the Daily Mail are reproduced with the permission of Associated Newspapers Ltd.
Extracts from The Times and The Sunday Times are reproduced with the permission of Times
Newspapers Ltd.
Quotes from Patient Opinion are included with the kind permission of Patient Opinion.
Every effort has been made to trace copyright holders and to obtain their permission for the use of
copyright material. The author and the publisher apologise for any omissions and would be grateful
if notified of any acknowledgements that should be incorporated in future reprints or editions of
this book.
First published in 2011
by Jessica Kingsley Publishers
116 Pentonville Road
London N1 9JB, UK
and
400 Market Street, Suite 400
Philadelphia, PA 19106, USA
www.jkp.com
Copyright © Michael Mandelstam 2011
All rights reserved. No part of this publication may be reproduced in any material form (including
photocopying or storing it in any medium by electronic means and whether or not transiently or
incidentally to some other use of this publication) without the written permission of the copyright
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Library of Congress Cataloging in Publication Data
A CIP catalog record for this book is available from the Library of Congress
British Library Cataloguing in Publication Data
A CIP catalogue record for this book is available from the British Library
ISBN 978 1 84905 160 6
ISBN pdf eBook 978 0 85700 355 3
This book is written in memory of the staff at the Walnuttree Hospital
in Sudbury, Suffolk. For so long they provided skilled, compassionate,
dignified inpatient nursing, genuine rehabilitation and palliative care for
their patients. It was the very antithesis of the neglect and degrading care
described in this book. Until, in October 2010, they were allowed to
provide it no longer.
It is surely of interest that they achieved this without outcomes,
targets, indicators, priorities, excessive gathering of statistics, unceasing
structural change – in fact, without all these hallmarks of the modern
health service.
This type of inpatient care was what local people had so appreciated
and wanted. They fought for it desperately over a period of six years,
during which time it was continually threatened by bureaucrats and
accountants. In an age of ‘patient choice’, it was then taken away.
Acknowledgements
I must thank, above all, Jessica Kingsley for her support and encouragement,
and for believing that the book would have something to say. Also her
staff, in particular Helen Longmate, Rachel Menzies and Victoria Peters
for their unstinting efforts and tolerance. In another quarter altogether,
I owe a great debt to Peter Clifford for reading through the draft with
such a helpfully critical eye and for finding and digging out some of the
raw material.
Description:No official statistics are kept for the number of hospital patients, in particular older people, who are subjected to neglect and abuse. That is, left malnourished and dehydrated, in pain, allowed to develop agonising and fatal pressure sores, not taken to the toilet, left to lie in their own bodily
