Uncaring, slapdash staff; patients left in pools of vomit or faeces; falls resulting in cranial bleeds, despite the supervision of nurses. The Patients Association’s recent dossier of nasty nurses is scary stuff, and it has made hearts sink all over the National Health Service.

The Patients Association is unusual for a charity in that it seems purely devoted to criticising the NHS. As anyone who has ever had a professional appraisal will know, there is useful, constructive criticism, and then there is another kind, which pours scorn without offering solutions.

The Patients Association produced its report in response to a number of complaints about bad nursing care. There is no doubt that this is a problem in the UK. Some of the stories in the dossier are harrowing. But as a scientific study of the state of nursing care in the UK, it is poor on almost all counts. These are selected stories, and by dint of self-selection, they are not representative of most people’s experience. Indeed, larger surveys run by the NHS suggest that about 2 per cent of patients complain of poor care. Certainly, this is 2 per cent too much, but it should not lead people to imagine hospitals staffed entirely by callous nurses.

The Patients Association doesn’t seem to recognise the problems which nurses face in doing their job. The front of the dossier declares “Patients … not numbers, People … not statistics.” But I don’t think heartlessness is the problem. In reading the stories, it becomes clear that bad care happens in woefully understaffed wards, where nurses are filling out paperwork rather than seeing patients, and where shift changes lead to layers of staff who know less and less about what is happening.

None of this excuses bad care, but it does make it more likely. When I started in medicine, nurses used to go around the ward at regular intervals, taking temperatures and blood pressures themselves. They would spot a dressing that needed changing and would learn who felt sick, or who was desperate for the commode. Now these duties are relegated to a nursing assistant, who may be kind and caring, but has little training and is not a nurse.

Hands-on basic nursing care has become an ever-lowlier occupation, as nurses sit at the computer filling out care plans. The Department of Health wants nurses to aspire to being managers, or specialist practitioners. There is no reward, and no thanks, for being an “ordinary” nurse – cleaning dirty feet or taking a glass of water to someone’s lips. If the Patients Association wants to make a difference, it could start by declaring nursing an essential, honorable and professional vocation, and making the government realise that it needs to be valued and rewarded.

Margaret McCartney is a GP in Glasgow.
margaret.mccartney@ft.com

For lively discussion of the latest medical issues go to the FT’s Health Blog