How We Treat the Sick: Neglect and Abuse in Our Health Services

About the Book

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 waste, cared for in a filthy environment and at risk of infection, ignored, allowed to fall over repeatedly, not spoken to, left naked or dressed in other patients' clothes - and discharged from hospital prematurely. This book bears witness to all these practices and more.

Setting out a wealth of evidence not previously brought together, Michael Mandelstam shows beyond question that neglectful care is a systemic blight, rather than mere local blemish, within our health services. He analyses the causes and factors involved, reveals the widespread denial and lack of accountability on the part of those responsible - and spells out the political, moral, professional and legal implications of this failure to care for the most vulnerable of patients with humanity and compassion. Most important, Mandelstam points to the main obstacles to a solution - and to how they can be removed and change be accomplished.

This book should be read by anyone concerned with the state of our health services, including National Health Service users, government policy makers and planners, public health practitioners and academics and researchers.

Table of Contents:
Foreword. Preface. 1. Introduction. 2. Assessing the Evidence for Neglectful and Abusive Health Care. 3. Health Services: Public and Private. 4. Systemic Nature of Neglect and Abuse Within Health Care. 5. Dignity in Care: All the Good Guidance. 6. Dignity in Care: All the Bad Practice. 7. Getting to the Toilet and Management of Continence. 8. Keeping the Environment Clean and Managing Infection. 9. Helping People Eat and Drink. 10. Pressure Sores and Falls. 11. Hospital Beds, Admissions, Stays and Discharges. 12. Older People: the Unwanted. 13. Patient Voices, Consumers and Markets. 14. Staffing Levels, Competence and Attitude. 15. Priorities, Targets, Fear and Bullying. 16. Misinformation, Concealment and Spin. 17. Muted Voices: Clinical and Professional Integrity. 18. Denial, Accountability and Blame. 19. Legal Implications of Neglect and Abuse. 20. Human Rights. 21. Criminal Offences of Ill Treatment or Wilful Neglect. 22. Manslaughter. 23. Health and Safety at Work Legislation. 24. Regulation of Health Care Providers and of Health Care Staff. 25. No Secrets: the Policy of Safeguarding Vulnerable Adults. 26. Negligence. Concluding Postscript. Index.

About the Author :
Michael Mandelstam provides independent legal training to local authorities, the NHS and voluntary organisations. In the past, he worked at the Disabled Living Foundation, a national voluntary organisation, and for a few years at the Social Services Inspectorate at the Department of Health. He holds postgraduate qualifications in law, information studies and the history of science and medicine.

Review :
'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. '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