Jeremy Laurance: A service that can't care has sown the seeds of its own destruction

The NHS remains an institution overly focused on the interests of the providers – the staff.

The exasperation felt by many on reading Ann Abraham's shocking report yesterday was summed up by Katherine Murphy, the chief executive of the Patients Association. "How many reports do we have to have before anything changes?" she asked.

The reaction from NHS organisations was as predictable as spring rain: the same old mantras about the disgraceful failure to accord elderly people the compassion they deserved and the need to learn the lessons.

But the lessons have been issued again and again. It is the NHS's failure to learn that is the problem. Which raises the question, is the NHS capable of doing so?

Some think it is not. They say a monolithic organisation on this scale, with 1.3 million employees, is simply incapable of generating the sense of ownership necessary for staff to take responsibility for the patients in their care.

After reading Ann Abraham's report even the staunchest defenders of the NHS must wonder if they are right.

Ageism is rife in the NHS. That has been established by innumerable investigations over the years. Denial of treatment on cost rather than clinical grounds is less of a problem than it was. But deep-rooted cultural attitudes to ageing remain. As Ms Abraham says, they are personal as well as institutional, a "failure to recognise the humanity and individuality" of the people concerned.

Despite the efforts of the last government to modernise the NHS and the injection of billions of pounds of extra resources, the problem persists. It is hardly surprising then that demands for further reform are heard.

An NHS that cannot feed and wash and relieve the pain of the patients it cares for is not worthy of the name.

Thirty years after Sir Roy Griffiths was drafted in from Sainsbury's to reform the NHS, it remains an institution overly focused on the interests of the providers – the staff. In a million ways – from making an appointment to see a GP to getting help with eating on a hospital ward – its lack of focus on the patient is evident.

Everyone wants a caring NHS, but if it cannot deliver the caring, it will spell its own demise.