Mary Dejevsky: Patient privacy is non-negotiable

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The Independent Online

There will, I have no doubt, be those who sighed: not that hoary old issue again. Equally, there will be those who leapt to accuse the Health Secretary, Andrew Lansley, of cheap point-scoring for harping on a problem that the last, Labour, government had largely solved.

Either way, I suspect a large proportion of his critics will either never have been near a hospital or only encountered one well-padded with private insurance. That leaves the rest of us for whom mixed-sex wards remain an NHS scandal that is very much alive.



We know the supposedly mitigating arguments. Britain still has a lot of hospitals dating from the Victorian era, with big, long wards and no privacy. It's impossible (read expensive) to adapt these to separate men and women – notwithstanding that no Victorian, or Edwardian, or even early Elizabethan, would ever have dreamt of wards accommodating men and women. Then we are told that providing separate wards makes for inefficiency (read expense), because spare beds are needed if women (or men) are not to be turned away, so if we insist on separate wards, waiting times will edge up. And the final gambit is this: even if separate wards are, by some miracle, achieved, hospital geography is such that men and women will probably still have to walk past each other's beds to reach the bathroom. Supposedly that's the best they can do.



Well, it shouldn't be. Tony Blair's remark that it should not be beyond the "collective wit" of ministers to abolish mixed-sex wards remains as valid today as it was 14 years ago when, as a clearly bewildered Opposition leader, he highlighted the problem. Fast forward to 2000, when a new Health Secretary, Alan Johnson, said mixed wards really did have to be abolished. He was correcting an unfortunate slip of the tongue by Lord Darzi, a health minister and eminent surgeon, who had described separate wards as "an aspiration that can't be met". Over the years, hospital managers had ticked their single-sex ward box after splashing out on nothing more elaborate than flimsy curtains and Labour had encouraged, through its Private Finance Initiative, one of the most ambitious hospital building programmes ever.



But the wish still wasn't father to the deed. Curtains are no substitute for walls, doors and separate plumbing. To my mind, even separate bays, which is what many modern hospitals have opted for, is only a halfway solution. Vast sums were spent on impressive atriums (that cost similarly vast sums to heat and clean), lavish back-offices and a computer system that has never worked properly. Patient privacy came second to all these.



And now there are new excuses on the horizon: it won't be long before hospital managers are citing the Government's "localism" and "cuts" as reasons to skimp on desegregating wards. But if there are, as there surely must be, statutory standards for hygiene and space, something similar should apply here. As patients know, but managers still fail to grasp, this basic aspect of privacy should be non-negotiable. Scotland managed it in 2005; Wales is on schedule for next spring. Why is it such a tall order, after almost a decade and a half of edicts, for England to do the same?





Visitors' visas and Russia's revenge



I have written several times decrying the way foreign visitors requiring visas for short stays in Britain are treated by the embassies and agencies they have to deal with. The process often seems expressly designed to make it most difficult for those with genuine reasons to come here, while those who know how to play the system do so with impunity. Well, it may not have been intended that way, but the Russians have devised an exquisite form of revenge.



Their visa service for the UK has now been outsourced to make it, so they say, quicker and more efficient. It entails filling out a form online, printing out said form, then taking it to a cavernous office in one of London's black holes for public transport. You must then queue: first, to be told that your online form was full of errors; second to use one of only two computers to "modify" it; and third to return for a new scolding, before being asked to hand over a photo and pay a large sum of money for combined visa and "service".



Among the questions is one requiring you to list all foreign countries visited in the past 10 years, with dates. (After spending almost an hour trying to find an order or format the computer would accept, I was told it was a known "glitch" and just to put down a few, despite fierce warnings about inaccuracy.) Then they want names, addresses and phone numbers of past employers. And a particularly choice question asks whether you have any specialist knowledge or expertise in nuclear matters. Altogether the process almost makes you pine for the days when you had to stand outside the consulate in the rain. At least there were trees and a pleasant view.



There's no rich and poor in joy-riding



If you live in a benighted area where the community support officers vanish just as the joy-riders come out and the police say they're too busy to deal with non-emergencies, take heart. The fuzz don't necessarily treat the rich any better. After nights of complaining about Arab playboys racing flash cars around their exclusive garden enclave, residents of Lowndes Square in Kensington (price for a one-bed flat from £1m) finally saw some law and order action. But it wasn't before one of the summer visitors, from Abu Dhabi, had ploughed his new (borrowed) Lamborghini into several parked cars and overturned a resident's BMW at 1.30am. The presumed driver was arrested and charged with dangerous driving and driving without insurance. But that's the level the nuisance must reach before it warrants uniformed attention.

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