Janet Street-Porter: Time the NHS starts putting patients first

Today this newspaper publishes a letter from David McVittie, the chief executive of Hillingdon Hospital Trust and its consultant oncologist, Dr Catherine Lemon. They accuse my sister and me of writing "misleading and sensationalist" half-truths about the care offered to her as a terminally ill cancer patient.

Let's be clear; the meeting held at the hospital between various executives and the doctors involved with my sister, was called at my behest, after she appeared to be slipping into unconsciousness in the totally unsuitable environment of a noisy mixed ward. Only then was she offered a place in a hospice, an option she was previously unaware of.

My sister had been writing her diaries (published in The Independent last Thursday and subsequently in two other newspapers) because it seemed to her that there was a fundamental breakdown in communication between the team "caring" for patients like her in the community and those based at the hospital. She was also appalled at having to endure the basic facilities and horrible indignities of a mixed ward, one of the main reasons she opted to end her life at home in the first place.

Since her diaries appeared, people have called, e-mailed, written and stopped me in the street to say that they hate mixed wards and consider them degrading; many people have had relatives or friends endure similar experiences.

GMTV was swamped the other morning with e-mails and calls from viewers agreeing that mixed wards are despicable. Letters from other former patients of Hillingdon hospital agree with much of what Pat wrote. Mr McVittie did not attend the meeting when Pat was dying, but it is true that the hospital apologised for her distress, and, as he so tactlessly puts it, "a few issues were raised' which he assures us he will be addressing. Not much use to Pat during her last 12 hours of life.

Pat had no complaints about the care offered by the cancer specialists at Hillingdon, or the wonderful skills of the people in the A & E department. What she couldn't understand was why nurses slept on empty beds during the night shifts, why no one had heard of her in the anti-coagulation unit, why carer after carer turned up and no one told her what they were meant to do. Why district nurses took blood samples, but left them for her hard-pressed husband to drive to the hospital. Why an emergency doctor's service for the terminally ill took more than two hours to respond on more than one occasion. Why she was only allowed one pillow on Grange Ward and why she left hospital in a delivery van with no one checking her medication, no diet leaflets and no information about the side effects of warfarin.

The trust told the media (via a statement) they were going to hold an inquiry, and publicly apologised to Pat's family. The first contact my brother-in-law received from the hospital was a phone call, a day after she had died, asking him if they could collect the bed and other equipment. Not surprisingly, he was distraught. He received a letter from the hospital apologising for what had happened and giving him details of their inquiry yesterday, almost a week after her death.

Denigrating the observations of someone who cannot answer back is not only tasteless, but misses the point. All Pat wanted was for other terminally ill patients in Hillingdon to have a better death than she did. She was full of praise for the nursing staff, but enraged by the bureaucracy and disorganisation she had to deal with each day.

Mr McVittie seems to harbour suspicions that somehow Pat and I had a hidden agenda in writing what we did. No! Our agenda was hardly a secret - to make sure that the National Health delivers what it promises and that the pen-pushers who write letters like his realise that it's time to start putting patients first before anything else.

Dreaming of a Brown Christmas

Round One to Gordon Brown in the Battle of the Christmas Cards. The Treasury's card features a bunch of ethnically-diverse youngsters reading around a tree while one little girl looks glumly at the ministerial briefcase, obviously left by their host. The message seems to be that Gordon values the young. Meanwhile, the omens are not good for the PM's card. Tony Armstrong-Jones revealed he snapped Tony and Cherie recently and thought the picture was to be released at Christmas. The Royal photographer was struck by how our PM has aged since 1997. Perhaps Tony and Cherie should have donned wigs and period costume. I'm sure posing as Nelson would drop a lot of hints about being regarded as a national hero.

* Gordon Ramsay's Kitchen Nightmares has just won an Emmy, and this week's episode contained so many brilliant moments, I lost count. Gordon tried to tell Ray, the owner-chef of a failing Lancashire pub, to stop serving over-elaborate food, stay out of the kitchen and throw out the funny plates. First a skip in the car park was filled up with redundant friers, stock pots, and kitchen detritus. Then Ray launched a new menu by parading around Kirkby Stephen with a megaphone proclaiming the Fenwick Arms the place for real gravy. The place was full, for the first time in months. Gordon departed happy. A month later, he returned to discover Ray back in the kitchen and a weird prawn cocktail served with mash on a scallop shell - one of Ray's "signature" dishes - back on the menu. It's TV like this that the British now lead the world in - like Wife Swap, these reality shows are sophisticated entertainment, packaging meaty stories. In the end this was a battle of machismo - and Ray may have wielded the spatula, but he lost the battle.