Leading article: Ministers, mixed wards, and mixed messages

Thursday 31 January 2008 01:00

So, after more than 10 years in office, two specific manifesto pledges and a host of denials that anything was amiss, the Government has finally coughed up its admission. There will be no end to the practice of accommodating male and female patients together in mixed wards. It cannot be done without rebuilding the NHS and providing single rooms for all.

This is the gist of what the Health minister, Lord Darzi, told the Lords this week. An eminent surgeon, who is conducting a comprehensive review of the NHS and is one of Gordon Brown's "big tent" appointments, the minister cannot be accused of not knowing what he is talking about. That his words elicited no more indignation than they did can be explained only by the somewhat sheltered nature of his audience.

In fact, they deserve a howl of national rage, a howl that should crescendo until ministers have no choice but to address the complaint. We have, it turns out, been led by the nose for a decade – fed an "aspiration" (Lord Darzi's word) that could not, apparently, be met.

When Tony Blair, then in Opposition, said that it should not be "beyond the wit of government" to get rid of mixed wards, we believed him. It seemed so simple. Was there not a time, in living memory, when men and women were automatically accommodated separately? No one of a certain age would have dreamt of finding himself or herself sharing a hospital ward with the opposite sex. How come this was suddenly so elusive?

Thereafter, we were periodically informed of "progress". The 2002 deadline came and went. When Patricia Hewitt was Health Secretary, we seemed within an ace of the goal. She had then to agree with unhappy patients that space divided by curtains and partitions was not exactly what most patients had in mind when they envisaged a single-sex ward.

Much can happen in 10 years. The Government is never shy of boasting about how many new hospitals have been built, how many new doctors and nurses recruited. Yet even the latest hospitals rarely offer separate wards. Even if they occupy separate bays, male and female patients must often share bathrooms. For whose benefit were these lavish palaces to medicine built?

Lord Darzi gave some of the game away when he told the Lords that "medicine has moved on" and wards are now "based on disciplines and expertise of the staff". In other words, they were arranged (like GPs' contracts) in "their" interests, and not in "ours". Clearly a fast-learner at the Labour "spin" school, he also ventured that the aim had never been separate wards, only separate "accommodation".

Eleven years after Mr Blair's burst of incomprehension, one in five patients is still placed in mixed accommodation. The indignity and misery this causes is eloquently chronicled in these pages by Janet Street-Porter, whose sister was treated for terminal cancer on such a ward. Yesterday, a report for the Mental Health Act Commission found that women and young people were accommodated in mixed-sex wards, with the attendant risk of sexual abuse. Many described their stay on such wards as frightening. Whether a patient is physically or mentally ill, such an atmosphere can hardly speed recovery.

In a rare moment of clarity amid the gobbledegook and spin, Lord Darzi said there could be no single-sex wards without building "the whole of the NHS into single rooms". Clear this might be, but it is nonsense. Mixed wards will be abolished when the Government gives hospitals no choice but to do so. There can hardly be a prospective patient who does not regard this as an absolute priority. Shockingly, the Government has just changed sides.

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