How to solve a problem like the NHS?

Florence Nightingale's Notes on Nursing, published in 1859, states that the "greater part of nursing consists in cleanliness", says Charles Moore in The Daily Telegraph. One hundred and fifty years on, for all our advances in education, technology, prosperity and science, this basic truth has been forgotten. Between 2004 and 2006, 90 patients in the three hospitals run by the Maidstone & Tunbridge Wells NHS Trust died from Clostridium difficile, and the disease contributed to the death of a further 241. This disease is an infection spread through spores in faecal matter: relatives of those who died reported that their loved ones were told to go in their beds' and were left lying in their own excrement. "Were it not for bad nursing, bad medical attention and bad administration, none of these patients need have died."

If Sainsbury's cold-meat counter killed 300 people, the firm wouldn't survive. Yet the NHS "sails on, dealing death", because we cling to the idea that a "single organisation employing 1.4 million people, with the GDP of an entire Scandinavian country, run by politicians, can meet our health needs". It can't. Under systems of social insurance, as in France and Belgium, problems remain, but there is "no danger that any patient will be treated as a nuisance" and hospitals are spotless. Money follows patients, who choose who treats them so every doctor and nurse wants patients.

Nursing lies at the heart of this scandal, said Lois Rogers in The Sunday Times. We have lost sight of what nurses are meant to do. Many nurses feel they are above emptying bedpans; politicians are reluctant to take on a profession widely seen as "overworked and underpaid", even though they earn an average of £30,200 a year with senior grades, including the modern matrons', on nearly £90,000. But there simply aren't enough of them, says The Sunday Telegraph. From 1997 to 2002, NHS staff numbers rose 16%. But if you look more closely, administrators and managers rose by 47%, nurses by just 2%.

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This is a symptom of the "monstrous inefficiency" with which taxpayers' money is being spent, said Patrick O'Flynn in the Daily Express. Spending on the NHS has almost doubled under Gordon Brown, but health outcomes have improved by only the smallest margin. A fortune is wasted on financial consultants; superbugs fell thousands and procedures such as tattoo removal are available free while life-saving drugs are withheld. The Maidstone & Tunbridge Wells NHS Trust is a prime example of the current state of affairs, said Rogers. Under the leadership of Rose Gibb (who was, until her resignation last week, on a salary of £150,000 and now stands to receive a £400,000 pay-off), they neither declared the outbreak of Clostridium difficile, nor tried to contain it. Instead they focused on saving money, cramming in beds and cutting staff. As patients dropped like flies, the trust spent almost £700,000 on turnaround' consultants, to advise on cutting costs. So much for our target-driven NHS.

And this is Kent, for heaven's sake, not some inner-city slum, said Amanda Platell in the Daily Mail. But nothing will change until politicians stop treating the NHS as a "sacred cow" and radically reform it. As for superbugs, the solution is simple, said Rogers. Mark Enright, a specialist in hospital-acquired infections at Imperial College, London, says: "You wash your hands, you wash the beds after the patients have been there, you have the laundry services working and everything should be OK." How many turnaround consultants do you need to tell you that?