Dirty toilets - 2018
Recently I complained about the dirtiness of some public toilets. The person who was supposed to clean them was not impressed, and very defensive. They seemed to think the toilets were fine, which I found quite puzzling. Looking at them a few weeks later it was clear that no serious cleaning had taken place. I struggled to see how the dirt could be denied and ignored. It reminded me of the experience of a Guardian journalist described in Claire Hilton’s “Improving Psychiatric Care for Older People: Barbara Robb’s Campaign 1965–1975”. ‘piles of faeces, some on a table’- 1968 Ann Shearer was invited to visit a hospital by an aunt of a child who was a patient. She wrote an article in 1968 ‘Dirty children in a locked room: A mental hospital on a bad day’ which revealed ‘…atrocious standards’. ‘…she witnessed squalor, including piles of faeces, some on a table’ (p.206-207). She experienced the following responses: ‘Senior staff at Harperbury rejected Shearer’s criticisms, saying that she lacked formal training or experience of working with mentally subnormal people. NHS managers described her as irresponsible, denied the allegations and blamed her for worsening staff morale and recruitment, undermining public confidence, and laying the last straw on the breaking backs of staff (Shearer 1976, p. 110). These defensive responses, eerily similar to those experienced by Barbara and the Sans Everything witnesses, give the impression of being automatic rather than stemming from methodical consideration. Rather than appealing to the Ministry to help put things right, the RHB complained to the Press Council, which investigated and interrogated Shearer. At the inquiry, as she recalled in 2015, Lord Devlin asked her how many piles of excrement she had seen. She found the question so bizarre and irrelevant to the main issue that she angrily replied ‘Shit is shit, my lord.’ The Press Council upheld the RHB’s complaint and criticised the Guardian for lack of objectivity and accuracy.’ (p.207). The Guardian later republished the article and was again greatly criticised. In response ‘Psychiatrist Leopold Field (1968) responded with a letter that NHS managers, when criticised, ‘develop an acute attack of paranoia and defend themselves in the most hysterical of terms’’ (p.207). ‘faeces on furniture’ - 2013 Moving on 45 years to the Southern Health Trust and Connor Sparrowhawk. The tragic story about Connor’s preventable death in 2013 is described in ‘Justice for Laughing Boy’ (2018). He too was in a locked room, this time a bathroom. Dr Sara Ryan describes the death of her son as ‘A death by indifference’. ‘We now knew we had left Connor in a shitty unit, which turned out to be even shittier than we imagined. The report [CQC, 2013] read like an inspection of a Victorian asylum; from no engagement with patients to medicines out of date and not stored properly, to faeces on furniture’ (p.102-103). Some of the emergency equipment wasn’t working and the oxygen cylinder had expired. Also, ‘Basic humanity, decency and sense were bafflingly absent in the responses to the family from health and social care professionals’ (p.102). The responses of Southern Health were, as in the other situations above, very defensive. ‘Getting accountability or justice for Connor’s death was to be a gargantuan task as, just as we had been warned, Southern Health NHS Foundation Trust continued the fight to protect its reputation.’ (p.115). One of my research participants said that 'There are many cultures within NHS organisations, but a common denominator with each is defensiveness’. Another described the NHS as having a ‘…defensive default’. Even after researching dysfunctional and perverse behaviour in the NHS for quite a few years it is still a struggle to fully understand how people can try to defend such obvious failings and such an appalling lack of basic standards; a determination to ignore blatant reality. Ann Shearer was right. Dirt is dirt, faeces is faeces and ‘shit is shit, my lord’. Shearer, Ann. 1968. ‘Dirty children in a locked room: A mental hospital on a bad day’. Guardian, 28 March.
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