• Audit

In February the NHS Ombudsman released a report into care standards for elderly patients; called ‘Care and compassion?’,1 it received widespread media coverage with a score of damning and derogatory headlines about the NHS. Accompanying analyses were equally scathing; the NHS reflects British society and the country has the service it deserves (similar to the old adage that a society has the police service it deserves), the NHS is centred around the needs of staff and not the patient and it has become too big for its own good and needs radical pruning.

Other points extracted from this barely restrained rhetoric are that these poor standards are the inevitable end point of a target-driven NHS culture that emphasises form-filling and the ticking of boxes under the auspices of a clipboard wielding manager, they reflect the dumbing down of postgraduate training in medicine, the change in working hours and shift patterns of doctors, an overemphasis on extended qualifications in nurse training and the obligatory (it is fashionable to blame them for everything) Generation Y problem. One consistent question rises out of this maelstrom of noise: does the …