Why Are British Hospitals So Bloody Awful?

Vernon Coleman

Back in the Middle Ages people were terrified to go into hospital. They knew it was a sentence of death. Relatives started digging your grave as you went through the doors of the local infirmiary.

Things are getting that way in Britain today.

British hospitals are now among the worst in the world. A recent survey of NHS staff showed that only 44% thought that they would be happy with the standard of care provided if they were patients in their own hospital. Many British patients are now travelling half way round the world to get treatment in hospitals where patients are treated quickly, efficiently, hygienically and with respect. So, for example, hospitals in India are offering attractive package deals for British patients who can't wait two years for treatment or who don't fancy the idea of being killed by an antibiotic resistant hospital infection.

Here are ten of the main reasons why British hospitals are so bloody awful.

1. Today's nurses are crap and generally give the impression of being uncaring, lazy and stupid. Things started to go wrong in the nursing profession when self-deluded, self-important nurses decided that they wanted to be treated as academics rather than as nurses. Nursing used to be a sacred vocation. Now it's just a career. I go into a lot of hospitals and the situation almost everywhere is the same: fat nurses sit drinking coffee in meetings. Patients lie desperately ringing their bells wanting attention. Nurses regularly refuse to lift patients. `That's not what we're here for,' one told me. `We're not weightlifters.' If you want evidence supporting the low quality of nursing care just look at the MRSA figures. Britain has the highest incidence of MRSA in the world. There's only one reason for that: sloppy nursing. Nurses don't wash their hands between patients. I've seen them go in and out of rooms where patients with MRSA are being nursed without washing or even wiping their hands. Garage mechanics have cleaner hands than most nurses. Relatives of patients in hospital need to take in antiseptic wipes and clean bed, tables and lockers every day because the staff won't do this. Patients need to have antiseptic wipes so that they can clean their cutlery.

2. The quality of the food served to patients in our hospitals is beyond appalling. You are more likely to contract a food bug in hospital than just about anywhere else in Britain. Hospital food is more likely to make you ill than a hot dog bought from a street vendor's stall. Hospital dieticians and nutritionists know nothing about food. Meat and tobacco are the two biggest causes of cancer in our society. They ban smoking from the wards but they still encourage meat eating. The way the food is served is a joke too. The cleaners put down their mops and hand out the food. Naturally, they don't bother to wash their hands. If the patient is physically incapable of eating what's been put before them then the tray is simply taken away. `Not hungry, dear?' says the cleaner, whisking away the tray as the patient grows weaker and weaker from lack of any sort of food. `We're not allowed to feed patients,' one cleaner told me. `I'm here to nurse,' one overweight nurse told me. `I'm not here to feed patients.' I had a suspicion that she was eating up all the leftovers. It is not unknown for patients who are not visited by relatives to starve to death in hospital.

3. Red tape, political correctness, litigation and a mass of bizarre rules and regulations have wrecked the way hospitals operate. Hospital staff who make egregious errors cannot be punished - let alone told off - because of new employment rules which are weighted dispiritingly in favour of the employee. New EU laws mean that the hours junior doctors spend sleeping must now be counted as time worked. The result is that there are nowhere near enough doctors to go around. And so nurses are being allowed to prescribe drugs and perform minor surgery. In my view nurses aren't trained or equipped to prescribe drugs. Doctors make enough mistakes. If you make a complaint about an employee and the bureaucrats move smoothly into action. At the very best you will get letters thanking you for your concern and assuring you that they are constantly reviewing their procedures. No one dares apologise because they're worried about being sued - either by the person who has been complained about or by the person who has done the complaining. As a result nothing ever happens. The same mistakes are made time and time again. Incidentally, doctors and nurses are now so terrified of being sued that much of medical practice is now governed not by what is right medically, or what makes common sense, but by the potential requirements of lawyers in the courtroom.

4. Hospitals are overrun with administrators. There are now more administrators in British hospitals than there are nurses. There are more hospital administrators than there are beds. When my mother was being thrown out of hospital because she was only 'terminally ill' and not 'finally terminally ill' I attended two meetings. One meeting was attended by nine bureaucrats who were there to insist that my mother be ejected from the hospital. The other meeting, attended by another batch of bureaucrats, was held in an entirely empty hospital ward. `We don't have any beds,' said one of the bureaucrats. `We have to discharge your mother.' It didn't seem to occur to her that they had plenty of beds - there were a stack of them in the room where we were having the meeting. And if they got rid of some of the bureaucrats they would have had plenty of money to hire the nurses they needed. The truth is that doctors have lost control. In an ideal world hospitals would be run by doctors - the only people working in hospital who have taken an Oath to care for their patients. But hospitals are now run by administrators. Doctors do what they are told. As a result most of them have lost interest. Consultants turn up once a week. Junior doctors are rarely seen on the wards. All have to spend most of their time attending meetings arranged by the bureaucrats or by social workers. Hours, days, weeks are wasted on meetings where people who have never met the patient and who know nothing about making a diagnosis or arranging treatment give their views about what should and should not be done.

5. Holistic medicine means treating the patient in whatever way will produce effective, safe results. It means combining orthodox and alternative medicine. But whatever they may claim there are virtually no `holistic' hospitals in Britain. And there are no holistic healers. If you want holistic medicine then you must become a holistic patient. That's a tragedy because most patients don't have the knowledge or the confidence to do this.

6. Hospitals have now got no chronic beds and so the chronically ill have to be thrown out as soon as possible so that there aren't too many patients sleeping on trolleys in the corridors. The mentally ill and the elderly are either discharged into the community (which means thrown out and left to fend for themselves) or they are killed. It is now official Government policy for the elderly to be deprived of essential medical treatment, and sometimes even of food and water so that they die rather than take up much needed space in hospital. You don't have to be very old to be treated this way. In some hospitals anyone over 60 is regarded as expendable. It used to be said that you can judge a civilisation by the way it treats its elderly.

7. Amazingly, doctors who work full time for the National Health Service are allowed to accept private patients - and to use NHS facilities when seeing them. NHS hospitals encourage this because when patients are seen privately the hospital, as well as the doctor, can charge a fee. And administrators - like doctors - have been accustomed to, even addicted to, all those private fees. For patients the downside is obvious - NHS patients take second place to private patients. And doctors and hospitals deliberately create waiting lists (a phenomenon virtually unknown outside the UK) so that there is a market for their private services.

8. Doctors rely too much on drugs - and prescribe new and untried drugs far too often. One in six patients in hospital is there because they he or she has been made ill by a doctor. That's staggering. Look into a twelve bedded hospital ward - two of the patients there are probably there because doctors have made them ill. After cancer and circulatory disease doctors in Britain are now the third biggest cause of death. That's truly scary.

9. Doctors rely on test results too much - and put far too little emphasis on old fashioned diagnosing. Some doctors even dismiss `taking a medical history' as old-fashioned mumbo jumbo. They treat the test result rather than the patient. But tests are often wrong and often misleading. And the more tests you do, the more likely you are to get a faulty result. The obsession with tests means that far too many tests are done. Doctors seem to have forgotten that there is no point in doing a test unless you believe beforehand that the results are going to affect the way the patient is treated.

10. Hospitals are obsessed with curing (which they aren't terribly good at) and don't understand, or have time for, the principles of caring. For example, many hospitals refuse to allow visitors to take flowers into hospitals - arguing that flowers are a nuisance. This is sad. It has been known for thousands of years that patients are far more likely to get better quickly in hospitals which are bright, light, airy and filled with gentle music and fresh flowers. Good hospitals are peaceful and are designed around a courtyard so that convalescent patients can walk in the cloisters and look at the flowers. But modern hospitals are designed for the convenience of the administrators. Patients are a bloody nuisance. I went in a hospital recently where the floors were carpeted because this made it nicer for the administrators when they were going to meetings. Naturally, the floors were stained with blood, urine and all the other remnants which would normally be wiped up off the floor. I know hospitals where the car park nearest the hospital entrance is reserved for administrators. Patients - however sick or frail they may be - have to walk, shuffle or limp half a mile in the rain.

Modern hospitals seem designed to create stress for patients rather than to ease it. Hospitals are so stressful, indeed, that there is some evidence showing that patients who have heart attacks may do better if they stay at home rather than go into a coronary care unit.


Those are the ten most important reasons why hospitals are so bloody awful. It wouldn't be difficult to deal with any or all of these problems. But doctors, administrators and nurses and politicians all have a vested interest in maintaining the status quo. The only people who would benefit from changing the things that are wrong with our hospitals are patients. And nobody seems to care about them.

There is advice on how to protect yourself on this website and in my books Coleman's Laws and How To Stop Your Doctor Killing You.

This article is based on material taken from Vernon Coleman's latest medical book Coleman's Laws, which is published by the European Medical Journal. Coleman's Laws, subtitled The Twelve Medical Truths You Must Know To Survive, is built around Vernon Coleman's twelve basic laws of medicine; laws which he has, over forty years, formulated for his own benefit, as a doctor, an observer and a patient and which now, for the first time, he shares with his readers. Coleman's twelve laws are illustrated with clinical anecdotes and reinforced with an utterly convincing barrage of scientific data. Coleman's Laws is available from the webshop on this site and from all good bookshops everywhere.

Copyright Vernon Coleman 2006