AggrievedRN - you sound exactly the sort of nurse the health system could do without. It may surprise you to know that formerly all those "chores" were once upon a time done by nurses without grievances who worked longer hours than you. They used their "chatting to each other time" to nurse sick people.

Once again, Lausanne, Switzerland

Whatever happened to the idea of holistic care. You may be able to write care-plans and manage patients who for some reason are more ill than they used to be but if your patient is malnourished or dehydrated then you are not doing your job. Progress is to be welcomed but not at the price of professionalism. It is no use nurses complaining about generalisation of peoples complaints. These complaints are common and genuine. How else are we now at a state where people are afraid to go into hospital. Yes of course there are thousands of great nurses but they are not the problem., as they tend to be aware of the whole patient.

SLC, Hants,

This is so shamefully true. In my experiences of hospitals, thankfully few, it is the staff who are to blame for the filthy state of the wards and the neglect of the patients. I have seen meals left at the end of an elderly patient's bed, out of reach. This old lady could not sit up unaided so how was she supposed to feed herself? The food was left to go cold and then removed without a word to the patient. Disgraceful! When I mentioned this to the ward sister I was told to concentrate on my own health and not concern myself with their duties! I'm afraid the days of the devoted 'angels' are long gone!

Suzanne, UK,

My father died at our local hospital this year. He went in with DVT and contracted c-dif and a urine infection from a catheter. He was ever so cheery when he went in, still had a glint in his eye but after a week of that place he was so depressed, pale and sunken in the face it literally took my mother's breath away.

They weren't monitoring how much water he was drinking, the notes were so slapdash the apathetic nurse I forced to go through them with me had to add things I told her had happened to him, he'd often be sitting in his own urine for so long he got sores, we'd bring the grandchildren to visit him of an afternoon and find him freezing in an openbacked nightie with his testicles on display to a mixed ward. It was just dire. I swear it's deliberate neglect.

Doreen, Warwickshire,

Instead of so much emphasis on 'Human Rights' we need more emphasis on 'Human Obligation'- dont we?
If the perpetrator of Philip Lawrence's murder leapt 'beyond the pale' through his heinous act then he should understand that a lengthy incarceration followed by exclusion from the scene of the crime through an A.S.B.O. or deportation is part of the punishment. If he returns eventually to the U,K. and seeks the support of his family, well and good. But he must carry his burden if he has leapt into the abyss and intends to climb back out of it.

Michael H.pester, Worcester, United Kingdom

An elderly friend of the family was sent to a hospital ward to recuperate from open heart surgury. The private room they put him in was was filthy - coated in dust, grease and cleaning products (equally dusty) littered the bed and pulley tray. His wife took one look and complained to the staff who ignored her. She promptly decided (being a no nonesense Irish woman from the old school) that rather than allowing her husband to stay in that horrible room and possibly contract a superbug or two, to clean the room herself, using the aforementioned cleaning products. The nurses were gobsmacked at how clean the room was after. Disgraceful that this is what it took, one for him to stay in a clean room, and two, how surprised they were at how lovely the room was after. For shame.

Lainey, London,

My father has just died from C-diff, though that is not mentioned on his death certificate. I don't work in the health service so cannot know how things are organised...BUT as long as we treat hygiene like rocket science we will get no where. Libby's Purves' article was brilliant, no nonsense, clear strategy, call to action. We must clean up the hospitals; so let's hear the solutions rather than objections to them.

sue, manchester, uk

Not all hospitals are the pits. My local acute hospital, where I had a two week stay 2 years ago, had it's own cleaners who were proud of their work.
We need to say NO to privatisation of services and start to remember that the'bottom line' should be the care of patients (in all aspects of the word, so to include their environment as well as their dignity) and NOT the money. Private services are there to make money, that is their number 1 objective so how can patient care come first in that way of thinking except as window dressing. Employ cleaners directly.
In addition, the idea that coaxing people to eat is a breach of their human rights is nonsense. The human rights act is being used to abdicate responsibility too frequently. Informed patient choice is another matter: people may wish not to eat for any number of reasons but to be clear, encouraging a person to eat or even raising the spoon or fork to their lips to enable them to eat is, I would post, not force feeding.

Ellen, Chesterfield, Derbyshire

Are you on the payroll of a partnership of employment law specialists by any chance? The only outcome of such a blitz on hospital staff behaviour would be a backlog of employment tribunals and lawsuits.
You don't need to hire disciplinarians, you need to stop stifling the ones who are there! It has become impossible in this day and age to fire anyone without involving a battalion of lawyers. Allowing dirt in a ward of sick people is gross misconduct on the part of all staff in the hospital, but watch what happens if a ward sister tries to discipline anyone for it. A lawyer gets rich and more patients die without any possibility of blame being allocated.
As for trusting politicians to deal with it, new labour has had ten years and made not one iota of difference except to increase the size of the bill for this mess.
If you really want to do us a favour, splash this column and more like over every headline in the run up to the next general election.

KR, Stockport,

I would fit your profile perfectly and would love to be part of a regiment of nurses who trained before 1975 who will storm the wards. I well remember the cleaning we were expected to do and the standards we had to maintain and the consequent pride we took in the care of our patients. Whilst there are many simplistic, headline-grabbing soundbites to the issues, and "Bring back Matron" is one of the worst, there needs to be a re-think of the way priorities are set. Whilst that is being done though, I suggest that the BBC commission a series of "Grumpy Old Nurse" and am hereby volunteering my services as a contributor-Jenny Eclair: are you there??

Linda McQuaid, Oxhey, UK

Where can I volunteer ?
(Next time I am in Britain)

Jacqueline Vallance SEN Ret., LEFKIMMI, Greece

The NHS doesn't need more money it needs to provide more value for money. My experience of hospitals is that large numbers of staff seem to hang around idly chatting. I've rarely seen any sense of urgency. Those people I know who are nurses rarely display anything other than contempt for patients and are more concerned with whinging about how undervalued they are than they are about doing their jobs. It seems to me that there is simply no discipline or pride in these institutions and that blaming the people with clipboards is just another excuse for civilian medical "professionals" not to pull their fingers out.

Thomas, Glasgow,

PJC of North Lincolnshire - I was talking about hospital nurses, of which I have some experience, and which the article was about. And in fact my comment was a criticism of the "system", not the nurses themselves.

Martin Evans, Newmarket, Suffolk

The story of the smashing up the erstwhile world-leading nursing profession and its control of hospital wards has been written up, told to politicians, and ignored. The Conservative John (now Lord) Moore agreed to break the apprenticeship system of nurse training and ward management, and to move training to the then Polytechnics, now universities. That proved a decisive change for the worse and removed the matron-sister-staff nurse-trainee nurse model. Nursing became a theoretical profession. The old Christian ethos of care was of course deliberately killed in the Polys as being exploitative. Cleaning was detached from ward sister control. Then feeding patients was relegated to an unworthy activity. And the Tories who did this won't face their error, Labour like it as it roots nursing in their Polytechnic strongholds of dogma with teacher training. For the patient it has been catastrophic. And billions could be saved by going back to hospital apprenticeship nursing and ward control.

T, Wycombe, UK

Annother vounteer ready for action! Where do I report for duty?

As a Registered Nurse who qualified 30 years ago and who has had the misfortune to be a NHS patient recently I was horrfied at the state of the wards in my local London hospital.

Until the whole structure for training nurses is altered to bring back students on to the ward for most of thier training and ward cleaners are once again under the direct responsibility of the ward sister we will not see an end to hospital aquired infections. These together with pressure sores (again now far to common) were regarded as unacceptable in my day and attributed to poor nursing care.

Nurse could and would make the difference - if only they were allowed to.

FS, London,

OK Troops,
Lets cut the cackle, and then cut to the chase.

How do we start this campaign rolling ?

I have been, in different roles, to 3 hospitals in my area, all with the initial 'B'
2 were good, all things being relative, 1 was noisy, grotty, slap dash. None knew of TLC. Business is business.
in the first 'B', I was fitted with a Heart Monitor at 17.30 hrs. after a 'slight' heart attack.'
In the M.A.U, at 6 the next morning, a nurse was fiddling with the wires/sensors.
She went away; came back, open the monitor up.
Put a battery in the empty space !!! 12 hour
At 23.45 asked to have the ward lights out. Not possible. They were dealing with a patient.
I mentioned the individual bed lights.
No Joy. "They don't all work !
Tried mine. No Joy.
On the same ward,I was allowed to walk to the toilet.
On the next ward, I was asked, when I repeated the exercise, "Have you not been advised that you are a bed-patient ?"
"You have an Acute Angina syndrome "

Wife SRN, HV tutor. Yes; I obey.

David W, Burnley, Lancs

Where do I sign up to be a storm trooper??
Aged 65, SRN, SCM

Dilys Nottingham, Derby, UK

"The daughter of a dementia patient reports that her mother ate nothing for two days because the nurses say piously that she “declined food”, and that to coax her would breach “human rights”. We have also experienced this warped rationale. Before she died, our 93 year old grannie, wheelchair-bound and very confused, could not be restrained to prevent her falling out; this would constitute an abuse of her 'human rights'. It was wonderful to see her right to repeated falls, with head and facial injuries, being so carefully protected. Perhaps we should stop strapping toddlers into buggies and highchairs too - very abusive of their human rights.

Jacqui, Leatherhead, Surrey

The problem is that nurses have become para-medic doctor replacements (but cheaper) and the manual jobs were delegated first to auxiliaries, and then to contract staff.

So now there is no connection between the medical care of patients and ensuring a clean hospital, just as there now seems to be no connection between medical care of patients and hospital food.

Peter FitzGerald-Morris, Rochester, England

When I moved from Sweden to the UK 7 years ago, I was surprised to see that doctors didn’t wear white coats. Being told by a medical student that some MRSA bacteria were spread by the doctors’ ties, I was even more shocked. At home hospital staff wear coats which are washed and disinfected by the hospital, something which also applies to curtains, bed linen etc. Also, we don’t have carpets in our hospitals…

Seems like a good idea to make nursing training involve more practice. Why not make both nursing and medical students do the hospital cleaning as part of their training in their ‘summer holiday’. They would then really know about cleaning and hygiene when they later take up a more ‘supervising’ role. I also believe that you learn to treat people with more respect generally if you have experienced what it is like to do the least attractive job and being at the bottom of the hierarchy.

E E M, Oxford,

PS. Other than cleanliness and hygiene aspect though, I think that the NHS offers very good and fast service and in Sweden health care is not free of charge.

E E M, Oxford,

What would you rather I do? Give your father a bedbath or feed your elderly mother? Perhaps you'd like me to arrange the flowers you brought as well as clean the bathroom. I'm sure I'll be able to squeeze in the 1001 other things I have to do in the few hours available to me whilst you sit on your backside tutting and doing nothing to help your own relative.

aggrieved RN, Pontefract,

I have been in mental health nursing for 5 years now. The problem with nursing is that the government has insisted on recruiting nurses from third world countries, where the standards are not the same. This is also the case with carers for the elderly. The standards are not the same and all the "training" in the world will not make a significant difference. There will be people reading this, as both visitor and employee to hospitals, who know exactly what i am talking about. There may also be those who feel the need to use the term "racist". I deplore racism and fight to challenge it in the workplace, however it is cleaning standards we are talking about and all my anecdotal evidence (very hard to do a real study on such a subject) has been before my eyes for the last 5 years.

david, london, england

Even the ward tidies where fresh rubbish bag,fresh drinking water and clean towels for each patient.were provided have gone. It is now just paper work. I agree, bring back some of the older nurses and we some patient care fand comfort for a change

jane, sydney, australia

I can't quite believe that many of you, Libby Purves included, have so little faith in younger nurses. My daughter is 31 and works an average 13 hour day or night in a post surgical ward with hardly any breaks because the ward capacity has doubled because of closures. She works hard to keep her patients "clean and comfortable and make sure they are properly fed" She even wipes their backsides (have you ever done that Martin Evans)?
This is the lot of the modern nurse. I've suggested she work in the private sector, but like her colleagues, she wants to help ordinary people to recover. She, and her colleagues, regularly get thank you letters and cards from patients. This article and some of these comments and cheap shots are like a smack in the teeth for her, I hope you are all proud.

kenw, Hemel Hempstead,

It was obvious standards would fall as soon as cleaning services were contracted out to the cheapest bidder. The ward cleaner was part of the ward "family" and was personally responsible for the state of the ward.

In January 2006, my husband and I visited a relative in a Midlands hospital, and saw a pile of rubbish in the corner of a lift: people were being wheeled into the lift, on stretchers, straight from theatre. When we returned (two days later), the rubbish was still there, with the addition of a pair of surgical gloves!

I complained to Housekeeping and the rubbish was removed but how many members of the hospital staff, both medical and administrative, had witnessed the mess but not bothered to do anything about it? So much has been said, and written, about dirty hospitals and infections, but the debate had clearly had not touched hospital staff there at all.

June Taylor, Evesham, UK

Wake up, people! Health care is no longer 'care', it is now a business and all that interests managers nowadays is targets. I am a working nurse, 'academically trained' (I also have a law degree) but I would love to spend time doing basic care. It's the best bit of the job as far as I'm concerned. But unfortunately I don't have the time because of all the other things I have to do.
This idea is a good one in principle but you forget in the old days patients were allowed to stay in hospital far longer and so there were lots of 'walking sick' . Nowadays patient turnover is so high we have lots more acutely ill patients on the ward requiring more intensive nursing not to mention the paperwork involved in admissions and discharges.
Bring back ward based cleaners accountable to the charge nurse and, please, stop generalising from one bad experience. We're not all lazy, slovenly or incompetent.

A. Watson, London,

"...academically trained but blind to the obvious..."

Never did seven words sum up the problem of today's nurses so succinctly. Well spoken Ms Purves.

Strormtrooper nurses with the powers you indicate is a brilliant idea and utterly logical, simple and with the power to be trulk effective.

And whilst they are in there perhaps the regime of strict visiting times and only two visitors per patient might also help in the battle against infection. Visiting relatives in hosipital in the past year I am struck how the wards are full or relatives in vast numbers seeming all day and evening long.

I hope like mad someone in Governemtn reads this article and realises, like so many great ideas, it is one of pure genius. I'll bet the infection rates would drop drastically very quickly.

Geoffrey McNab, Belfast, UK

It seems to me that it's not even just the wards that aren't clean. My elderly father was recently in hospital with gastric problems, and during the course of a two week stay was able to use the bath only once. This wasn't because he was too weak to bathe - it was because the tub on the ward was full of rubbish, and there was no plug. This, on a supposedly recently refurbished ward. I realise that being clean isn't the only requirement toward recovery, but it must surely help. Bring on the pre-1975 nurses, say I!

Stella, Hull, UK

Heartlands Hospital in Birmingham looks spotlessly clean throughout, but you never see a nurse wash his or her hands. What you say about the failure to attend to weak or hesitant patients who can't feed themselves is true, though. I saw one elderly patient who was just very, very slow and she would always have most of her food whisked away before she could finish unless a visitor protested.

Frank Upton, Solihull,

This time last year my son had an operation for a triple farcture of his leg and was in hospital for 6 days.
36 hours after the op.,he lay in a blood stained operating gown, unwashed, and no one had offered him a mouthwash or his own toothbrush. Blood stained, crumb-laden, sheets had not been pulled straight and a pan of urine remained on the bedside table from the night before. When I attended to these matters myself at visiting time, a passing nurse kindly offered to assist. As to food - he never ate a bite in 5 days from the hospital trolly though was obliged by the attendant to tick the menu. Food was served but lids never checked before removal. Anti septic hand gell was NEVER pointed out to me ( & sadly I was unaware at that time of its existence and importance) nor did I ever see a nurse use the gell attached to her belt during my week's attendance on the ward. Waste? Insouciance? Care? Hygiene?
Thank You Libby Purves for highlighting the problem. Will it help?

Rosemary, Oxford,

I asked a male doctor this question -
If female nurses are the 'doctors handmaiden' what are male nurses?
He said "foot stools".
So now you have the answer.
Once upon a time Matron was the most respected post in a hospital.
All the merits were there - compassion, firmness, knowledge and the art.
Now there are 'suits' who dictate such that the professional code of conduct takes second place to 'suits'.
T'aint the origin or development of nursing that is the problem.
It's the contex in which it currently resides.

Retired District Nurse, Dorset,

I trained in 1981. The differences between then and now are just too complex to list. We have far more sick patients now, patient turnover is far more than it was. Cleaning staff have been reduced over and over again.

As for nurses gossiping and not working etc, from the time I walk onto the ward to the time it is time to go home, my colleagues and I do not stop working. Forget about prisoners not having human rights, what about our human rights to have a food break, or even a loo break during our shifts?

It is easy to be a fat cat journalist who sits on her behind every day moaning about nurses. Would you like to walk in my shoes sometime Libby Purves?

Yes, in my 26 years of nursing I have seen some things decline, but put the blame squarely on the people who deserve it, the politicians for systematically starving the NHS of funds for decades.

If all nurses declined to work the unpaid overtime we work every week, boy would you know it.

Ann, Crewe, UK

I feel that our hospitals are a reflection of our society.My recollections of life 40 years ago are of my mother on her hands and knees scrubbing the floor,nothing would be missed.My father thoroughly washing his car every weekend,and how he polished the chrome in particular.People took much more pride in themselves then also,shoes were polished and trousers pressed.Today men go without a shave for days on end,they all wear filthy looking trainers that don't need polishing etc.
Who would have thought there would ever be a TV programme where two ladies go into people's homes just to clean them. In general our whole standards have declined where cleaning is concerned,and unfortunately hospitals as part of our society are very much part of this trend.

Mike, Dunstable, England

"The daughter of a dementia patient reports that her mother ate nothing for two days because the nurses say piously that she “declined food”, and that to coax her would breach “human rights”.
I have also seen this warped rationale in action. Before she died, my husband's 93 year old Grandmother, who was very confused and unwell, repeatedly sustained injuries to her head and face caused by falling out of her wheelchair. When we protested at this lack of basic care, we were informed that it was "against her human rights" to restrain her in any way. I'm sure she was glad that her right to injure herself was being so carefully protected. Perhaps we should outlaw the use of reins or straps in buggies and highchairs too?

Jacqui, Leatherhead, Surrey

Clinicians do not see cleanliness as a clinical problem, rather an administrative issue. They easily blame contractors and anyone but clinicians. Until clinicians see cleanliness as their problem, and stop ignoring it, the problem will persist. The same goes for feeding patients and seeing to their personal and private care.

Examples:
1. I was being examined by a registrar for a skin complaint. He called in his consultant who came from another patient, did not wash his hands before touching me and then returned to his own patient without washing his hands.
2. I was given an enema by a consultant prior to an examination, was sent to a public toilet to get over it and needless to say the WC was foul. I the returned to the examination room, carrying whatever I picked up from the WC with me and deposited it on whatever I touched. i was not offered hand washing facilities and those in the WC were foul.

Stephen Roberts, Milton Keynes,

I cannot comment on the nursing profession or any changes therein but having worked as a hospital cleaner for a contractor during my uni holidays I saw some problems firsthand. Firstly, we were not given any training in hygiene, some cleaners did not use disposable gloves when cleaning and did not clean their hands between different cleaning tasks thereby risking spreading germs all around the ward. Secondly, we were given x amount of hours to clean particular wards and only paid for those hours. If I cleaned diligently, even at speed, I could never do the wards in the time allocated. If I had been less conscientious I could have finished on time every day but the ward would not have been clean, most cleaners just wanted to finish on time. Our cleaning contract boss only became bothered if nursing staff complained the wards were not clean enough, all they told us to do was to make sure to do the most 'visible' cleaning to ensure wards 'looked' clean.

Neve, London, England

20 yrs ago our local nurse complained about the fillty hospitals
which 'contract cleaning' had created.......and things got worse, in line with the increasing budgets allocated to contract cleaning....

mike, oxford, england

At the age of 73, I will no doubt soon be under the control of a nurse. I am nevertheless an expert on my own health perhaps because I have a degree in science, but more likely because I have taken an intelligent interest in my own bodily functions and the medicines given me. It would be surprising if this were not the case since I have spent many years thinking about my health and the likely outcomes: the doctors I have consulted have perhaps never spent more than a grand total of 12 hours with me in 50 years. If I arrive in hospital, clearly I must come with a few bottes of disinfectant and some brushes to clean out the area I will occupy. Will I be allowed to do so?

Brian Lewis, Manila, Phiippines

this artical is so one sided i thought i was reading the daily mail. I do wish jounalists would not demonise all modern nursing practices. we do care, we do feed our patients, we do clean - constantly.

staff nurse, london,

Go for it! Long overdue.

kay, leeds,

Great article in today's Times, Libby Purves. Yes, a truly radical solution to the appalling lack of cleanliness in our hospitals has to be found. We must go to the root of the problem.
Phylloxera, the deadly vine louse from North America that ravaged the world's vineyards in the late 19th century, prevailed because the bug attacked the roots of the plant, so when the grower saw the first signs of damage above the soil, it was too late. They tried flooding the vineyards,and even burning them, but it was only when every one of millions of European vines was grafted by hand on to resistant rootstock from America that the problem was finally solved.
Thus, a total committment to a solution, a determined lead from the top, and a lot of plain, old-fashioned elbow grease
preserved the wine industry worldwide. Are these too much to hope for now, when so many lives are at stake?

Michael Gould, Newhaven, East Sussex

My mother was a nurse and old school Matron - combination Victorian Governess & Regimental Sergeant-Major. Everthing was starched and immaculate - shoes polished, uniform crisp and when she said 'jump' she expected her nurses to only ask 'how high'. Snr doctors were treated as a battalion CO while jnr doctors had the same status as half-witted subalterns.

She had no time for modern hospitals where some (no names no personal abuse) look like they just got out of bed and wards are left dirty because 'its not my job'. My recollection of my last trip to A&E (with the walking wounded from school cricket) included:

- nurses sitting on the ground at the hospital entrance smoking;

- a doctor with a cornish pasty in his mouth, carrying a can of coke while a packet of crisps was stuffed in a jacket pocket;

- nurses giggling outside a loo awash with paper on the floor and cigarette butts in the basin.

If they can't cope on the little things how do they cope with the big things.

H, London,

The rot set in when hospital cleaning was 'outsourced' to cleaning companies and nursing training was 'outsourced' to universities. The cleaning companies were driven by profit; and just because you can write a good 'academic' essay doesn't mean you will be a good nurse. Both ideas came, I believe, from the American model of hospital management and have been a disaster.
In the past, nurses spent their first year of training learning basic caring of patients; bathing, bedmaking, making them comfortable and feeding them if necessary, during which time they actually got to know their patients as human beings. Only after they had mastered basic care did they progress to the more academic and technical aspects of nursing. Hospital managements should really take note and take action on the views of their patients instead of only paying attention to their budgets and government 'directives'. It would probably be cheaper in the long run.

Anne, Nice, France

Much better suggestion than anything the Government has come up with and no doubt cheaper and more effective ... so it will never happen . The Government only adopts expensive options so that it can announce proudly how much money it is spending/investing regardless of whether it actually does any good .

Benzo, Nr Chelmsford,

It seems to be a combination, in some cases, of poor or weak management, indifference on the part of managers and individuals, and, an unprofessional and uncaring attitude of those who work in the NHS. There is little point bleating about being a caring profession when nurses, possibly because of their training and degree-level qualifications, are unable to nurse, spend their time fiddling with computer terminals and do not appear to understand the fundamental principle that they are there to assist patients to recover from whatever illness brought them in and that patients are not simply a number or a record sheet but a human being. Like other areas of public service there is a crying need for someone to get a grip and muck out the Augean Stables using 'hire and fire' with those who do not comply or appear incapable of complying.

Kenneth Armitage, Suffolk, England

It's all very well to state the obvious - that hospitals are filthy . The interesting question is why. What do nurses themselves think? There is rather a shortage of comments from working active nurses.whenever this subject is mentioned - the middle aged ones always dominate the discussions and say it never happened in their day. Libby's light hearted suggestion is funny but of course it would never happen. Actually we need the real story as to why this is allowed to go on and on and on. I hope one day a newspaper or TV programme might do a proper analysis of the problem.

JA, London,

I guess that Mr Evans from Newmarket has never heard of the District Nurse. Your comments are ill informed.

PJC, North Lincolnshire,

How true. When I used to visit my mother in hospital as a child in the 60's the wards were spotless. The ward sister ensured absolute cleanliness.

Not that hard really it just required dedication and diligence!

The latest situation is appalling. No doubt this government will set more targets and paper trails to increase workload and costs but fail to rectify the problem.

M Peasley, Swansea, UK

My 7 month old son was recently in hospital and picked up a dreadful stomach bug following major surgery on his kidney. This was solely, in my opinion, down to poor care.

Syringes were left in the cot, as were scissors. My wife and I spent time ensuring sheets were clean (they were happy to leave him covered in vomit and faeces), we had to do all care (feeding, nappies etc), we had to ensure the correct medication was given on time and the only response we got was "I'll be with you in a minute".

Nurses complained if nappies weren't heavy enough (nappies are expensive!), people wandered about with impunity and the security was appalling.

I have had 3 operations this year, and have been shocked at the filth in toilets, wards, floors and almost everywhere else. In fact, on each occasion I have discharged myself early; the contractors (Serco) do not do their jobs properly, and nurses are happier to chat and laugh than concentrate on patients.

Maternity wards are dire too.

John Ball, Norwich, UK

the trouble with nursing these days, is it attracts those who are more interested in the academic field, research, etc: which was a good initiative to recruit those with a few more active brain cells than the profession had attracted.
unfortunately, the pendulum has swung in this field, where it is more important for nurses to have the latest paperwork to prove they have attended a course, rather than any ground work in very basic nursing care.
academic nurses are less likely to be interested in cleaning out dirty lockers or clearing out the sluice room thoroughly, and nursing is not about these issues only. the ability of some nurses who i have had the pleasure to work with is surprisingly a let down. frequently, they have no idea on how to clean up after they have had a meal, how then can we expect these same individuals to take care of a patient's needs.

lucky, london, uk

What happened to carbolic? Student nurses were always cleaning and scrubbing sluice rooms treatment rooms, ward kitchens and the wards, as well as keeping their patients clean. We used to save the tea leaves from the ward teapot, these were regarded as an an antiseptic also, as well as keeping the wards spotless. Sister used to supervise a team effort on a sunday morning, the cleaning of the ward floor boards with the left over tea leaves. Two young student nurses
would start at the end of the ward (40 bedders) with long yard brooms and brush the tea leaves down the ward!! The tea leaves used to take up any dust and residual fluff, and thoroughly clean the wooden ward floor!! , bed curtains were changed, and all spare beds were washed with a carbolic solution. The wards were also given a good airing, tough luck if it was freezing outside. Fresh air blew the cobwebs away!!
Sister was also very strict about the wearing of jewellry and shoes that were worn other than on the ward!

Mrs Maggie Snook, wool, wareham, Dorset UK

Count me in!! I trained 1970-73, and finally last year decided I could no longer tolerate or work in the profession I loved, but no longer wanted to be part of, and felt fearful of ever having to be on the other side of the fence receiving care, because of the lack of basic experience that many of the nurses of today are getting - or not getting. I was one of those Sisters of a ward who had our own domestic staff who took a pride in their ward. As well as the routine daily cleaning, there was a weekly rota of cleaning tasks, with beds being pulled out into the middle of the ward to thoroughly clean behind, wheels cleaned etc.etc.. The Sister served the meals from a trolley , and was able to give appropriate sized portions and food depending on patients needs and likes/dislikes, and 2nd helpings to those who wanted ! Where have those days gone - I loved them - things WERE better in the past.

J.Barker, Perth, UK

How disapponting! As a nurse of 10 years i am disappointed of the public lynching of my profession and the obvious lack of understanding or interest you have in the progress within nursing careers, thats right, we do not carry out the level of cleaning duties that vwere required years ago.. BECAUSE we are busy saving lives, organising safe and suitable discharges, managing case loads of patients, teaching and supporting our juniors in the priciples of nursing not cleaning, attending to the dying and their loved ones, performing extended roles to raise the profile of our profession and obtain satisfaction in challenging ourselves to acheive more and more.
I am proud of where i work and those i work with, we are restricted by time and by resources, the NHS has never been so busy and full to capacity on a daily basis. |The job has changed beyond recognition to those who trained years ago, i would like to see them do the job that we do now.

Katie Browning , Birmingham, UK

There certainly was a point at which health care in this country decided that patients' nutritional needs and the cleanliness of the ward/unit should be put under the heading of "hotel services" rather than under the heading of "nursing responsibilities". However good the cleaner or the person delivering the food trolley, they are not trained in the implications of hygiene or nutrition for people's total well being. Nurses used to be.
Another development which has not helped is the jettisoning of caring for personal hygiene needs to untrained staff. We used to benefit from time spent bedbathing or bathing in the ward bathroom to assess a patient's general well being. The "quick licks" that patients get now (if they are lucky) don't allow for such thorough observation by trained eyes and it isn't seen as "real nursing" job anyway.
Let's abolish 'nursing' and re-invent something better.

Steve, Preston, UK

Surely the nursing unions have been part of the problem too? They have pushed for years to make nursing a professional vocation requiring increased pay.
Now we have nurses completing degrees after 3 years of university.
I have a sister who qualified as a nurse 3 years ago. It was demoralising for her and those in her year to realise they had been sold nursing as a great job, learning some of the same things as Doctors and then working as sick-cleaners.

The irony is if we sacked the cleaning staff, took on more nurses, scrapped nursing degrees and go back to diplomas, we could have nurses trained alot quicker, ready to muck in and clean the wards when necessary AND be better paid.

James Wilson, Bristol,

I was that STORM TROOPER for over two years in the largest teaching hospital in the country.I was also part of an MRSA enquiry which Identified keys areas for improvement.The PEAT INSPECTIONS were conducted and real progress and improvements reported were evidenced based. Unfortunately with my honest straightforward approach and truthfulness meant I was not considered for re appointment by the trust.The fault is not that of government but of the organisations who are allowed to select the people who they know will give favourable reports.I have a very large data base which will confirm the real reasons for hospital aquired infections if anyone should care to look?Mr Hunt who I belieive is covering this area of responsibility only needs to check with the Chair of the Scrutiny Board who conducted the earlier enquiry.This will give him a clearer picture of how to improve the current situation.It is not all about extra funding.The trust concerned failed the MRSA/INFECTION target.Sad!!!

Mary E Hoult, Leeds, Yorkshire

Obviously the answer, but obviously the impossible.

Your still operating under the assumption that Hospitals exist to cure sick people.

They dont, they operate to meet targets, because targets can be monitored on a spreadsheet, by the Emperor (Brown) in his ivory tower.
The actualy results are irrelevent, the waiting list being 6 months long is the important thing.

If a patient wishes to refuse to food, even because they're in a coma, thats their human right, it must be respected, at all costs.

Dominic, Manchester, UK

I was treated as an emergency at a vetinary practise for a very wicked set of squirrel bites,they had all the kit to deal with animal bites on humans, the vetinary hospital was immaculately clean , spotless, the staff were very busy,but
the hygiene standards were faultless, especially when you consider the variety of cliental they have to deal with. I would prefer to be looked at by a vet in a vetinary practise than an NHS hospital any day!

Mrs Maggie Snook, wool, wareham, Dorset UK

My son had a tonsil operation in Athens last April in a public hospital. The ward was spotless and cleaned every day. Even walls and doors were washed. His room and bathroom disinfected every day. No nurse would touch him without protective gloves. Not a sign of MRSA.
My husband is a heart patient and visits 3 hospitals regularly in Hertfordshire. I have yet to see a staff member washing hands or wearing gloves before treating him. Deplorable.

Alice, Stevenage,

Fantastic idea! Send them in, we might actually get something done about the problem.

Nina Mclean, Waltham Abbey,

Hospital management is just another part of an incompetent government " business" The fact is they are unable to do the jobs they are paid to do, everybody knows this., but nobody has the "bottle" to do anything about it, so, it will continue.

The hospital management should be ashamed that the kitchens are full of disease carrying vermin and the catering staff, low paid, incompetent, don't give a damn about health and hygene of the food they store and cook, or themselves.

They should install former members of the military, either army, navy or air force catering staff to smarten up the hospital cooks and staff, they wouldn't get away with such severe bad food management in a military establishment. They would be inspected every week, with un- announced inspections, and if any unclean place was found they would be on a charge.

What was it that caused the British to be so useless in everything they do, they never used to be.

Phil de Buquet, Newport, England

This is an idea that would be cheap, easy to implement and guarantee to provide improved standards of hygiene in hospitals. I can grant no higher compliment but to state this is pure, unadulturated common sense.

And the chances of this, or a similar, practical plan for improving hygiene being proposed by our elected reps?

I have another idea, someone should propose a white paper where by all MP's and Peers spend one night a week in their "local" hospital.... the idea would probably be shot down on "health" and safety ground though.

Daniel, Uxbridge,

As an 'academically trained nurse' I want to reassure that nurses today do understand how crucial cleanliness and hygiene is in hospitals. Scapegaoting nurses for pitfalls in NHS hygiene management is ill informed and demoralising. Systems have changed since the 1980s. Hospital cleaning is contracted, people are paid to clean the hospital - Fact. The way this is executed needs to be addressed and storm trooper nurses would be perfect to instill pride into cleaning if standards are not met. Washing and feeding patients is paramount and a joy of the profession - not a forgotten relic of the golden days of the NHS. The only people who end up hungry and dehydrated on my ward are the nursing staff in our efforts to tend to our patient's washing and nutritional needs. Nurses today manage more acuelty unwell patients in the ward setting, we have greater work load, more responsibilites, more liability, and far less respect.

rachael brown, Oxford, UK

I was in hospital in Leicester recently and was disturbed by some procedures in use. Hand washing on entering wards appeared to be optional, I only saw the dispensers at each bed used once in two days. The cleaner used the same mop for the toilets as was being used on the ward floors.

I was identified as a possible MRSA carrier but I was in the open ward with no special precautions. On my next stay I was put in a side room but was free to roam around if I wished. On the positive side nurses did wash their hands on leaving this room and wore disposable aprons.

The worst procedure was allowing people to move from ward to ward selling newspapers etc. taking cash from one patient and giving it to others. A better way of spreading bacterial contamination around the hospital is hard to imagine.This practice makes a mockery of the attempts at hygiene.

I worked for 34years in the pharmaceutical industry , Quality Systems and site audits were part of my responsibility.

Peter Watson, Quorn, Leics.

All those "normal taboos" should be shelved permanently, not just for a month. Contractors such as cleaners and caterers should be on contracts that specify minimum standards - very high minimums indeed - and they should be paid only if those standards are fully and continuously met. The people currently termed "managers" should be renamed what they are: "administrators" - i.e. people whose responsibility is to get things done. They should have no authority whatever over the medical staff - the most junior nurse should be entitled to tell even the chief administrator to "get that floor cleaned!" or "get somebody in here to feed that patient!". The people at fault in the NHS are the ones writing wooly outsourcing contracts without teeth!

Rosie, Upminster,

In 1986 the kitchens at Hammersmith Hospital were a disgrace and the (largely agency) nurses in the newly created leukaemia (Dacy) ward appeared untrained, slovenly and incompetent. Patients and families struggled against daily errors with drugs (toxic ones), disgusting food, lax hygiene standards and nurses (one or two were good) too pre-occupied to replace caps on Hickman catheters (leaving the patient to bleed into the bed). One night the ceilings in these "secure" units collapsed when a bed pan washer exploded - leading to an invasion from the local fire brigade (none of the patients had much hope and all died). Has anything changed?

David Lee, New York, USA

Dream on, Libby Purves, dream on!

China Hand, Hong Kong,

There is an analogy here with the police. The 'real' police are now so expensive and so scarce that another, lower level has been introduced to do the basic jobs and keep the costs down. This probably needs to happen with nursing, now they are graduates and much better paid. Perhaps we should recruit an army of community support officer equivalents to do the hard work in the wards and leave the nurses to a supervisory role more suited to their qualifications and current perceived status? Of course we could then manage with fewer nurses.. and maybe the wards would be clean for the first time for ages. It might even be cheaper. I doubt it could be worse.

colin f, Shrewsbury, UK

I trained in the mid 1980's in a large and major teaching hospital in the North of England. We were told that it was a sackableoffence to be seen outside the hospital in our uniform. Now its a common occurence to see nurses in uniform in the supermarket either before or after work. A sight that revolts me - I know where its been and what it could have been in contact with.

Rings, earrings, necklaces are all commonplace in patient care settings...

MH, Chester le Street, Co. durham

Brilliant article spot on, the effect of " matrons rounds" seems to have been missed. Hattie Jaques done a classic take off in a Carry On Film

Dave Madley, Alicante, Spain

Brilliant idea to "draft in a volunteer regiment of ex-nurses trained before 1975: opinionated middle-aged women with strong memories and no fear of offending". Will they do it? One hopes so!

T. Bishop, London, UK

Absolutely! I trained as a nurse in the 80's and still remember Grand Rounds. Sister was feared and a summons from Matron was enough to render palpitations. We made beds (after scrubbing them clean), rubbed cream on elbows, backs, knees and bums to stop them getting sores, practised strict sterile techniques, tentatively suggested to doctors they wash their hands between patients, organised for elderly patients' cats to be fed at the home they hurridly left (because we knew they wouldn't recover whilst fretting), chastised the cheekier male patients and knew our lives depended on our cupboards being properly stocked and all patient's charts being properly recorded. Not long ago I went to hospital...(private) The RN's didn't even know how to put a wound bag on the right way ...no one had ever shown them! Pain charts were forged, I had to give myself medication and frankly, I despaired of what nursing had become. Yes, get us cranky middle-aged nurses back on the wards - and quick!

Erika Wadlow, Sydney, Australia

The regiments of retired Nursing Sisters are now ladies that dine, and up and down the Country, meet in groups for regular lunches. They no longer discuss the cause of the disaster in the NHS, for years nurses were not paid their value, and moral went down and down.
Now read Golden Carrots to lure Students to Science in the UK>science section of this timesonline. History is due to repeat itself. Richard Lambert, Director General of CBI, estimates we have a shortfall of 2.4 MILLION of Science, Technology, Engineering, and Maths Graduates (STEM). We just do not pay them enough to attract them to these professions essential for the National prosperity. The proposal is to offer them peanuts of £1000 a year to study STEM degrees.
Now compare the number of Have your say replies to Libbys article on the golden age of Nursing, and the number of comments on the vital STEM staffing in a competitive World.
In ten years time there will be no wealth to pay pensions.

Gut Liam, Hertford, England

Your article sounds perfectly sensible, however it will never happen. NHS managers are frustrated by the fact that they can not recruit their own staff anymore in the UK because they being dictated to by universities who now train nurses.
Hospital managers can get their hands on nurses from places like Malawi and the Philippines, these nurses will be compliant, keep their mouths shut and do what they are told under the threat of repatriation if they leave the health service.
Will overworked nurses try and keep hospitals clean when they are just trying to make it through to the end of their shift, returning home exhausted. We are also making nurses redundant and simultaneously spending billions on a computer system that is plagued with problems. We also have the Private Finance Initiative that has delivered new hospitals but will cost a huge amount of money over the coming decades as we pay back the loans. The health service spends billions on "projects" but wont pay for cleaners!!!

Graham Wharton, St. Albans, UK

Storm-trooper nurses I qualify, trained pre 1975, ex-Sister no nosense, put my name down, but hurry we are a dying breed.

Carol Read, King's Lynn, Norfolk

Nowadays, everyone wants to be a star. No one wants to do humble boring jobs. If they do end up in a menial job, they do the minimum they can get away with. I think the only solution is to hope that robots will soon become sophisticated enough to do our "dirty" work for us.

JL, Liverpool,

It's about time someone preached the obvious. There's benefit in the modern hospital system and a lot of things that did need to change. But we've thrown out the baby with the bath water and now need to get back to basics.

Steve, London,

I'm sorry to say it, but I will. After four weeks in hospital in the last couple of years. the problem lies with the quality of the cleaning staff. No one else wants the job so it goes to (mainly) men from other countries and cultures who do not have the least idea of what the work entails. They seem to think that an inadequate wafting of a dry mop on the floor without picking up stubborn litter or moving stuff that's in the way is all that's needed. I have watched in amazement as this performance went on day after day and felt like getting down and doing the floor myself. So, my wife cleaned up after the cleaner had done his job. I'm talking now about three separate hospitals. A modern nurse doesn't do that job anymore, and there's no chance of bringing her back.

John, Birmingham, UK

whats needed is more people running around with bed pans and less people strutting around with clip boards

jerym eedy, caerphilly, uk

Bring it on!
We are volunteering for the job. I think our CVs are appropriate:
retired health professionals, fit in mind and body, and fully paid up members of the WI.......

Rosy Platt, Sutton Coldfield,

Since when has nursing been an "academic" subject? It seems to me that we don't actually have nurses now. We have "paramedics", who see themselves as little less than doctors, and we have auxiliaries who bring and take away the food, but we don't actually have nurses - people to care for patients, keep them clean and comfortable and make sure they are properly fed.

Martin Evans, Newmarket, Suffolk

Get rid of the twits with clip boards, and replace them with workers with scrubbing boards, and then decrease the admin
staff by 60%, while increasing the front line staff by at least as much. Then stand back and watch the difference. It's the armies of administrators who create the problems, and cost a fortune, while the nurses are the real workers, who actually make a difference.

Lezli Taubler, London, UK

What a splendid idea, Ms Purves. There might even be outside funding for it - from the television industry. Imagine, "How clean is your hospital?". I'm sure Kim and Aggie would be up for it.

Will Martin, Kent,

Oh Ms Purves, thank you, thank you, thank you!!! As a nurse of some 32 years standing, and having worked in both the NHS and private sectors in the UK and the public and private sectors in Australia (where I currently reside after 10 years in London) I can only applaude loudly your idea for a one month attack on hospitals. In fact, I'll offer to do it down here at the same time as you do it up there! It constantly amazes me that medical, nursing and allied health personnel don't understand the very basics of hospital hygiene. Sure, we had bugs back then, but nothing like we have today and all because we lost the plot with cleaning. So, let me know when you plan on commencing the attack!

Kathryn, Melbourne, Australia

If only!

Barry Mellish, Bromley, UK

I remember when we got cockroaches in the kitchens at a large teaching hopsital in the north of England. My consultant commented that St Elsewhere's in London would have bigger ones.

The staff canteen was due to be renamed at the same time and there was a competition on for the new name. For some reason management overlooked our suggestion of "The Roach and Horses."

Dr Peter Davies, Halifax, West Yorkshire