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Politics in the NHS


The importance of cleanliness in hospitals
Harold Lambert Physician
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We don't know how much of cleanliness is symbolic, but even if it's not... even if washing the wall didn't actually get rid of the bug, it's certainly a very important symbolism of your care, and there were two elements to that. One is I realised that it's probably not true of the modern generation managers but those early managerial system people... I realised it wasn't a thing they thought was up to them, whereas I thought it very much was up to them. And the other thing was changing contracts for ward cleaning and, you know, you had these ward... what were they called, orderlies or whatever. Anyway, they were part of the staff, and they took the tea round and they knew the patients, more than I did because I wasn't there much and they were, in that sense. And, you know, Dolly would come and say, Mrs... and all that sort of stuff, and they were promised their jobs, but within weeks of the contract they got rid of them and they had perfectly pleasant, nice people but a) they didn't know how to deal with this, and b) they moved from ward to ward. And I regard that as a very, very important moment in... plus the managerial feeling of distance. I mean, I remember what... I was going to a meeting in London and I walked out to go to the tube at Tooting and the hall of ours was filthy. And I rang up to speak to the senior executive and he was somewhere else. Then I had to go to the meeting and I came back and rang again and I got hold of some junior administrator and the really depressing thing was that he was quite interested in what I said, he wasn't defensive at all, but he obviously didn't think it was what he was doing, part of his deal. Isn't that amazing? I mean a hall of a hospital should be cleaned many times a day, shouldn't it?

[Q] Absolutely.

British doctor Harold Lambert (1926-2017) spent his career tackling infectious diseases, helping in the development of pyrazinamide as an effective treatment for tuberculosis. He also published work on the rational use of antibiotics and was a trustee and medical advisor for the Meningitis Research Foundation.

Listeners: Roger Higgs

Roger Higgs was an inner city GP for 30 years in south London, UK, and is Emeritus Professor of General Practice at Kings College London, where he set up the department.

He gained scholarships in classics at Cambridge but changed to medicine after a period of voluntary work in Kenya in 1962. He was Harold Lambert's registrar for 18 months in the early 1970s, the most influential and exciting episode in his hospital training. He set up his own practice in 1975. He helped to establish medical ethics as a practical and academic subject through teaching, writing and broadcasting, and jointly set up the 'Journal of Medical Ethics' in 1975.

His other work included studies in whole person assessment and narrative in general practice and development work in primary medical care: innovations here included intermediate care centres, primary care assessment in accident and emergency departments, teaching internal medicine in general practice and establishing counselling services in medicine.

He was made MBE in 1987 for this development work and now combines bioethics governance, teaching and writing with an arts based retirement.

Tags: Tooting

Duration: 2 minutes, 3 seconds

Date story recorded: October 2004

Date story went live: 24 January 2008