Rosemary has just spent two days in hospital, where, despite being over 70, an ex-smoker with a heart condition and a still-rotting leg from MRSA contracted in 1997, her treatment was tip-top. What a surprise! Being old and female, she is a dead loss in terms of "monetary value", AKA "wider societal benefit". And she is not even "pushy" – an attitude David Haslam, Nice's chairman, thinks we must all adopt if we're to get the best treatment.
Does Mr Chairman really know what he's talking about? Rosemary was treated almost too perfectly. The nurses were so attentive, she had to beg them to leave her alone. But it wasn't allowed. They had strict instructions, on a plastic card hanging from their waists, which must be obeyed. The card ordered them to ask Rosemary the same list of questions every half-hour: What was her name (already up on the wall)? Date of birth? Any pain? Need the lavatory? Was she comfortable? Want her position changed? Had she everything she needed close at hand? Nurse must also tell her the plan for her day. Anything else? Written in bold on the card, so Nurse didn't forget to tell the patient: "I have the time." Plus a reminder to reset the cardboard clock beside Rosemary's bed every 30 minutes, the only thing Nurse failed to do. Naughty. It was in capitals on both sides of the cards.
Poor nurses. Does management think them all dim and incompetent? Rosemary was worn out by her regular inquisitions, and not even thrilled by her "welcome pack" with its eye-mask, ear plugs, pencil, paper, non-slip socks and shiny information booklet, which all looked rather costly. She wondered who was shelling out for all this. Wouldn't a few more doctors and nurses have been better value?
"Sounds like teaching to me," says Fielding, who was bossed around and mistrusted by management for years, while he slaved away at the chalkface – while some other creatures make a fortune out of shiny booklets. Perhaps management needs a list of instructions. On a sheet of cheap A4. I have some suggestions …