By TD Fuego
Recently, there has been a spate of media reports of physical attacks on hospital staff by members of the public. Whilst these reprehensible acts must be condemned, we must not forget to think of the other side of the coin. As law-abiding citizens, we cannot obviously justify the unjustifiable nor defend the indefensible.
But, we can certainly try to understand why these phenomena occur.
People go to the NHS because they are in need of medical care. I don’t know of anyone who goes there with the slightest intention of dishing out verbal abuse, let alone physical assault, on the staff. All the member of public wants is (1) treatment for his complaint, and (2) be shown some understanding of his needs. All preferably done with a modicum of courtesy.
Being a cardiac patient since 2001, I myself have to attend (note the emphasis) the OPD on a regular basis. So, I speak with 9 years of first hand experience about our beloved (??!) NHS. Up to the gate of the hospital, the patient is considered a normal human being. Unfortunately, the moment he enters the Accident & Emergency (A&E) or the outpatient department (OPD), he turns into something worse than a stray dog as far as a large majority of staff is concerned.
For a start, as Tulsi1 would put it, no one seems to have given them any Sanskar2. Nobody will ever say “Good Morning” to you. Worse, they won’t even respond to yours. Medical friends tell me, whatever a patient’s complaint, protocol dictates that a doctor uses his stethoscope to do a HLF, check the heart and lung functions. But frankly, I cannot remember when a hospital doctor last carried out this most basic of procedure on me. As for a response to my greeting, you can forget it. Take a moment to listen to any of my concerns, also forget it.
As soon as you sit down, they start to copy the prescription the Consultant wrote down years ago. I consider this to be an utter waste of a trained doctor’s time. Other countries’ medical organisations have computerised their records and prescription systems years ago, but ours is still merrily chuffing along in the steam age. But even in that situation the NHS might as well hire a clerk at a fraction of the medic’s salary and have him photocopy the prescription because, in essence, that is exactly what every doctor I have seen does.
As for manners, at best, the staff treat the patient with total indifference. At worse, it is with the rudeness of a total ignoramus. But, the same member of staff can turn into a super, sweet fruit pie the moment he spots a friend or a relative — going to the extent of helping them jump the queue, whilst ignoring the old lady who can barely stand on her feet, as she queues up with 10 other patients outside the consulting room.
The Lady Parrot
Not very long ago, my wife was bitten by a dog late on a Sunday afternoon. So I, the dutiful husband, took her to the Victoria Hospital A&E for the usual jab, medication and dressing. As usual, there was a shortage of staff and a large number of people.
We had been there only a few minutes when three men arrived in a hurry. From their grubby appearances, it was obvious that they had been working on a building site. The younger one, who looked about 25, had had a serious cut on one of his upper arms. His mates had bandaged it with whatever piece of cloth they had on them and wisely applied a tourniquet above the wound to stem the bleeding.
As per normal procedure, they went to the Reception desk. The lady behind the glass partition asked for name, address, etc., and promptly handed them a blue card and told them to alle attane3 without so much as looking up at the man. Eye contact, so vital when dealing with people, for some reason that escapes me, is something these people seem incapable of engaging in.
Anyway, one of the men tried to reason with her that his friend was a serious case and could she, therefore, please arrange for him to see a doctor straightway. No, she insisted, they had to take their turn in the queue. Would she please at least call a nurse to have a look? Again, the same curt reply, ou bizin attane, parrot fashion, head down.
Whilst all this was going on, one of the men’s colleagues, who had been off that day, arrived impeccably dressed and clean. He also tried to reason with the lady, but to no avail. Annoyed, he even shouted at her, but she remained her impassive self. There is nothing worse than being ignored when talking to someone. Unsurprisingly, he lost his temper. But for the glass partition separating them, I feel pretty sure he would have slapped her face. Being born a coward and a confirmed pacifist, I abhor violence. But, in this particular instance, I may well have applauded the man’s action.
Hearing the hullabaloo, a man eventually came out of one of the offices. But, instead of calming down the situation, he also began to argue with the men. Eventually, they managed to get through to him of the seriousness of their friend’s wound and he arranged for the patient to be seen by a doctor. None of us who had arrived before these men uttered a word of protest about queue jumping because, even as lay people, we could see the gravity of the situation. So, why could not the “madam” behind the Reception?!
Unaware of the recruitment and confirmation procedure of the Ministry of Health, I am not in a position to make any specific suggestion. But, there are certain guidelines that are common to good personnel management (I believe it is now pretentiously termed Human Resource management; as opposed to Animal Resource management, I suppose!) across all organizations, be it a bank, a supermarket or, yes, even a hospital.
- Recruitment. Qualification is not the only criteria. That is why every organization carries out interviews and written tests, sometimes several times. Some even go as far as putting the candidate in a mock situation typical of the job.
- The square peg in the round hole. This is at the root of much of the problem, particularly in government departments and low paid jobs in the private sector. Always, try to match the person to the job.
- Training. Again qualification is not enough. Continuous training for the job is not only vital, but also a worthwhile investment.
- Further qualifications. In a fast moving world, it is imperative that staff are “encouraged” to learn new skills, acquire new qualifications. In our Cyber-island, incredibly, there are many workers who do not even know the difference between a VDU and a video.
- Standard. Staff must be told about the standard that is required of them and ensure it is always maintained.
- Discipline/Control. Must be maintained at all times. Staff cannot be allowed to chat away about last night’s television programme whilst the customer is made to wait to be served.
- Accountability. Everyone must be accountable for their action. Sometimes, it may be a matter of someone’s life or death.
- Appraisal. Performance must be appraised on an annual basis against preset targets and rewarded accordingly. Automatic promotion, based on seniority, is the bane of our not-so-civil Civil Service.
- Supervision. Even when we have done all the above diligently, people will simply not perform to standard if supervision is lax or non-existent.
- Sacking. The ultimate weapon, sometimes this is the only alternative available. We must not hesitate to send people away if they fail to deliver.
This list does not come from any textbook, nor does it pretend to be exhaustive. It is a series compiled from personal experience in a dozen different countries, in dozens of different set-ups. It provides a first, basic step towards good customer care — something we yak about ad nauseum, but invariably fail to deliver. A relic of our colonial past?!
- The lead female character of a Hindi serial
- Virtuous human values
- Wait there
* Published in print edition on 26 November 2010