No official statistics are kept for the number of hospital patients, in particular older people, who are subjected to neglect and abuse. That is, left malnourished and dehydrated, in pain, allowed to develop agonising and fatal pressure sores, not taken to the toilet, left to lie in their own bodily waste, cared for in a filthy environment and at risk of infection, ignored, allowed to fall over repeatedly, not spoken to, left naked or dressed in other patients' clothes - and discharged from hospital prematurely. This book bears witness to all these practices and more. Setting out a wealth of evidence not previously brought together, Michael Mandelstam shows beyond question that neglectful care is a systemic blight, rather than mere local blemish, within our health services. He analyses the causes and factors involved, reveals the widespread denial and lack of accountability on the part of those responsible - and spells out the political, moral, professional and legal implications of this failure to care for the most vulnerable of patients with humanity and compassion. Most important, Mandelstam points to the main obstacles to a solution - and to how they can be removed and change be accomplished.This book should be read by anyone concerned with the state of our health services, including National Health Service users, government policy makers and planners, public health practitioners and academics and researchers.

Foreword. Preface. 1. Introduction. 2. Assessing the Evidence for Neglectful and Abusive Health Care. 3. Health Services: Public and Private. 4. Systemic Nature of Neglect and Abuse Within Health Care. 5. Dignity in Care: All the Good Guidance. 6. Dignity in Care: All the Bad Practice. 7. Getting to the Toilet and Management of Continence. 8. Keeping the Environment Clean and Managing Infection. 9. Helping People Eat and Drink. 10. Pressure Sores and Falls. 11. Hospital Beds, Admissions, Stays and Discharges. 12. Older People: the Unwanted. 13. Patient Voices, Consumers and Markets. 14. Staffing Levels, Competence and Attitude. 15. Priorities, Targets, Fear and Bullying. 16. Misinformation, Concealment and Spin. 17. Muted Voices: Clinical and Professional Integrity. 18. Denial, Accountability and Blame. 19. Legal Implications of Neglect and Abuse. 20. Human Rights. 21. Criminal Offences of Ill Treatment or Wilful Neglect. 22. Manslaughter. 23. Health and Safety at Work Legislation. 24. Regulation of Health Care Providers and of Health Care Staff. 25. No Secrets: the Policy of Safeguarding Vulnerable Adults. 26. Negligence. Concluding Postscript. Index.