Rise and demise of the hospital: a reappraisal of nursing

Abstract

Hospitals face an uncertain future. After a century of achievement and progress, the public, clinicians, managers, and politicians are increasingly expressing concern. Currently, the UK public's principal worry is the danger of hospital acquired infection, particularly methicillin resistant Staphylococcus aureus (MRSA),1 but it also includes mixed sex wards, poor quality food, inadequate cleaning, insufficient attention from staff, and the risk of being the victim of a medical error. In 2000, 850 000 adverse events occurred a year, costing the health service £2bn ($3.4bn; €2.9bn).2 Up to 40 000 patients die each year because of iatrogenesis, with a similar incidence in other industrialised countries.3 This contributes to politicians' enduring concern: hospitals' apparently insatiable appetite for resources.