Our great leaders are about to announce their rather ambitious plan to put an end to mixed sex wards in hospitals. It’s certainly not the first time this desire has been voiced. Tony Blair called for their abolition in 1996, when Labour was still in opposition, saying it should not be beyond "the collective wit" of ministers to achieve. 14 years on and it clearly was. Its successful implementation has been a goal that has eluded ministers for years.
As with many of the government’s ideas this one seems rather attractive on paper, but as soon as the practicalities of achieving it across the board are considered, it shows itself to be an unrealistic aspiration. Many of our hospitals are old Victorian buildings that would require extensive renovations in order for them to comply. These are unlikely to occur since we are living in a time of massive public service cutbacks and a pre-existing shortfall of hospital beds. I do understand the feelings of anxiety, exposure and vulnerability that mixed sex wards may create, to say nothing of those dreadful ‘backless’ hospital gowns that leave little to the imagination. If it is indeed the case that patients are left uncovered in front of patients of the opposite sex then it seems to me that a simpler and more urgently needed solution would be to improve the training and discipline of nurses and doctors on such wards, perhaps by bringing back the concept of ‘Matron’. These dragons may have been feared by all, and certainly struck terror into the heart of every junior doctor who crossed them, but boy did they get things done properly.
Rather bizarrely the government makes much of the apparent indignity of the sexes having to share bathrooms. I’m not really sure why this should be such a problem -surely there are bigger and more pressing health issue that need tackling than whether Mrs Jones prefers to find the loo seat left down when she pays a visit? As is so often the case it’s not only the idea that is questionable, but also the way in which ministers attempt to enforce their ideas. NHS trusts will be warned that they will face fines if they do not get rid of their remaining mixed sex wards by the end of the year. Just what an already cash strapped trust needs when trying to implement a change that will require a considerable increase in spending to achieve.
Just how necessary are these proposed changes? In a recent survey of 150 patients admitted to a variety of different wards 24 per cent said that they had no preference as to the type of ward they went on, and 57 per cent actually preferred mixed sex wards; their reasons being that they felt it created a more normal atmosphere and better reflected the outside world. The concept of segregating the sexes stemmed in part from the data that in the community young men commit most violent crime, and women were said to report feeling vulnerable on mixed wards. But in an institutional or hospital setting research has found a very different picture. There, women have equal rates of episodes of violence, there was considerable spread in age range, and that age and gender failed to predict assaultiveness. I cant help feeling that all this is a bit of a sly distracter however; same-sex wards may be nice to have, but must come secondary to safe clinical care and good medical outcomes. Assessing your hospitals worth by how comfortable you stay was, as you would a hotel, is most definitely flawed. Patient satisfaction and consumer choice are all very well politically, but isn’t therapeutic benefit the one main issue on which health care planners should focus? What effect will same-sex wards have on therapeutic outcome? I’m not sure anyone actually knows the answer. Yet.
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