Tuesday, 18 July 2017

A cost-free improvement for the NHS

I have not actually seen the film "The Sense of an Ending" but was sufficiently intrigued by the adverts to buy Julian Barnes's book.  There I was delighted to read, put in the mouth of the first person narrator, Tony Webster, sentiments that coincide exactly with my own:

Do you know something I dread?  Being an old person in hospital  and having nurses I've never met calling me Anthony, or worse, Tony.  Let me just pop this in your arm Tony.  Have some more of this gruel, Tony.  Have you done a motion, Tony?*  Of course, by the time this happens,  over-familiarity  from the nursing staff  may be well down  my list of anxieties, but even so. (Page 69)

Change "Peter" and "Pete" and that's exactly how I feel, not just in the context of old age and physical incapability, but in all contexts when discussing matters with people I neither know nor am likely to know. (eg buying insurance over the telephone, receiving letters from my Party's leader).

However, Barnes is right (presuming he is airing his own views.) that the situation is most acute in the medical context, when we feel at the most vulnerable.  In that situation the last thing we need is to addressed  by authority figures in a manner which takes us back to our days in the mixed infants.

So the free improvement for the NHS is that all staff should  address people by their honorific (Mr. Mrs, M/s or something posher) and family name  and that should be the default position.   If patients then prefer their first name, nickname or something more familiar that's fine, but the initiative should come from the patient, not the practitioner.

I am not and never have member of BUPA or any other private medical scheme, but I'm pretty sure  that in those places patients are" Mistered" and "Missised" routinely.

More generally, the English language, which is so prolific is most other areas (we have half a million words and counting, compared with a mere 100 000 in French) we have no equivalent of the French Monsieur,
Madame or |Mademoiselle, which can be used indiscriminately without any sense of status difference or servility.  The French also get around the difficulty of distinguishing between Missises and Misses by addressing every woman who appears to be over 30 as Madame. (though that may be an unwelcome rite of passage)

In English, outside school, the army, police  and high-end department stores , "Sir" and "Madame" sound deferential, and outside Buckingham Palace and detective stories featuring senior female officers I suspect no-one uses the abbreviation  "Ma'am" (to rhyme with "jam," not "psalm").

I have no suggested alternatives to make but should be pleased if someone could come up with one to replace "Pall", "Mate" "Squire " (ugh) or nothing at all.

Of course, here in Yorkshire the unisex "Luv" covers all cases

*Barnes himself has dispensed with quotation marks


  1. For once, I agree entirely. Except that I don't think the distinction is quite as stark as you think: there are certainly those within the NHS who use titles, and there are those in private healthcare who are altogether too familiar.

    I think it's just a general sad and regrettable trend of the modern world in all aspects that people feel they can address you using your Christian name as soon as they meet you. O tempora o mores etc, if only we could turn it back.

    And also, 'jam', 'psalm' and 'Ma'am' all rhyme (and so do 'Sam' and 'ham').

    1. Well it's great that we're 90% in agreement. I can't comment on private health-care as I've never been involved in it, but it's interesting that the higher-status people in the NHS (consultants, doctors) tend to be the more polite (ie formal) and it's the receptionists and junior nurses who tend to be excessively matey. Oddly enough, I'm quite happy to be called "Luv" but bridle when people I've never met before use my given name.

      On pronunciation I'm afraid I disagree."Psalm" has a long "a" as do "palm," "calm," "farm," "harm." "Jam" has a short "a" as in "Sam" "ham" and, apparently "Ma'am" (and certainly "Mam," as in Allen Bennett.

  2. Thank you so much for giving me the link to your blog! I've just been reading through your articles, so interesting and captivating - what an inspiring person!
    I look forward to reading more of your posts :)

    Best wishes,


    1. Wow, that was quick. Hope we can keep in touch

      Thanks for your kind comments

    2. More to Meg.

      I may have mislead you in my somewhat flippant response to your query about Quakers and drinking alcohol we have a series of quaintly-named "Advices and Queries" the relevant one of which is Number 40;

      "In view of the harm done by the use of alcohol, tobacco and other habit-forming drugs, consider whether you should limit your use of them or refrain from using them altogether. Remember that any use of alcohol or drugs may impair judgment and put both the user and others in danger."

      So I hope my drinking wine with my snack on the train won't have led you astray.

      My favourite "Advice and Query" is Number 27: "Live adventurously. . ."

      Look them up (I don't know how to give a link in a comment, but "Quaker Advices and Queries" should find them.)

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