Experience is a wonderful thing: it enables you to recognise the same mistake when you're just about to make it again.
Unfortunately, the NHS seems to have pockets of fundamental amnesia when it comes to care of the elderly, as the new report from the Parliamentary and NHS Ombudsman reveals (the Ombudsman, Ann Abrahams, will give evidence to the Health select Committee at 10.30 today).
I have seen reports of this kind too often, and I've only been writing about the NHS for 13 years. Most recently, last November.
Here is a Comic Relief and DH report from 2007 into the prevalence of abuse (this is in private homes).
Here is the 2006 joint report from the Audit Commission, Healthcare Commission and Commission For Social Care Inspection into services for older people, which "found that some older people experienced poor standards of care on general hospital wards, including poorly managed discharges from hospitals, being repeatedly moved from one ward to another for non-clinical reasons, being cared for in mixed-sex bays or wards and having their meals taken away before they could eat them due to a lack of support at meal times. ... some older people can be particularly vulnerable and it is essential that extra attention is given to making sure that givers of care treat them with dignity at all times and in all situations. To fail to do this is an infringement of their human rights".
Here is a report from the Standing Nursing And Midwifery Advisory Committee in 2001, which was abolished in 2005. This document states that the care the elderly receive is "mainly deficient" in meeting basic need.
I could search on and on and on. God knows how many such reports senior health journalists such as Nick Timmins, Nigel Hawkes or John Carvel will have seen.
In the event that similar levels of mistreatment were happening to animals, my sense is that we would see criminal prosecutions.
The uncorrected oral evidence of the health select committee first session on complaints and litigation offers telling testimony.
This is not a problem everywhere in the NHS. There are many organisations and individuals and teams who take nursing and patient dignity incredibly seriously. But there are pockets of stinkingly bad performance.
Stinkingly bad performance which organisations, teams and individuals allow to continue. And consequences do not appear to follow.