It may have been the "apparently high mortality rates in patients admitted as emergencies" that prompted the first of many investigations into Stafford Hospital. But it's the reports of bedridden patients lying in their own urine and excrement that illustrate the depth of the "systemic failure" at the hospital. Because everybody knows that isn't right. You need no training – medical or otherwise – no management expertise or experience, no special "vocation" or long-honed skill, to understand that you don't do that to animals, let alone humans.
And that, in a nutshell, is the problem. Our intensely hierarchical economic system runs on specialisation – the attainment of qualifications, the accumulation of experience, the possession of skill, talent, instinct, flair, ruthlessness, the ability to manage or make money, all wrapped up in a bundle that makes an individual special and unique. So the things that all humans are expected to comprehend, and be able to turn their hand to, have no value.
I'm not just talking about the NHS. Of course, hospitals contain concentrated numbers of people who can't get to the loo by themselves, and a lack of cleanliness can and does have sometimes fatal consequences. So the general failure to reward "menial" tasks is particularly egregious in hospitals.
But it's the norm now, in all organisations, for the people who clean up after others to be unimportant, poorly paid and denied the employment rights that are awarded to those they serve. David Cameron now says that nurses should be paid according to the level of their care and compassion. Why so? Nobody else is. The cleaners of lavatories, the scrubbers of shit, the moppers of piss, they're all on the vastly inadequate minimum wage (something the Conservatives fought tooth and nail to resist), and that's if they are lucky. It's simply wrong for an entire culture to run on the idea that such work is demeaning, fit only for the desperate, then be appalled when no one – not even nurses – prove to be immune to such overwhelming and deliberate stigmatisation.
This is not about public versus private sector. Actually, it never is. It's about cultural values versus economic values. As it always is. This week, alongside the final report of the fifth inquiry into the Stafford hospital scandal, came the news of Gloria Foster's horrific final days. A private company, Carefirst24, had been coming in to look after the 81-year-old widow four times a day. But the agency was closed down last month, after police and the UK Border Agency raided its premises, arresting six people who are alleged to have employed illegal workers using the identities of former staff. Surrey county council were supposed to have taken over her care. But she was "forgotten", and on a chance visit a district nurse found her, neglected beyond saving. She had lain alone, dying, for nine days.
Obviously, blame can be doled out, in this particular instance, to both the public and the private sector.
Yet, underlying it all is a common, almost universal problem – that of recruiting UK citizens to do work that is not highly regarded, economically or culturally, in this country. In this respect, public versus private, left versus right, is a misguided, counter-productive, proxy war, played out in the most blind, address-the-symptom-not-the-cause way as an "immigration" issue.
The right insists that, without the welfare state, people would have no alternative but to accept work that is seen as neither culturally nor economically rewarding, seemingly oblivious to the fact that this would further stigmatise the work.
Is it realistic to expect people to be such paragons that they take pride in care and compassion that neither pays the bills nor provides social respect? Isn't it weird to expect the least successful to take a stand against the economic and social values that the most successful members of their culture reject?
The left, meanwhile, has all but given up trying to persuade the private sector that the example set by its own values is a huge part of the problem they profess to hate. What's the best way to lower taxes, decrease the size of the state, tackle unemployment and stimulate the economy? It's for the private sector to offer security and status to all of its employees, instead of dividing them into valued staff members and shadowy night-time figures on cost-saving contracts. Yet rather than making cultural arguments, the left all too often ends up defending an economic status quo doomed forever to generate a bigger state and higher taxes.
It's staggering that contracted agency employment, which does so much harm in terms of the status of work and the role of "teamwork" that management consultants consider to be so important, has been adopted wholesale by the public sector instead of rejected in self-disgust by the private.
The history of nursing over the last half-century, of its movement from vocation to profession, is part of the problem with Stafford, as is widely acknowledged. But it cannot and should not be seen as an isolated case.
The problem is not just that people with degrees don't necessarily want to strip beds. It's also that it's assumed that those who do strip beds are doing so because they are no capable of nothing "better". That contempt is written into a system that ignores the demand for such work, and its importance, because it wrongly believes that there's an endless supply of interchangeable and instantly replaceable people to fill it. There is not. That's why, outside government, in the Confederation of British Industry and the Institute of Directors, conservatives are supportive of high levels of immigration. They want people who have different economic and cultural values to the ones they promote themselves, to do work that they want to curl their lip at and call "dirty" or "unskilled".
Hospitals are a case in point. There's plenty of skill in being kind to people who are ill, confused, in pain, frightened, lonely and dependent. There's plenty of skill in taking the time to smile, show an interest in people's woes, exchange some warm pleasantries and take an interest in providing comfort. Part of the misery of being in hospital is that the nurses don't have time for that, and trying to steal that time makes patients feel guilty and apologetic, on top of everything else.
Yet it's ludicrous to make nurses an exception, standard-bearers for care and compassion in a system that otherwise rejects such skills as bleeding heart do-gooding with no economic viability. Compassion should be a priority in all walks of life. Instead, the ability to "create wealth" is.
Care and compassion are a debased currency that society's losers are supposed to hand out, free, throughout the "system". But how can low-paid workers have compassion to spare, when they are never shown any?