Mixed-sex wards endanger and humiliate women
Courtesy of some artful timing, the latest of Theresa May’s difficulties – on mixed-sex hospital wards – caused less of a stir than her choice of the Alps, also disclosed as Westminster shut down, for her and Philip’s next walking holiday. Confirmation of a 50% rise, in May’s one year in office, in the number of patients treated in same-sex wards, a subject of consuming Tory interest until she dropped it from their manifesto, must now take second place to a £26 shirt dress.
Accusations of shiftiness are more quickly forgotten, after all, than are reversals on this scale. The unacceptability of mixed-sex wards has been a cherished theme for every opposition since Tony Blair alighted, in 1996, on what is still, universally, agreed to be a valid cause of public upset.
Mixed wards, he said “cause indignity, upset people”. Subsequent studies, including a 2008 examination of nurse and patient perspectives, confirmed he had not exaggerated. There were patients, it confirmed, of both sexes and of varied ages, who “experienced a lack of privacy, worried about bodily exposure and felt uncomfortable”. Nurses entirely sympathised. “Mixed-sex accommodation,” it concluded, “is an unacceptable solution to bed shortages.”
Moreover, investigations showed, objections go far beyond the allegedly trivial ones, according to more disinhibited patients, of commodes, Carry On! gowns, proximity to men who might resemble, to pick one or two names at random, the Pimlico Plumber and twat-detector Charlie Mullins or the BBC star and famed beauty connoisseur, John Inverdale.
Patients and their relatives attested to intrusion, exhibitionism and leering from nearby beds, even with staff around. In 2009, Channel 4 discovered that almost two-thirds of sexual assaults by patients in hospitals (21 out of 33 in 2007/8), occurred in mixed-sex wards. Variations on Blair’s question to an evasive John Major – “Is it beyond the collective wit of the government and the health administrators to deal with that problem?” – was a reliable line in opposition outrage until Jeremy Hunt declared in 2014 that this indignity was “nearly”, or “virtually”, history.
Regulations introduced by the coalition government in 2010 compelled hospital trusts to report their figures for mixed-ward occupation, then fined them £250 per night for breaches. “We want to see the end of mixed-sex wards,” Nick Clegg said. “Everybody knows this has got to end.” As recently as his 2015 conference speech, a key part of Hunt’s claims to representing “the party of the NHS” was the unqualified triumph: “mixed sex wards eliminated”. The mysterious disappearance of mixed-sex elimination from the recent Tory manifesto, plus its own virtual elimination from the J Hunt repertoire, has in turn revived opposition testimonials to the distress underlying the statistics.
Norman Lamb, the Lib Dems’ health spokesman, described soaring mixed-sex breaches, as hospitals come under more pressure, as “an utter scandal and an affront to basic human dignity”.
If this trend continues, thousands more patients may, when parliament resumes, have occupied a bed a few feet from a stranger of the opposite sex, an arrangement explicitly deplored in the NHS constitution. It “commits” to patients “that if you are admitted to hospital, you will not have to share sleeping accommodation with patients of the opposite sex, except where appropriate”. As for providers, they are expected, according to the NHS handbook, “to eliminate mixed-sex accommodation except where it is in the best overall interest of the patient involved or respects their personal choice”.
Pending the Brexit-funded, £350m-a-week NHS spending bonanza advertised on buses by his fellow ministers, Gove and Johnson, and the vast number of individual en suite rooms that will result, maybe Hunt’s best solution to his mixed-ward catastrophe lies in a collective shift in those personal choices. As Justine Greening has confirmed, announcing her consultation on the 2004 Gender Recognition Act, plus an LGBT survey to inform public services, the May government is not unfamiliar with recent shifts in thinking about gender identity. These, if more generally accepted, could see the end of binary arrangements such as men and women’s hospital wards. What if Hunt reimagined his privacy-free wards, washrooms and lavatories, as not so much a system in collapse as a success for the concerned, gender-aware progressives who used to be called the Tory party?
True, the consensus, at least in mainstream opposition politics, that mixed-sex wards are an outrage, dangerous, a disgrace, even, possibly, a breach of article 3 of the Human Rights Act – against inhuman or degrading treatment – militates against any rapid acceptance that their polarising of sex difference could do more harm. Then again, looking at the speed with which gender-neutral lavatories have spread, largely as a response to trans people’s experiences of discrimination in binary bathrooms, he might find himself on the right side of history, if the wrong one of his own constitution.
A health service that is instructed by the BMA to use the term “pregnant people”, so as “to include intersex men and trans men who may get pregnant”, will naturally wish, Hunt might argue, to extend this level of inclusiveness to the old men/women ward arrangements, provided that there are plenty of curtains, tons of dignity and low voices. The risks to women in gender-neutral/mixed-sex wards, from the sort of molestation documented by Channel 4, are less easily countered. Not, emphatically, because such wards would include trans women or men identifying as women who have not physically transitioned: their choices are already respected in wards. Rather, when the irrelevance of biological difference is used to cancel women-only spaces, some of them hard won, these effectively become public areas, no different from the trains and tubes where, it turns out, sex attacks, most of them against women and girls, have doubled in five years.
Any woman catching up with that news in a mixed-sex ward may have reflected that offenders, when at large, sometimes fall sick. The increased likelihood for patients of being in a mixed-sex ward, arrives just as increased reporting makes clear the astonishing levels of day-to-day harassment experienced by women and girls.
Similarly, its male perpetrators presumably use bathrooms. The growing desegregation of these places, though deplored by many women, and with the obvious threats to safety, privacy and dignity, has signally failed to inspire – maybe understandably if you consider the male sanitation gains – even a fraction of reflexive, high-level revulsion as do mixed-sex wards.
Samira Ahmed’s persuasive complaints about the Barbican’s opening to all a women’s loo did not prevent its endorsement elsewhere as a model of inclusivity; women’s resentment about surrender of their space being, we are instructed, as quaintly unhinged as it is nakedly transphobic. All of which makes same-sex wards yet more worthy of defence: they could soon be the only surviving women’s spaces.