A constant stream of harrowing media stories highlights incidents of extreme lack of compassion in institutions charged with caring for the vulnerable. The recent Delivering Dignity report is an attempt at addressing this perceived problem in the care of the elderly in hospitals and care homes. The 2011 Dilnot Report, responding to a situation where demand for adult social care is predicted to rise by 25 per cent in the next decade, argues for a ‘root-and-branch reform of the system’.

How can we tackle this supposed compassion deficit? Suggested solutions include checks for evidence of compassion, such as the evaluation of staff’s caring skills ‘as a measure of performance’, an emphasis on ‘dignity and compassion’ as core competences of the nursing syllabus and NHS recruitment procedures, and local dignity champions in every hospital. But can we really train people to be compassionate? Might this become no more than red tape and checklists? As the Alzheimer’s Society observes, ‘there is no such thing as a one size fits all approach to care’. Might such external measures even backfire and undermine carers’ confidence in their capacity to care for the old, infirm and vulnerable? Is the problem institutional, the NHS being too big and bureaucratic, the private sector being too interested in profit-making to care? Might we look back to the old charitable hospitals as a model, or indeed the contemporary hospice movement?

Or is there a deeper cultural problem? The popularity of TV programmes like the BBC’s Call the Midwife affirms an ongoing cultural validation of the ‘caring professions’, but do we as a society care less about each other? Superficially, we are encouraged to display our caring credentials with an assortment of plastic wristbands in support of various causes and to help our neighbour through the Big Society initiative. But with even volunteering widely promoted in schools as a way of boosting your CV, are we viewing compassion too instrumentally? If so, is there even an institutional fix? Even if no one had to pay for social care and ward sisters and staff threw out the checklists, would this mean an end to the disturbing headlines? Does the crisis in compassion for the elderly reflect a deeper lack of respect for wisdom and experience? What are the causes behind our seeming inability to care?

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