Report 'a crisis of compassion: who cares?': Battle of ideas, 20-21 October 2012, London.

This is a summary of a conference session that was conceived in recognition of the fact that real problems have been identified in regard to the poor quality of health and social care that vulnerable people – sick, elderly and disabled people – receive in the United Kingdom. It is an issue that has been in the news pretty much constantly over the past year. This crisis began very publicly in 2009 when Margaret Haywood was struck off the UK Nursing Register for secretly filming neglect and mistreatment of elderly patients in a Brighton Hospital. She had resorted to this underhand approach because she had not had a positive response when she tried to draw attention to the poor care she was witnessing (see debate between Paul Wainwright and Chris Belshaw in Nursing Ethics 2009; 16(5)). Moreover, in 2009, in Stafford Hospital, appalling standards of care and chaotic systems were revealed. The fall-out from that still reverberates. Then, there was the horrific Panorama exposé about Winterbourne View where vulnerable people were teased, taunted, kicked, poked, slapped, doused with cold water, had mouthwash poured into eyes, wet wipes forced into a mouth, head butting led to a broken nose and so on. Eleven members of staff have pleaded guilty to abusing vulnerable patients and have now been sentenced (http://www.bbc.co.uk/news/uk-england-bristol-20092894). Christina Patterson’s articles in the Independent about her poor care added fuel to the fire, horrified readers and embarrassed the nursing profession sending the leadership scurrying for excuses and solutions. And we have had the dehydration scandal. A 22-year-old diabetic patient was so desperate for a drink of water that he phoned the police from his hospital bed. The Office of National Statistics reported that 43 hospital patients starved to death last year and 111 died of thirst. Another 8 people starved to death and 21 people died of thirst in care homes. So, nursing and care in general has been tried and found wanting. We have been accused of being uncaring and too posh to wash. Whistle-blowing, undercover reporting and filming are consequently now commonplace in care settings. All types of solutions – technical, educational and regulatory – have been suggested or are being implemented in an attempt to address this crisis of care. This week, the government announced that it is to spend £46m training 10,000 National Health Service (NHS) workers, half of whom will be nurses and midwives, to develop skills, knowledge and competence in leadership so that they will then provide exceptional care and act as role models and inspirational leaders for future caregivers. A whistle-blowing charter ‘Speaking Up’ has also just been launched. Twenty-eight