Month: July 2016

Visit to the UCLH Archive

I recently paid a visit to the University College London Hospital (UCLH) archives in Euston to discuss gratitude and see some of the archive’s holdings. Annie Lindsay and Penny McMahon have charge of a vast amount of material. Some fascinating highlights are on public display in UCLH’s highly recommended heritage trail. Annie and Penny gave me an insight into the kinds of documents that are preserved. Patronage, of course, is well documented, and this has an enduring legacy in a number of wards in hospitals being named for their donors. Complaints are also kept on record although, interestingly, Annie pointed out that in the past this largely depended on the diligence of the superintendent in charge. I was shown a formal complaints form from 1890. Complaints were often lodged by the patient’s sponsor on their behalf if it was felt that treatment was not up to the expected standards that the sponsor had paid for. Does paying for treatment at the point of delivery make complaints more common, I wonder?UCLH archive

We also discussed how gratitude is given and received today. Social media is important at UCLH and tweets saying ‘thank you’ are printed in the staff magazine. Patients expressing gratitude in this way is clearly valued and noticed. There is also a ‘good deed feed’ on the staff intranet for saying ‘thank you’ to colleagues.

The UCLH archive has a great collection of photos. The pic on the right is one of staff participating in festive shenanigans to help raise money for the hospital.

Doctors’ views on gratitude

A few weeks ago I had the opportunity to present some of my work on the gratitude expressed in the Frimley correspondence to GP trainers and trainees from West Middlesex Hospital, whose two days away were delightfully themed around ‘happiness’. It was a nice way to hear some stories of gratitude from the frontline.

We had a lively discussion about whether patients are morally obliged to feel grateful. Lots of the delegates were uncomfortable about the word ‘moral’, although most agreed that patients had lots to be grateful for. The overwhelming majority felt that patients should be grateful for the NHS in general, rather than specific practitioners. This sits uncomfortably with some of the literature (e.g. Simmons, 1979, Moral Principles and Political Obligations) in which it is argued that there are difficulties with expressing gratitude to an institution, especially if the individuals that form it are merely carrying out their duties. Most of those joining in the discussion thought that gratitude was owing to the NHS because patients got a lot more out of it than they put in. Some invoked comparisons with other parts of the world, making the case that access to the NHS is a privilege and definitely something for which to be grateful.

When it came to receiving gratitude, the most memorable gifts or cards came from patients from whom it was unexpected. An example was given of a man that had to be sectioned and was incredibly angry at the time, so a card saying ‘thank you’ a few weeks later was particularly touching. Homemade food as a currency of gratitude was also prominent, especially amongst the Asian community. Receiving gifts was confirmed as a particularly tricky issue for doctors with high potential to cause offence by refusing gifts, but sometimes it’s tricky to tell whether gifts do indeed come with strings attached.