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Doctors and nurses have reacted strongly to publicity of patients' poor experiences at North Shore Hospital.

Quite rightly, they and some patients who have been successfully restored to health there argue that medical treatment is excellent in all but a few cases at North Shore and throughout the public system.

Most people, most of the time and particularly in cases of obvious emergency, seem to talk positively of their medical treatment and the doctors and nurses involved. And that is no more than we should be able to expect.

Where there does seem to be a systemic problem is in broader care and attention shown to those unfortunate enough to show up at North Shore, and some admitting areas and wards of other big hospitals.

Blame it on overcrowding, underfunding, staff shortages, bed and equipment shortages or staff members dispirited and cynical for whatever reason, personal or professional. But it cannot be denied. Nor can it be shrugged off as inevitable or acceptable.

Too often, sick people wait, are assessed, put somewhere else to wait and then abandoned. Hours pass in pain and anxiety in waiting rooms and corridors, with little chance of catching the eye let alone the attention of a passing medic.

Some staff seem to have perfected a distant stare beyond waiting individuals. Wilfully ignoring members of the public as a means of prioritising workload would not be countenanced in any other form of public service. Why is it seen as unavoidable in perhaps the most important of all?

If a room or a procedure is unavailable, surely a human face with clear communication and genuine caring can be managed in the meantime. The nurses who do stop to do it lift spirits and improve understanding.

Lines of beds holding quite ill patients in corridors are the most visible sign of unsatisfactory services. Exacerbating the problem are "efficiencies" and changes in non-medical services such as catering and cleaning: meals left out of reach of a marooned patient; beds unmade or unchanged for days; cleaning of child patients left exclusively to parents.

Trivial as these issues may seem to the hospital administrator or medical expert, the cumulative effect on patient and public confidence in the standard of care can be great.

Failings in "service" are common strands of complaints made to the Herald since a mother's story published last Saturday about her daughter's distress at North Shore Hospital with abdominal pain.

In today's paper, members of the surgery department respond to that case and another reported this week. In an open letter, they address issues of medical treatment and physical building and bed limitations.

But they do not discuss the distress the young woman suffered from incidents of offhand or negligible communication, or why buzzer calls for pain relief might take 90 minutes to be answered. The surgeons write, curiously, of "perceived delays in care" at their hospital.

Improvements in administration and resourcing cannot simply be about more heads, bricks and mortar. They must also change attitudes.

A Waitemata District Health Board review of the "care" of David MacDonald, who had to crawl along the floor to seek pain relief when he could not raise nursing help and was then left on the floor by a nurse, says staff have been reminded of the need for "timely pain relief and compassion".

Those who govern our hospital system should also take heed.