The System’s Illness

I have long argued that a health unit genuinely oriented towards health cannot make ill those who place their trust in it. Treating people as diagnoses, reducing identities to bed numbers, infantilising the patient instead of recognising the citizen, all of this reveals a structural failure: a system that has lost its own sense of purpose.

Treating people well is not merely a matter of care. It is a form of governance.

This is not a matter of distinguishing between public and private provision. It is a matter of governance. It requires recognising that the way we treat people also reflects how we manage resources, decisions and institutions. The absence of dignity and respect is not merely an ethical failure, it is also a problem of management, productivity and sustainability.

As the Harvard Medical School has emphasised, “Respect is an essential component of a high-performance organization. It helps to create a healthy environment in which patients feel cared for as individuals, and members of health care teams are engaged, collaborative, and committed to service.” (Lucian L. Leape, Harvard Medical School, Setting the Stage: Why Health Care Needs a Culture of Respect, 2018).

Every dehumanising gesture prolongs hospital stays, deepens dependency and increases costs. The absence of listening and empathy deteriorates organisational flows, delays recovery and undermines trust. A system that fails to understand this relationship ultimately produces illness itself: in bodies, in teams and in institutional reputation.

To treat well is not merely to care. It is to govern with clarity. And those who govern with clarity understand that health, trust and efficiency are inseparable. A unit that treats disease without understanding what makes the system itself ill loses the essence of its mission.

Treating well is not a detail. It is a form of governance.