SIR – The reaction to your story about dirty toilets at Worcestershire Royal Hospital (Worcester News , August 25) tells us a good deal about why things go wrong in NHS hospitals.

Everyone is either passing the buck or being defensive.

In the story a nurse is reported to have said: “It is not up to me to see that it is clean.”

It may not be the nurse’s job to do the cleaning, but the nurse should take action to see that something is done.

But now that all nurses are graduates, they seem to think such aspects of basic care are beyond them.

The patient was advised to report the problem to the ward sister.

A ward sister should take notice of everything that affects patient care and should know from observation whether the toilets are clean without needing to be told.

The chief nursing officer [Helen Blanchard] said she was “disappointed” with the patient for not wanting to discuss her concerns directly.

Given the chief nursing officer’s defensiveness and the attitude shown to the patient by the nursing staff, can it really be surprising that the patient felt she would be wasting her time if she reported the matter to the ward sister?

KELVIN HARD

Worcester