Why do seemingly caring people behave unkindly? As one author put it, ‘how do good staff become bad?’ (Farquharson, 2004, p. 12). There are many dimensions to this question. There is always a systemic component which will be considered later, but in this chapter we focus on the processes at work at the individual level.

First, it seems appropriate to remind or acquaint ourselves with some of the most notorious scenarios that have occurred in supposedly caring institutions. We start with a description of a ward in Mid-Staffordshire NHS Trust, in the English Midlands, between 2005 and 2009 taken from the executive summary of the report of the inquiry (Francis, 2010, p. 10).