Editorial

Bridget Penhale (School of Health Sciences, University of East Anglia, Norwich, UK)

Margaret Flynn (Director, Flynn and Eley Associates Ltd., Llandudno, Wales, UK)

The Journal of Adult Protection

ISSN: 1466-8203

Article publication date: 23 February 2021

Issue publication date: 23 February 2021

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Citation

Penhale, B. and Flynn, M. (2021), "Editorial", The Journal of Adult Protection, Vol. 23 No. 1, pp. 1-5. https://doi.org/10.1108/JAP-02-2021-067

Publisher

:

Emerald Publishing Limited

Welcome to the first issue of this volume in 2021. As usual, we begin with some items of interest gleaned from the media in recent months, to provide some food for thought, and will then introduce the papers in this volume.

Few people will lament the closing of 2020. The pandemic has amplified: inequalities; the principal outcome of sustained austerity which has hollowed out health and social care; the grief and losses arising from failing to accept the necessity of testing, tracing and isolating; the rise of populism; the “chumocracy” revealed by multi-million pound contracts issued without due process; and the rise of hostile debate and challenge. The competence of leaders, not celebrities, in handling COVID-19 in Germany, New Zealand, South Korea, Vietnam, Taiwan, Senegal and China is enviable. Sir Michael Marmot’s review, “Build Back Fairer” [1] sets out the post-COVID case for acting on the social determinants of health and reversing the deteriorations within the public sector, most particularly in Public Health. There is little doubt that pre-existing inequalities (of different types) has led to record COVID-19 deaths in the UK.

“Caring” in all its forms has become a prominent political consideration, particularly in the UK. In this context, its undervaluing was exemplified at the outset with the discharge from acute hospitals of untested, but COVID-infected, care home residents. In addition to its generational hit on older people, the pandemic killed men and Black, Asian and minority ethnic people disproportionately. As millions of people volunteered to help their communities and a global scientific collaboration to design a vaccine commenced, the best of humanity’s hands-on care was revealed.

People with learning disabilities are dying from the COVID-19 virus at more than six times the rate of the general population [2]. Public Health England has noted that the age-band with the largest number of deaths was 55–64 years for people with learning disabilities but over 75 years for the general population. Those with learning disabilities aged 18–34 were 30 times more likely to die of the virus than their counterparts in the general population.

The pandemic has expanded our understanding of “home”. From being associated with location, shelter, comfort, security, emotional intensity, possessions, privacy and space over which we have control and autonomy – its new associations include “bubble”, workplace, classrooms, places of higher education and DIY forays. Notwithstanding this, for some, it has represented a surge in domestic violence and a significant toll on mental health. Furthermore, who wants mean welfare benefits when there is big money to be had through a variety of means? The pandemic has prompted many homeowners to review their living circumstances. It also appears that a number of scammers are flourishing [3] on intercepted house deposits as well as other financial scams – some even related to COVID-19.

We begin this new year in the hope that it is not as tumultuous as 2020. Safeguarding practice has some experience of misinformation and spin without remorse, so we are grateful that it is not the default position of most services, either within the health and care sectors, or beyond.

Closer to home, in the UK, the jabbing finger tactics of the far-right have been glimpsed in the jaw-dropping misinformation concerning exhausted migrants fleeing persecution or conflict. The not so coded appeals to prejudice bring the mass detentions, cultural and “demographic genocide” of the Uighurs to mind. China’s coercive birth control [4] coexists with segregation, vilification, rape and starvation rations and revisits the horrors of oppression seen through the centuries. Beijing’s promise to respect Hong Kong’s freedoms and autonomy, made in 1997, has been broken by imposing a national security law prohibiting acts of “treason, secession, sedition or subversion” [5]. And brutal policing, seen in the days before and after the law came into effect, was seemingly immune and oblivious to international condemnation.

Twenty-five years after the Srebrenica genocide, its survivors are having to fight against the tactics of denial used by the far-right. As the Survivors’ Network stated:

The theme ‘Every Action Matters’ seeks to encourage every person to reflect on their own behaviour and choices that they make, and demonstrate that however insignificant it may seem, every action matters, whether positive or negative. It aims to show that those who stand up and unite against hatred can make a difference. It sets out to dispel the notion that one person cannot make a difference and show that the action of one individual does matter and that they can achieve a great deal, however small their action may appear initially… We remember the stories of the Mothers of Srebrenica and all the survivors who have fought tirelessly against genocide denial and for justice. Despite all that the Mothers of Srebrenica have been through, they have never sought vengeance and never acted with hatred as they regard hatred as a sign of weakness, and they refuse to be weak. Because of their actions, there has not been a single case of retribution against the Bosnian Serbs, with their actions paving the way for the chance of reconciliation. Instead, they have chosen to campaign for justice, playing a pivotal role in the sentencing of many of the key architects of the genocide. They returned to their home determined to show the perpetrators that they had not succeeded [6].

The funeral of “pivotal” Windrush campaigner, Paulette Wilson took place in September 2020 [7]. She came to the UK at 10 years old and, despite having worked here for decades, she became one of the thousands who faced deportation owing to being classified as an immigration offender, with no right to live in the country largely owing to an absence of official documentation of the right to live in the UK. She was arrested twice by immigration officials and spent time in a removal centre. Following her release from detention, Paulette Wilson helped others who were similarly misclassified to secure British citizenship. Despite being reassured that proof of arrival in the UK was no longer necessary, and their disembarkation cards being destroyed by the Home Office during 2010, individuals were subsequently accused of not having any lawful right to live in the UK and threatened with deportation. It is unlikely that immigration officials anticipated the public disbelief and sympathy that resulted from the experiences of individuals like Paulette being widely publicised. Small Axe is Steve McQueen’s anthology of five films developed for the BBC. The films tell true stories about the lives of West Indians and the injustices they endured in London during the 1960s and 1970s and are worth catching – if providing some difficult viewing.

The barbaric death of an African American man in police custody on 25 May 2020 in Minnesota resulted in nation-wide and subsequently global protests [8]. George Floyd had been arrested and a member of the public filmed a white officer kneeling on his neck for 8 min and 46 s, leading to his death. Although there were some demonstrations of unity, the response of the police to public demonstrations was characterised by excessive force that did not spare journalists. State sanctioned brutality is backlit by racism and a world forged by colonialism. Executive orders developed to discourage the use of “chokeholds” by the police (and others) lack ambition.

Following this, in England the Metropolitan Police has set a new target for recruits to the service, with 40% of entrants to the force be from Black and minority ethnic communities [9]. “As well as historic grievances, new ones were brought into relief [during 2020] as anger over George Floyd’s killing by US police led to mass protests in Britain”. Stop and search powers are an enduring flashpoint because almost half of all stop and searches undertaken in England are by the Metropolitan police and disproportionately target black people, even though the force covers 12% of the overall population.

And in further relation to injustices, at the tail end of 2020, the Grenfell inquiry heard that Kingspan, the company that made the combustible insulation used in the building of Grenfell Tower in London, went to considerable efforts to convince the construction industry that its product was safe, albeit in the absence of test data. The evidence provided by Philip Heath, who is still a Kingspan employee, was shocking. Having brushed off the challenges of a specialist concerning the insulation, he wrote an email to a friend suggesting that the contractor “was confusing him with someone who gives a dam (sic)” [10]. Three directors cashed in on £6m of shares in advance of allegations concerning Kingspan being aired at the public inquiry [11]. The company has now apologised for its “process shortcomings” during 2005–2014.

There is irony in the frequency with which politicians describe events as “wake-up calls”. The Independent Medicines and Medical Devices Safety Review [12] sought to improve the NHS’s ability to respond where concerns have been raised about the safety of particular interventions. The review considered ways of strengthening the voice of patients and families to build a system that listens, hears and acts with speed, compassion and proportionality. It is a legitimate source of fascination that retreading this fault-line and concerns about patient safety is also familiar terrain within many safeguarding reviews.

Bizarrely the USA’s election fight has persisted in recent months with the incumbent unwilling to acknowledge his defeat. Allegations that votes were altered and/or compromised triggered some recounts and dozens of legal challenges to no avail. The health of the US democracy lies in the balance, not least because in the build-up to the election, the campaign strategy purged electoral polls of likely democrat voters and unsuccessfully sought to discount mailed-in ballots. The far-right insurrection that took place on the day in early January when Democrat Joe Biden was finally announced as the next President of the USA strongly indicates that Trump’s war on truth and legacy of bitter division likely has years left to run and that the much needed period of healing required in the USA will be lengthy.

This issue of the journal consists of five papers, three of which are from international contributors, which is a welcome start to the volume and this year. The first paper, by Avanish Patel of Alliance University in India considers the issue of older peoples’ fear of crime as a factor in relation to elder abuse. The mixed-methods exploratory study that was undertaken aimed to develop understanding of the impact of the crime rate on individuals’ health and well-being and to explore the links between fear of crime and psychological factors. Of the respondents, those people with experience of victimisation (either direct or indirect) were more adversely affected by anxiety, fear and insecurity. Although this is perhaps not too surprising as a finding, may provide some reminder to practitioners about the potential longer-term impacts and consequences of victimisation for older people.

Our second paper, by Akeem Modeste-James and colleagues from the University of the West Indies explores the issue of decision-making relating to the identification of elder abuse by primary care doctors in Trinidad and Tobago. Findings from a relatively small number (14) of interviews with doctors working in government run primary care clinics established a general lack of knowledge about relevant policies and procedures relating to elder abuse, together with a concomitant lack of training about elder abuse. These factors result in doctors failing to take action concerning elder abuse issues that were considered to be non-clinical – and remind us of the need for holistic and inter-agency approaches to intervention (and prevention) in situations of abuse and violence.

The third international paper is a legal- and policy-oriented discussion of the development of the Vulnerable Adults Act 2018 in Singapore – and is provided by Jill Manthorpe of King’s College London (KCL) and Joanne Cheng of the University of Singapore. The paper aims to describe and analyse the development and content of the Act through an examination and synthesis of the available documents for the appropriate period. This includes policy and legal documents, reports of the relevant parliamentary debates, media reports and pertinent research. This is placed within the broader legal and social contexts of Singapore. Useful information is provided about the applicable roles of government and community organisations, together with the relevant professional duties and powers.

The fourth paper in this issue is also a policy-related paper, by Stephen Martineau of the Health and Social Care Workforce Research Unit (KCL) and examines early considerations of the issue of self-neglect. This is achieved through a thorough review of three papers concerning early research in this area, undertaken between the 1950s and 1970s. The developments that have occurred and identification of some points of continuity across the time periods are clearly set out. These are usefully discussed in the context of the current statutory framework and contemporary thinking and practice about the issues involved. The paper is likely to be of particular interest to those concerned with situations of self-neglect.

The final full paper of this issue is by Jan Bailey and colleagues from the University of Chester. The paper considers older peoples’ experience of financial scams but interestingly does this through an analysis of the evidence available from the Mass Observation Archive (MOA) which had invited written responses from a sample of 80 older people about the issue of scams. Individuals provided responses to a specific set of questions provided by the MOA in their invitation and these were analysed using qualitative methods, with a number of themes identified. Similar to the first paper in this issue, the impact of victimisation (this time relating specifically to scams) on individual health and well-being is clearly delineated. Again this serves as a useful prompt for professionals to carefully consider the impact (of abuse, violence and crime) on individuals in associated safeguarding work.

The issue closes with a book review provided by Helen Thacker of Norfolk County Council. The book reviewed is concerned with findings from recent research undertaken in the field of elder abuse. A number of interesting findings that are presented in the book are highlighted in the review.

We hope that you will find this issue of interest and use to you within the context of your safeguarding interests and work. As always we are interested in receiving contributions to the journal and if you are potentially interested and wish to discuss this further before committing pen to paper (or more likely fingers to keyboard…) do get in touch with one of us to progress this further – our contact details are provided on the cover of hard copies and online on the journal website. As a quick reminder, our next issue will be the second part of our Special Issue series on COVID-19 and Safeguarding, and we look forward to providing readers with further interesting contributions on this topic. Finally, we hope that everyone has been managing to stay safe and healthy during these strange and challenging times and look forward to providing future issues throughout the year.