Editorial

Citation

Penhale, B. and Flynn, M. (2013), "Editorial", The Journal of Adult Protection, Vol. 15 No. 5. https://doi.org/10.1108/JAP-07-2013-0030

Editorial

Article Type: Editorial From: The Journal of Adult Protection, Volume 15, Issue 5.

Whatever happened to respectful scepticism or even nosiness? The House of Commons Home Affairs Select Committee has determined that a “woeful lack of professional curiosity” characterises the recent cases of child sexual exploitation in Rochdale, Rotherham and Oxford. The Committee was keenly critical of local authorities, the Crown Prosecution Service and the police. The Select Committee found that that Greater Manchester Police had recorded allegations of sexual exploitation as non-crimes and asked a victim to sign a disclaimer stating that she was unwilling to support a prosecution, for example[1]. Arguably this says something profoundly uncomfortable about the statutory basis of children's safeguarding boards.

During May, the Law Society proposed a one-minute “pause for unity” in a protest that was held outside parliament in London. In the wake of the Justice Secretary's “unworkable and possibly unlawful cuts” of around a further £220 m from the criminal legal aid budget, there is widespread concern that the proposals will lead to an increase in miscarriages of justice. The charity Shelter shares the concerns of the Bar Council that the cuts will make it yet more difficult to assist homeless families to find a place to stay. Lord Neuberger, the president of the Supreme Court does not believe that significant savings will result. The introduction of price-competitive tendering in contracts to represent defendants in criminal trials, and the restriction of legal aid will make it harder to bring judicial review challenges (Check out Lord Neuberger's speech to the Institute for Government, “Judges and Policy: a delicate balance”).

An outcome of the proliferation of food bank charities – they are becoming an established feature of our towns and cities – is that politicians may sidestep the need to address the causes of food poverty. There is unease that they may become embedded within the welfare infrastructure, albeit with modest and non-recurrent grants at a time of soaring demand.

June was not a good month for the Care Quality Commission. It is alleged that the English regulator suppressed an internal review into a maternity unit at Furness General Hospital. The regulator acknowledges that it provided false assurances and that it was tardy in identifying failings at this unit. A complete change of the regulator's executive team and the resignation of the chief executive of Morecombe Bay NHS Foundation Trust are believed to reassure us.

During July, the Inquest into the death of Jimmy Mubenga recorded a verdict of unlawful killing. After a long deportation battle, during October 2010 Jimmy Mubenga was put on a plane to Angola accompanied by three private security contractors from the scandal plagued G4S. He had been restrained using rigid bar cuffs, bent forwards with his hands cuffed behind his back. Although other passengers overheard Jimmy Mubenga as he shouted that he could not breathe, his guards claimed not to have heard him. The verdict is significant since the Crown Prosecution Service had initially determined that there would be no charges. As the family of Jimmy Mubenga know dangerous methods of restraining people are not curtailed by policy.

Tax avoidance by the multinational companies sits uncomfortably alongside hard-hitting welfare reform in austere times. The change from the Disabled Living Allowance to Personal Independence Payments will result in hardships since lost and reduced payments are the acknowledged outcomes. While the treasury anticipates a “saving” of over £2 bn, the Hardest Hit coalition of charities point out that the cuts will impact on people's ability to get out, let alone getting employed. The “bedroom tax” which targets under-occupancy in social housing is already fracturing people networks and communities. In the meantime, lawful “sweetheart deals” brokered by senior HMRC figures have made it possible to water, feed and nurture tax avoidance blooms as the austerity wave crashes onwards. Whatever happened to good government and the knowledge that our taxes can – and have – bought all that we value: health, education, safety and public spaces. It's not that long ago that the rail regulator confirmed that the state-run, East Coast rail service requires less public subsidy than any of the 15 privately run rail franchises in Britain.

Speaking of good government, Margaret Hodge, the Chair of the parliamentary public accounts committee asked the National Audit Office to investigate Serco – a leading private contractor of government services. Figures concerning Serco's out of hours GP service in Cornwall, suggest that staff falsified data on 252 occasions and thus presented a deliberately more favourable picture than the reality. It appears that the data manipulation had a history of at least four years (Guardian Newspaper: Felicity Lawrence, 7 March 2013). All the while, the apparent hell-bent privatisation of the NHS continues. Surely as we celebrate the NHS’ 65th birthday there is scope for an investigation into how such companies add value, not least since we are paying for their profits and bonuses? With re-organisation costs of £3 bn and rising, problems such as those exposed at Tameside, inquiries into poor care, allegations of bullying and the pressures arising from newly fractured services are gifts to those who are determined to highlight how unsustainable the NHS has become. A Freedom of Information request by Fiona Mactaggart MP found good news for competition lawyers: hospitals have already spent £1.67 m on legal advice from competition lawyers. This is in addition to the costs of tendering everything out (The Guardian: Polly Toynbee, 5 July 2013).

The House of Lords has established a Select Committee to “consider and report on the Mental Capacity Act 2005”. The Committee is exploring the following key issues in detail and has invited views on any or all of 27 questions concerning the extent to which the MCA has achieved its aims; the effectiveness of its implementation; the implications for those directly affected by the Act; the adequacy of the Deprivation of Liberty Safeguards; the accessibility of the Court of Protection and the Office of the Public Guardian; the role of the Care Quality Commission in inspecting the MCA standards; other legislation; the implications of the MCA in Wales; and the compliance of the MCA with the United Nations Convention on the Rights of Persons with Disability. Hopefully some of you will have been able to contribute to this consultation exercise whilst it was running.

The Committee is considering the Mental Capacity Act 2005 in general and, as such, was not established to investigate individual cases. The work of the Select Committee has been broadcast on www.parliamentlive.tv, which occasionally has items of relevance to individuals with interests in safeguarding.

Also of note during early July, amendments to the Care Bill were being debated in the House of Lords in parliament; this included the sections of the Bill related to safeguarding and a number of potential amendments were debated. Baroness Greengross (previously of Age Concern and now chief executive of the International Longevity Centre in London) introduced several amendments concerning elder abuse, to make ill treatment or neglect of a vulnerable adult a crime (effectively widening the scope of the Mental Capacity Act legislation to all vulnerable adults), to introduce mandatory reporting of abuse, and to give access to people isolated or trapped in their homes by abusers. It is good to see these issues raised at this level and to know of the continuing support of such people as Baroness Greengross.

In other news, during the annual gathering of the world's ministers of health at the 66th World Health Assembly, held in May, several member states called for an action plan to be developed to address interpersonal violence. Seven governments – Belgium, India, Mexico, the Netherlands, Norway, USA and Zambia – issued a statement at the end of a panel discussion declaring violence against women and girls “a major global public health, gender equality, and human rights challenge, touching every country and every part of society” and proposing an agenda item on the topic for the 67th World Health Assembly next year. To see the statement, visit: www.who.int/violence_injury_prevention/media/news/2013/21_05/en/index.html

A report on the post-2015 development agenda, prepared by Ellen Sirleaf Johnson, David Cameron, and Susilo Bambang Yudhoyono recommended that there should be a goal under the theme of empowering girls and women to “prevent and eliminate all forms of violence against girls and women”, and under the theme of ensuring stable and peaceful societies, to “reduce violent deaths per 100,000 by X and eliminate all forms of violence against children”. The theme of “freedom from violence” recurs throughout the document. This report will serve as a background document for discussions on the definition of the post-2015 development goals that will replace the Millennium Development Goals. For the press release and full report see: www.un.org/apps/news/story.asp?NewsID=45044&Cr=mdg&Cr1

Also in early summer, the World Health Organisation (WHO) launched a report on global and regional prevalence estimates for intimate partner violence and sexual violence (IPV-SV) against women. Overall, the report found that 35 per cent of women worldwide have experienced either physical and/or sexual violence at some point in life. Most of this violence is IPV, which is experienced by almost one third of all women who are or have been in a relationship. Women suffering IPV are more likely to have a low birth weight baby; twice as likely to experience depression; and in some regions, 1.5 times more likely to acquire HIV. And as we know, IPV-SV also happens to women with disabilities and older women too. The full report can be downloaded from: www.who.int/reproductivehealth/publications/violence/9789241564625/en/index.html

At the same time, WHO also released clinical and policy guidelines on medical and mental health services for women who have suffered IPV-SV. As a complement to the prevalence report mentioned above, the guidelines provide evidence-based guidance on medical and mental health services for women who have suffered IPV-SV, and the organisation of support services. The guidelines are available from: www.who.int/reproductivehealth/publications/violence/9789241548595/en/index.html

This issue of the journal contains a number of papers that we hope will be of interest to you. The first paper, by Sally Cornish and Michael Preston-Shoot concerns a piece of work that was undertaken in Scotland relating to the Adult Support and Protection (Scotland) Act, 2007. The paper reports on the findings of research on the governance arrangements of adult protection in Scotland. There was a particular focus on the outcomes of provision for the leadership and management of adult protection, within a clear multi-agency perspective. Some comparisons are made in the paper between findings from similar work undertaken in England and those from Scotland. The research found a complex variety of arrangements and experiences across different areas of Scotland. Several different dimensions were considered, including issues relating to the management of Adult Protection Committees, policy and procedural development, multi-agency working and training issues.

Our second paper is provided by Rachel Clawson and Deborah Kitson of the University of Nottingham and concerns the development of a Significant Incident Learning Process (SILP). A number of different methods have been used by agencies to review cases when a vulnerable adult has been seriously harmed or has died, the method chosen has tended to depend on whether the review was single- or multi-agency in nature. A group of Safeguarding Adults Boards in the East Midlands have undertaken work to develop an alternative method to Serious Case Reviews and this paper explores the introduction and evaluation of a pilot study of the use of a SILP. The findings from the evaluation emphasise the need for skilled facilitation and well-developed and robust ground rules. The paper explores a new approach to reviewing cases previously reviewed using SCRs, and should be of interest to all agencies and organisations represented on Safeguarding Adult Boards.

The third paper in this issue is by Shelly Jackson and Thomas Hafemeister from the USA concerning differences between Adult Protective Services (APS) workers and older clients relating to the cause of abuse that has happened in the domestic setting. One of the issues that they wished to investigate was to what extent differences in perceptions about the cause of the abuse might have an effect on intervention in cases. Interviews were held with pairs of caseworkers and older clients (or their proxies). There was a change in the amount of discrepancy between caseworker and client views during the course of investigations, with a decrease over the period of time. In addition, where the differences in perceptions continued over time, this was associated with difficulties in obtaining effective resolutions of the situations. These findings will be of interest particularly in terms of the development of techniques used by caseworkers to lessen the discrepancy between their views and those of their older clients in relation to abusive situations.

In the final paper of this issue, Janet Gill and Qulsom Fazil have written an interesting and thought-provoking paper on learning disability, chronic health conditions and issues relating to diet and healthy eating. A relatively high number of adults with learning disability have chronic health conditions such as type 2 diabetes and/or obesity, and such conditions affect both life expectancy and quality of life for the individuals concerned. This small-scale study explored the role that formal, paid carers take in the promotion of healthy eating patterns and how they managed the dilemmas presented of balancing an individual's right to make unhealthy decisions about food against a duty of care to protect an individual from harm (from unhealthy eating). The findings emphasise the challenges that staff faced in attempting to obtain a balance between choice of food and duty of care and found that staff were often motivated by an approach relating to best interests for individuals. Links to adult safeguarding issues are drawn out in the paper, as appropriate. A lack of guidance, policy and training for paid care staff is highlighted as unhelpful and future developments in these areas are proposed.

We hope that this issue of the journal will provide readers with some interesting reading and material and that your summers will have been good. Do get in touch with (one of) the editors if you have any ideas for future special issues of the journal (currently these appear twice per year) or for papers or other materials for submission. We are always happy to have discussions about the journal.

Note

www.publications.parliament.uk/pa/cm201314/cmselect/cmhaff/68/6802.htm (accessed 15 July 2013).

Bridget Penhale and Margaret Flynn