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Emerald Group Publishing Limited
Article Type: Editorial From: The Journal of Adult Protection, Volume 16, Issue 6
Welcome to the final issue of 2014, which somewhat remarkably sees a close to the 16th year that the journal has been in existence. We hope that you will find the issue of interest. As usual, firstly here is some news information from the past few months (since the last editorial) with links to safeguarding issues.
Thanks to the Office of National Statistics, we know that the wealthiest 10 per cent of households in Britain own 44 per cent of total household wealth while the least wealthy half of households combined owned just 9 per cent. Still – the government's deficit (more than £90bn a year, since you ask) must be reduced, so the long-term costs of continuing high levels of poverty and the failure to meet housing demand must be overlooked. Absurd – says US political economist Robert Reich. He argues that the human costs of such measures – needless suffering – require bolstering of working people's living standards, including wage bargaining and ensuring that the rich pay their fair share of tax: sustained recovery is only possible if the middle and working classes have money to spend and if, rather than cuts and austerity, investment in “public goods” is made a priority. The top tax rates do have to rise and we have to invest much more substantially in education, infrastructure and human resources – and make sure our poor children and lower middle class children all have real chances to get ahead.
We can provide a helpful “for example” here – Focus on Social Care for Older People: Reductions in Adult Social Services for Older People in England by Sharif Ismail, Ruth Thorlby and Holly Holder was published in March by the Nuffield Trust and the Health Foundation. It confirms that a quarter of a million people have lost their state funded help to carry out such activities as bathing, dressing, eating and taking medication. This, in turn, is putting undue pressure on friends and families and resulting in needless (and financially expensive) hospital admissions.
As the Journal of Adult Protection repeatedly notes, scammers thrive, most particularly during sustained austerity – and especially if scammers create copycat websites of banks and the HM Revenue and Customs, for instance. These cloned web site addresses are almost identical to the genuine websites and are created to capture people's login and password information. Then there are the busy telephone scammers who persuade people to hand over their life savings by claiming that they are investigating fraudulent attempts to access their account. These scammers suggest that their hapless victims should ring their bank and when they do so, they believe they are dealing with bank staff. Needless to say, the latter ask such credible questions that the inevitable happens. This form of scamming puts the spotlight on telephone networks. When we end such telephone calls/replace the handsets we can remain “on-line” for many minutes. This leads victims to believe that they are subsequently calling their bank – as the scammers helpfully suggested. Miles Brignall has reported that an 89-year-old recently lost more than £100,000.00.
Pictures that tell a thousand words are being tested to destruction by hidden cameras and social media. Winterbourne View Hospital led the way and although the Priory Highbank specialist hospital for the treatment of neurological disorders in Bury, Greater Manchester, was not the focus of a BBC Panorama, secret filming during 2012 by the family of a patient at this privately run hospital showed two health care assistants slapping a young brain damaged man. One was recorded as saying, “You won’t beat us, bastard. There's this very fine line between abuse and neglect. Don’t you dare be sick on me boy, don’t you dare you dirty, scummy boy”. Their victim had sustained brain damage following an accident. The two healthcare assistants eventually received prison sentences of seven months.
And while we talk about prisons, one of us has personal experience of our punitive prisons. A relative sent a copy of The Economist to a new prisoner/ex-student who got in with a drug-pushing gang whilst at university and sought to do likewise…Naïve of us all to believe that Chris Grayling's callous restrictions on access to books for prisoners who have little else to occupy them would not extend to The Economist. The restriction similarly scuppers the “Storybooks Dad” scheme, which encourages dads to record a story for their children. Since some children give their dads their favourite books it is shameful that this may no longer be possible.
Doing nothing is incredibly difficult. Giving people the option of 15-minute spells of uninterrupted solitude turns out to be too tedious. Professor of Psychology Timothy Wilson reported the staggering finding that some people favoured self-administered mild electric shocks rather than do nothing. Does this provide an impetus to bring back the treadmill perhaps?
Check out the social enterprise Dot Dot Dot. As they say on their website, Dot Dot Dot:
[…] lets people who do great volunteering live as property guardians in buildings that would otherwise be empty. We turn empty buildings from a blight into an asset – providing a vital security service to property owners, giving our guardians cheap accommodation, and making a meaningful and measurable contribution to communities.
Dot Dot Dot is not offering a single solution to the nation's ills – but what if the idea embraced guardians with a responsibility for helping particular tenants, perhaps non-readers for example? A colleague has just returned from Rwanda – where 20 years ago 800,000 people were murdered in 100 days – and remarked on the proliferation of media promoting peace and reconciliation – and on the final Friday of the month all citizens devote 3.5 hours to volunteering in their communities.
Speaking of other measurable contributions, who will lament the early termination of Atos’ contract to administer millions of fit-for-work test for sick and disabled people? This is further confirmation that outsourcing and privatisation have an uneven record in delivering value and improving services. Atos’ inhumane tests will not be missed so there's no compensation for beleaguered Atos, and as for sick and disabled people…? Little wonder that Left Unity – the new party of the left in Britain – established to offer an alternative to the main parties’ agenda of blaming the poorest for society's problems and destroying the welfare state  is engaging with the long term and unfair austerity championed by the Conservative-led coalition. Ken Loach is a film director and member of Left Unity.
Full marks to Andy Burnham – he facilitated the publishing of all the documents concerning the Hillsborough tragedy. Full marks and more besides to the bereaved Hillsborough families – their tenacious fight for justice has resulted in the opening of a new inquest. They challenged the findings of the inquest of 1990-1991, its failure to quash offensive allegations and to tell their relatives what happened. The latter did not address contesting accounts of the events and the imposition of arbitrary rules in advance, e.g. all victims were assumed to have died by a particular time. As the Hillsborough families have shown us, injustice does not recede quietly.
The National Violence Surveillance Network, hosted by the Violence Research Group at Cardiff University, collates data about violence related injuries from Emergency Departments across England and Wales. Their analysis shows that there have been falls in violence every year since 2001, bar 2008. The downward trend means that an estimated 234,509 people sought hospital treatment at Accidence and Emergency departments in England and Wales during 2013; this is 32,780 fewer people than during 2012. Since alcohol habits and the affordability of alcohol are associated with the fall in violence the quest for a statutory minimum unit price for alcohol will continue.
Exploitation is form of violence that endures. Whether it is children in poor countries making trainers, workers in textile sweatshops and computer manufacturers – or even crews of the Thai fishing trade – their bleak lives service the consumers of rich countries. Needless to say, the tale of mistreatment does not respect the provision of health and social care. There are workers entering the UK with conditional visas, i.e. they will work in Sunnylands Home, where they will live and eat, and we will not bother ask why on earth they could not blow the whistle….
Take a look at Sara Ryan's blog, http://mydaftlife.wordpress.com for an update on the sorry aftermath of Winterbourne View Hospital and more specifically Bill Mumford's resignation from the Joint Improvement Programme.
And there are two further lots of homework for you to consider:
take a look at the Criminal Justice and Courts Bill and the offences of ill-treatment or wilful neglect of people receiving health care or adult social care services; and
ask yourself why the Commonwealth Fund has declared the NHS the world's best healthcare system .
As the montage of brutal and incomprehensible news headlines spanning July and August grew to include:
Islamists order mass FGM for Iraqi women;
Arizona execution lasts two hours as killer Joseph Wood left “snorting and gasping” for air;
Isis threatens to kill Briton in video showing beheading of US hostage; and
Islamic State “beheads US hostage Steven Sotloff”.
we are reminded of the assertion advanced by Facing History and Ourselves: People make choices, choices make history. Just as young people want to know what has been done and what can be done – the capacity and limitations of responses to the degradation of human beings acknowledge that what has been destroyed cannot be fully restored. When nothing changes as a result of a safeguarding investigation – apologies – an inquiry, does it mean that the alleged perpetrators are innocent and/or that all is forgiven?
At the end of July we learned from the National Catholic Safeguarding Commission that 52 Catholic priests in England have been laicised or defrocked since 2001. It may be recalled that during July, Pope Francis asked six victims of sexual assaults by priests for forgiveness and referred specifically to the role of Bishops in protecting children and young people. His request has been criticised since he, rather than the offending priests sought forgiveness, and perhaps also because forgiveness is a substitute for neither justice nor punishment.
Alexis Jay's Independent Inquiry in Child Sexual Exploitation in Rotherham was published during late August. This sets out the shameful scale of sexual exploitation – a conservative estimate of 1,400 children – of whom over a third were known to services. Following seduction by drugs and alcohol and being duped into believing that they were having relationships with Asian men, they were gang raped and trafficked to work as prostitutes. The girls who resisted were doused in petrol and staff from services were advised against identifying Muslims rather than criminals because they feared being labelled as racists. Nine men were convicted during 2010 but this has not halted the abuse. On the slight upside, new victims have come forward as a result of the media coverage. One conclusion we may draw is that indifferent bureaucracies are as damaging as denials and cover-ups.
Little wonder it has taken a while for Mathew Oakley's independent report to be released by the DWP. He considered the ways in which sanctions were administered on mandatory back to work schemes and noted of the correspondence concerning sanctions:
[…] letters that the review team saw were hard to understand (even for those working in the area), unclear as to why someone was being sanctioned and confusingly laid out.
This left claimants bewildered as to why their welfare benefits were stopped and typically, they were not told about hardship payments to which they were entitled.
Heck – even the scammers are reaching new lows … Donna Ferguson has revealed how emails are being sent revealing that test results have confirmed that you have cancer and as you open the attachment you are locked out of your computer. All is not lost however since you may pay a ransom to the scammers and all will be well. Then there are the hoax assassination threats, the threats to expose you as a paedophile unless you purchase bitcoins from a particular account, the emails from funeral homes inviting recipients to funerals – and yes the attachment therein contains malicious software. More customised scamming draws on information gained from Facebook and Linkedin ….
Finally, the incoming president of the Royal College of Psychiatrists has reflected on the huge “treatment gap” facing people with mental health problems since less than a third get any treatment at all. Professor Simon Wessely has proposed that if the situation was paralleled for cancer patients, it would not be tolerated.
This issue of the journal has papers from a number of areas of the UK, covering different topics relating to safeguarding. Our first paper is by Michael Mandelstam and considers the issue of neglect of older people in hospital settings and associated legal issues surrounding the offence of wilful neglect. The paper argues that there is an evident mismatch between application of the law relating to wilful neglect and the levels and extent of neglect in hospitals and discusses a number of potential solutions to this situation.
The following paper, by Roderick Landman looks at the issue of Mate Crime from a number of different perspectives. It serves as a useful introduction to the topic, considering the background to the issue, together with some of the factors that may make individuals with learning disabilities both vulnerable and susceptible to this type of abuse. The paper also suggests a provisional definition of mate crime, whilst arguing for conceptual and analytical distinctiveness from other forms of abuse and hate crime.
Pauline Heslop and colleagues from the Norah Fry Centre have provided a contribution concerning the findings of the Confidential inquiry into the premature deaths of people with intellectual disabilities, in relation to the Mental Capacity Act (MCA), 2005. Over 200 deaths of people with intellectual disabilities of 16 years or older were reviewed in the course of the Inquiry. There were two key findings in relation to the MCA (and direct links to these deaths): these are analysed and discussed in the paper, which provides much food for thought, especially in relation to future practices in this area.
The paper by Katherine Graham and colleagues from the Social Care Workforce Research Unit, King's College, London explores different models of adult safeguarding that exist and presents a review of the literature as well as information and detail about the mixed methods study of models of safeguarding that is currently underway.
Rachel Robbins and colleagues from the University of Manchester have been involved in an investigation of the Multi-Agency Risk Assessment Conference (MARAC) processes that have been developed and adapted for adult safeguarding in recent years. The paper reports on a scoping review that was undertaken as an initial phase of the study, it also discusses the potential and challenges of using MARAC processes in supporting adults who may be at high risk of further violence.
Through her analysis of the aspects relating to safeguarding in the coalition government's policy document, A Vision for Adult Social Care, Di Galpin of Plymouth University has provided a paper reporting on the role of language and discourse in shaping interventions and responses to older people at risk of harm. The results of the analysis suggest that more focus has been paid to macro issues than to responses that address the abuse of elders who may be at risk of harm.
Finally, we are delighted to include a paper by Tim Spencer-Lane from the Law Commission about the results of the work that the Commission have undertaken on reform of the regulation of health and social care professionals. Some readers will recall an earlier paper on this topic published in the journal, which outlined the review and it's intentions (Spencer-Lane, 2013) so we are pleased to include this paper, which provides a flavour and summary of the final report and draft legislation that has been developed as a follow-up to the earlier paper.
As always we are interested in receiving submissions to the Journal about issues relating to adult safeguarding from a range of perspectives. If you have any ideas for papers or even special issues (as we have two per year) that you would like to discuss further we will be happy to do so. Meanwhile we hope that you will find this issue both useful and thought provoking and thanks for continuing to support the journal; have a good festive season.
Bridget Penhale and Margaret Flynn
2. www.theguardian.com/society/2014/mar/18/robert-reich-attacks-economic-austerity (accessed 19 March 2014).
5. www.dotdotdotproperty.com/about (accessed on 20 July 2014).
Spencer-Lane, T. (2013), “The regulation of health and care professionals”, Journal of Adult Protection, Vol. 15 No. 1, pp. 15-25