Flynn, B.P.a.M. (2014), "Editorial", The Journal of Adult Protection, Vol. 16 No. 1. https://doi.org/10.1108/JAP-11-2013-0044
Emerald Group Publishing Limited
Article Type: Editorial From: The Journal of Adult Protection, Volume 16, Issue 1.
As the New Year begins, we were reminded late last year that there is so much about the messy topic of adult protection that is ongoing, galling and heart-stopping.
Beginning with the ongoing and galling, you may be interested to note that the complex tax engineering policies of businesses such as Google, Amazon and Starbucks do not register in official tax avoidance figures in the UK. The amount that was lost to tax avoidance during 2012 was £4 bn. Although HM Revenue and Customs have lost some £35 bn in total to evasion, avoidance and payment failure there are “Amnesty-lite” deals for cash-rich tax evaders and the “quoted Eurobond exemption” means that beloved energy groups and companies qualify for tax exemptions (Syal and Wintour, 2013).
Several tycoon tax avoiders might have helped the NHS’ blighted IT programme. After costing £10 bn, the NHS's medical software package/patient record system Lorenzo has been abandoned. This sobering outcome illuminates the attractiveness yet poor track record of managing huge IT projects (Syal, 2013).
HM Revenue and Customs has identified over 100 care providers for investigation. Some companies are breaking the law by employing workers at or below the minimum wage of £6.31 an hour. This only adds to the misgivings concerning 15-minute visits to wash, dress and assist with feeding older people and people with disabilities. We diminish preventive homecare at our peril and wonder what the future might hold and what legacies this may result in (Ramesh, 2013).
There's still no cap on the interest charges, which payday lenders and loan sharks can make. It follows that an irresponsible short-term loan market can carry on “rolling over” the loans. Establishing a presence on UK high streets somehow legitimises their activities – including their power to take money from borrowers’ bank accounts through continuous payment authorities, which give their debts priority over all others. Their appalling rates of interest mean that they can empty accounts as frequently as they deem necessary.
No surprise that sexual and physical domestic violence is also associated with the coercive control of money. Researchers at NatCen (National Centre for Social Research) analysed the Adult Psychiatric Morbidity Survey for England. Women who surface from such violence advise keeping a secret kitty; holding on to receipts; planning an escape; and getting confidential advice (NatCen, 2013).
As the UK security firm G4S struggles to recover its reputation, it's now under investigation for allegedly using forced injections and electric shock treatment to subdue the inmates of a South African prison. Since the prison's “emergency security team” was legally required to film all actions, the video evidence is compelling. Restraint and antipsychotic medication was imposed on patients irrespective of their mental health status. The team members associated with such practices were dismissed. This journal's reflections on the adequacy of such a solution to abuses hardly need re-iterating but we’ll do it anyway. Sacking staff associated with hands-on cruelties is a limited and short-term solution that has little impact on the overall culture of organisations (Harding, 2013).
Glimpses of our changing NHS fulfil the promises of Jacky Davis and Raymond Tallis’ NHS SOS How the NHS was betrayed – and how we can save it. Their thesis is prefaced with two quotations. Our quiz for readers is to guess which speaker said what. The speakers are Andrew Lansley and Aneurin Bevin.
Danger of abuse in the service is not in the way that ordinary people use the service. Abuse is always at the point where private commercialism impinges on the service – where an attempt is made to marry the incompatible principles of private profit with public service. The solution is to decrease the dependence on private enterprise. A free health service is a triumphant example of the superiority of the principles of collective action and public initiative against the commercial principle of profit and greed.
The first guiding principle is this: maximise competition … which is the primary objective.
Margaret Hodge, the Chair of the Parliamentary Accounts Committee is interested in accountability. She has challenged the private contractor Serco. Serco won a contract to run Cornwall's GP out of hours service (by undercutting the local GP co-operative by £1.5 million). Whistleblowers confirmed that their service was unsafe and that NHS data were being falsified. Margaret Hodge stated: “It's absurd that the government contracts with one company, which can’t cope and misleads us all, and then just hands the job over to another […]”. Dr Clare Gerada of the Royal College of GPs lamented the legacy: commissioners tied up in a contractual and competition nightmare. Belatedly, an editorial in the Lancet has criticised the coalition government for expecting NHS hospitals to be financially successful and deeming them failures if they do not meet efficiency targets, whilst cutting costs (Lawrence, 2013).
Shame that the Home Office didn’t check out their van campaign billboard message “Go home or face arrest” with Joe and Josephine Public, or even public health specialists. Blunt messages don’t work and blunt messages which are associated with right wing extremism and white supremacists come at a cost (BBC, 2013). The Twitter and Facebook messages that appeared from individuals to challenge the campaign and provide some resistance were restorative.
We anticipate hearing more about fuel poverty in the coming months, i.e. households having to spend more than 10 per cent of their income on heating. It's possible to build ultra-low energy homes (there are 150 Passivhaus certification homes in the UK) but we can’t expect such developments to be promoted by the energy companies. Oldham CCG deserves full marks for investing £200,000 in retrofitting 1,000 cold homes with new boilers and exterior insulation. It's the same mentality which informs child protection: what are the long-term consequences? We must do all in our power to protect children who disclose sexual assaults or who are believed to have endured such assaults, since so many psychiatric patients are survivors of childhood assaults and abuses (Vidal, 2013).
Finally, the heart-stopping … headteachers are to have more autonomy. They will not be expected to have among their staff a person trained in safeguarding and safer recruitment for example. Of the recent child deaths, Gillian Shephard observed that: “[…] teachers took no action. What is this telling us? Now is simply not the moment to assume that schools will do it right” (Tickle, 2013).
This issue of the journal marks a new volume (our 16th) and we are pleased to be able to bring you a selection of papers about a number of different aspects of interest in the field of adult safeguarding. Our first research paper is by Michael Preston-Shoot and Sally Cornish and presents findings from recent research on the outcomes of adult protection in Scotland, with a specific focus on how service users, their families and professionals perceived the effectiveness of formal protection orders made within the framework of the Adult Support and Protection (Scotland) Act, 2007. The study used a mix of methods, including analysis of Adult Protection Committee Biennial reports, interviews with key informants and service users, family members and professionals and professional workshops. Findings point to the principle of proportionality being firmly established within practice in this area and it appears that early and prior concerns about paternalism and excessive use of protection orders have not been fulfilled. Whilst the rest of the UK still seems mired in discussion about legislation, it is helpful to have findings from studies such as this to reflect on and learn from.
Our second paper is also from Scotland and is by Martin Campbell, who previously contributed to the journal special issue on Scotland. It too is a research paper, which was undertaken to determine the extent of community nurses’ knowledge of the ASP Act before and after a one-day training course. The impact of the training on pre-training knowledge of nurses in one NHS area was investigated, using the training methods reported as preferred by the participants. The study found a significant increase in scores relating to knowledge about the Act after training and the authors suggest that further evaluative studies of the nationally approved training in Scotland should be conducted with associated attempts to improve the extent to which the learning from the training is or can be transferred into practice.
The following paper is a conceptual piece by Jonathan Parker and Sara Ashencaen Crabtree and explores the rather controversial use of covert research in order to study groups who might be considered vulnerable, together with the social contexts that they live in. This includes consideration of the possible use of such research at times and in areas where more overt strategies might be difficult, or lead to a denial of access to settings and/or individuals. The paper also contains some thoughtful consideration of the issue of consent within such situations. And although the use of covert research has received considerable criticism, particularly on the grounds that the key principle of informed consent is generally breached, the authors argue that there is some potential use for ethical research in safeguarding, in particular as it may well enable access to data that reveals abusive situations and practices and may allow access to be gained to the lived experiences of people who are situationally vulnerable to abuse and neglect.
The fourth paper in this issue is another thought-provoking contribution from David Hewitt. The paper examines the recent government consultation on the (possible) need for a new power of entry within situations where there are safeguarding concerns, and it also provides a critique of the conclusions that government came to as a result of the consultation. This is achieved through an analysis of the report of the consultation exercise and the statements that were submitted during the consultation process. The report is also considered in relation to other reports compiled after comparable exercises. From the analysis, however, it appears that only a minority of respondents supported the conclusions drawn by government albeit that some of these respondents were vociferous in their objections to the proposals. The majority of respondents, including a substantial majority of social care and health professionals were clearly in support of the proposals. This may perhaps be indicative of a case of some pre-existing agenda setting and decision-making on the part of government.
The final paper in this issue is by Tim Spencer-Lane of the Law Commission. This is also a review paper, which explores the Law Commission's review of the professional regulation in health and social care and the final report of the Public Inquiry into Mid Staffordshire Hospital. The aim of the paper is to consider how these are likely to impact on professional regulatory bodies. In order to achieve this the paper provides both a summary of these documents together with a discussion of the most relevant recommendations from the Francis Report and the government response to these and also consideration of the responses to the consultation exercise undertaken by the Law Commission, which concerned the potential proposals to reform the legislation in relation to professional regulation for health and social care.
We hope that you will find this issue thought-provoking and interesting. If you are thinking about writing for the journal and have some ideas that you would like to discuss, please do contact one of the editors. Enjoy your reading!
Bridget Penhale and Margaret Flynn
BBC (2013), “Theresa May says ‘go home’ will not be rolled out across UK”, BBC News, 22 October, available at: www.bbc.co.uk/news/uk-politics-24624383 (accessed on 10 December 2013)
Harding, A. (2013), “South Africa G4S prison staff accused of abuse”, BBC News, 28 October, available at: www.bbc.co.uk/news/world-africa-24699725 (accessed 10 December 2013)
Lawrence, F. (2013), “Serco condemned over move to offload troubled GP service in Cornwall”, The Guardian, 11 October, available at: www.theguardian.com/business/2013/oct/11/serco-gp-service-cornwall (accessed 10 December 2013)
NatCen (2013), Adult Psychiatric Morbidity Survey, available at: www.natcen.ac.uk/our-research/research/adult-psychiatric-morbidity-survey/ (accessed 10 December 2013)
Ramesh, R. (2013), “Council funding cuts force care firms to pay less than the minimum wage”, The Guardian, 22 October, available at: www.theguardian.com/society/2013/oct/22/council-funding-cuts-care-homes-minimum-wage (accessed 10 December 2013)
Syal, R. (2013), “Abandoned NHS IT system has cost £10bn so far”, The Guardian, 18 September, available at: www.theguardian.com/society/2013/sep/18/nhs-records-system-10bn (accessed 10 December 2013)
Syal, R. and Wintour, P. (2013), “MPs attack Amazon, Google and Starbucks over tax avoidance”, The Guardian, 3 December, available at: www.theguardian.com/business/2012/dec/03/amazon-google-starbucks-tax-avoidance (accessed 10 December 2013)
Tickle, L. (2013), “Autonomy for headteachers or safety for children?”, The Guardian, 30 September, available at: www.theguardian.com/education/2013/sep/30/guidance-protecting-children-greater-riskVidal, J. (2013), “Actively cutting energy bills in Oldham – welcome to the ‘Passivhauses’”, The Guardian, 1 November, available at: www.theguardian.com/environment/2013/nov/01/cutting-energy-bills-oldham-passivhaus (accessed on 10 December 2013)