Our response to the File on Four programme
Who cares about elder abuse?
According to data obtained by the BBC through FOI requests, there were 23,428 safeguarding alerts between 2013 and 2016 about domiciliary care, (information was obtained from only half the local authorities asked as the others failed to reply). 700 of those cases involved the police, with just 15 resulting in any form of prosecution. The concerns involved neglect, psychological, physical and sexual abuse.
The Department of Health response to this data was typically bland,
“This government has introduced tougher inspections of care services, given councils access to up to £7.6bn of dedicated funding for social care and will continue to challenge local authorities that do not fulfil their duties under the Care Act.”
The situation facing social care is now critical. More specifically, the situation facing frail and vulnerable – defenceless – old people is now routinely degrading, humiliating and abusive and it is getting worse. It goes against the basic standards of humanity and it has increasingly been so for years, with equally bland statements emanating from Government whenever a Report brings it to public attention.
This situation is not caused by the occasional abusive care worker; most do their best in very difficult circumstances, many provide outstanding care despite those circumstances. There are indeed some horrible people working in our care services, it is too easy to gain such employment, but they are not the root cause of the problem. They are a symptom.
This situation is systemic, it has been caused not through ignorance or stupidity but by short-term and often ideological decisions taken by successive Governments, of all political persuasions, over the last decade. It has been caused by Directors of Adult Social Services, and Councillors, who would not uphold minimum standards of humanity and instead collaborated with Government ideology by making cuts that would inevitably cause harm, albeit harm that would not be immediately obvious in many cases. And it has been caused by care providers who have chased contracts at a value that could never have delivered any level of quality care, but which meant they remained in business for a while longer, (including the bigger ones, assuming they were able to skim off enough to keep investors happy). This is a human made disaster, not an accidental one.
Consider just these four issues:
- To be a nurse you have to be on the professional register, from which you can be removed if you fail to meet expected standards. It is a pro-active way of controlling who can have access to patients. But there is no such ‘positive’ register for care staff. Why? Because the coalition blocked the proposal when they came to office. Instead, we have a barring list – and even that doesn’t include every care worker who has neglected or abused.
- To be a nurse you have to have a level of training that is verified, not by the employer, but by an external body. To be a care worker you may have the Care Certificate, lauded by Government as something that makes a difference, but which is in fact not legally mandatory or independently verified and is signed off by the employer.
- The Standards against which care providers are inspected have been changed several times since they were first introduced more than a decade ago, and not for the better. They are now so conceptual that it is virtually impossible for a relative to use them as a means of challenging neglect or abuse. Why? If, for example, we can have explicit ratios of staff to children in nurseries – to ensure their safety and quality of care – why cannot we have similar in residential care? Instead we talk vaguely about ‘sufficient’ staff, whatever that means.
- Elder abuse does not get prosecuted. Only 0.7% of cases actually reach court, and then it is not unusual for the sentence to be community service or suspended. Hardly a deterrent for an issue that affects over 500,000 older people. Which begs the question, why is a crime against you prosecuted if you are in your thirties but not if you are in your eighties? It can’t be solely about witness reliability or other countries wouldn’t be so successful with their prosecutions.
At the heart of all this is ageism, a belief that older people do not require the same human standards that they enjoyed when they were younger. Of course, no-one says this. They simply allow it to happen. Despite the fact that everyone wants to get old – because no one wants to die young – we tolerate old age being subjected to inhumane and degrading treatment, so much so that we no longer recognise it for what it is.
File on Four broadcast the reality of what it truly means to be on the receiving end of services that no longer aspire to be quality, but are instead about doing the minimum possible for the cheapest possible. But, unlike a programme about child abuse, it will quickly fade in memory. Government will not feel obliged to launch an inquiry, no Minister will do anything substantive, Directors will continue to arrange degrading care, and the Department of Health will prepare their next bland statement for the next media expose.
And this will continue until we shake off an ageist attitude that allows them all to get away with it. The question is simply this: will we do it before we’re on the receiving end of those services?
How to help: