Monthly Archives: May 2013

Today is World Elder Abuse Awareness Day 15th June 2013: this is not about blame, it’s about change…………

The United Nations has designated the 15th June of every year as World Elder Abuse Awareness Day. Across the world communities come together on this date to shine a light on the problem of elder abuse.

The abuse of older people is not a new phenomenon unfortunately. The US was one of the first to identify the abuse of older people as a social and political issue that required action. Research developed in the 1980’s in Australia, Canada, China, Hong Kong, Norway, Sweden and the US confirmed this was an international phenomena. The following decade saw developments in Argentina, Brazil, Chile, India, Israel, Japan, South Africa, the UK and other European countries (World Health Organisation,2002).

In the UK staying out of harm’s way for many is just a matter of locking doors and windows and avoiding dangerous places, people and situations; however for some older people it is not quite so easy. The threat of abuse is behind those doors, on the hospital ward, in the residential institution or in the individuals own home, well hidden from public view. For those living in the midst of abuse violence permeates many aspects of their lives, sometimes perpetrated against them by carers’, professionals, family members or others known to them. Although government and society are increasingly aware of the abuse of older people it stills seems to persist. The Francis report highlights how poor care in a hospital setting actually constitutes abuse, we have also seen disturbing media reports regarding abusive treatment of older people in residential homes. Sadly even in individuals own homes some older people are not safe from abusive behaviour. This provides a disturbing view of how older people are valued in society and how some are cared for in the UK.

This is not about blame, it’s about change, let’s make a difference together.

You can get involved and make a difference by contacting Action on Elder Abuse, a charitable organisation fighting to improve the care and protection of older people across the UK, click here to find out how you can work together on the 15th of June to raise awareness and make a difference to older people in your community.

If you, or your organisation, is involved in the care and support of older people in the UK the National Centre for Post Qualifying Social Work have developed resources to help develop the skills and knowledge required in the workforce to ensure older people are protected from abuse and supported to live lives without fear. Please click here if you would like more information, or go to our website http://www.ncpqsw.com

If you know of an older person being abused contact your local social services Safeguarding Adults team, or ring Action on Elder Abuse helpline 080 8808 8141. If you feel someone is at immediate risk of harm contact the appropriate emergency services.

Improving NHS care is about more than leadership and management, it’s also about values…..

As Mr Hunt attended the King’s Fund annual NHS Leadership and Management Summit I wonder if discussion focused on the ‘values’ that will shape our future health and social care system?

There is clear evidence that many older people receive good quality care provision in both the private and public sector, however, sadly poor levels of care is also a feature of our care system. Whilst the focus currently is on the leaders and professionals charged with developing and delivering care, wider society too has a role in ensuring compassion in care is the ‘norm’ and not the exception, as The Independent suggests

‘For a while we may pause to express outrage. But we then move on to the urgent business of our daily lives. Spot checks and hit squads may arrest the worst practice…but they will not do much about a society that has hardened its heart against the elderly’

So how could we soften those hardened hearts?

Geert Hofstede cultural dimensions theory explores the impact a society’s culture has on the values of its members, and more importantly, how these values relate to individual behaviour, which in light of recent reports may offer lessons to us all on how we develop a culture of compassion that extends from society into hospitals and care homes. One of the dimensions identified as important by Hofstede is the notion of masculinity vs. femininity, although the concept is not reduced to a male vs female dichotomy rather, this relates to communication and leadership styles underpinned by a particular culture. Hofstede suggests masculine cultures place more emphasis on competitiveness, assertiveness, materialism, ambition and power, with success measured in terms of ‘winning’, i.e. meeting targets. Whilst feminine cultures place more value on cooperation, consensus and caring relationships, where quality of life is the measure of success. Sweden and Norway score highly as feminine societies. This means valuing the ‘softer’ aspects of culture i.e. compassion,consensus and cooperation. The focus from this perspective does not suggest one set of values is superior to another, rather that both are of equal importance to society, both should be viewed as of significant value in society. The suggestion is the embedding of both of these perspectives in a more balanced manner could provide the conditions to support the change so many would like to see in our care system.

A culture of ‘masculinity’ arguably dominates government, and society, in the UK, where ‘value’ is predominantly linked to ‘value for money’, unlike Nordic countries where values such as ‘equity’ and ‘cooperation’ are viewed as equally important. This has been achieved by taking a whole systems approach to developing a balanced value base across society. Arguably the new Public Services (Social Value) Act 2012 is trying to ‘nudge’ public sector commissioners of care toward their ‘feminine’ side as Patrick Butler of the Guardian suggests ‘the act requires public authorities to take into account social and environmental value when they choose between suppliers, rather than focusing solely on cost’. The message appears to be: money is not everything!

For those not convinced, and who would argue money is everything, it’s worth considering the effect of Nordic policies on the competitiveness of their economy. The Economist reports the World Economic Forum rate Sweden, Denmark, Finland and Norway as ‘top of the class’ as well as being probably the best governed countries in the world. How have they achieved this? Well it is beyond the scope of this blog to explore this in detail, but it would appear they have somehow managed to successfully blend ‘big government’ with ‘big society’ without compromising either, and I wonder how much of this is to do with the active development of ‘feminine’ cultural values where equity and egalitarianism are viewed as equally as important as competition and choice.

My previous blog looked at the potential lessons we could learn from Finland, suggesting public sector provision may be improved if we change our focus from a market/target driven culture in health and social care to one characterised by equity and responsibility.The Nordic countries may not have all the answers, but they do provide an interesting alternative. So interesting that Labour leader Ed Miliband has recently visited Sweden to see for himself the Nordic model. However, to learn from these would involve politicians moving away from addressing the problems identified in the care system in individual silos to taking an approach that focuses on a wider value base to develop a compassionate society.

The Struggle for Truth by the most Vulnerable

jaynelinney

All of you who read my blogs are well aware of the petition I’ve been working on with Debbie Sayers; and just in case you’ve missed it, here’s the link https://www.change.org/en-GB/petitions/work-pensions-committee-hold-ids-to-account-for-his-use-of-statistics-2#.At the time of writing 94,223 have signed asking for IDS to be formally held to account for the abundance of Lies, He & his juniors Ministers have repeatedly told regarding DLA and the upcoming changes.

Today we officially learn, the Work Programme is failing the UK’s most vulnerable (i); I say officially because we have known almost from the outset, this would be the case; this is based on scores of blogs, media articles and conversations on FaceBook & Twitter, that have gone on since the programmes inception. Yet, Ministers of the DWP have once again repeatedly stated the Programme is succeeding; more Lies?

Yesterday we discovered the DWP has delayed publication of the official data about how many JSA & ESA claimants have…

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Every elderly patient to get personal NHS care co-ordinator. Really Mr Hunt?……

Please,Mr Hunt, stop with the soundbites and treat us with some respect. Every elderly patient to have personal worker to co-ordinate their care.  Really???

This issue is far to serious for soundbites Mr Hunt, older people in this country can face unimaginable cruelty in our care system, whether it be on the hospital ward, a private residential or nursing home or in their own homes.

Understanding of the nature of abuse and maltreatment older people might experience now parallels that of child abuse.  Referrals regarding abuse received by two adult social service departments suggests in England ‘Older people dominate the abuse landscape’ (Mansell et al, 2009).  Experimental statistics regarding the abuse of vulnerable adults from the NHS Information Centre support this finding, where 61% of referrals were for older adults aged 65 and over (2012).

From a European perspective research findings suggest older people’s experience of ageing in the UK falls behind that of many of its European counterparts, with the UK performing most poorly on indicators such as income, poverty and age discrimination (WRVS,2012).  The report states “the UK faces multiple challenges in providing older people with a positive experience of ageing, scoring poorly (although not always the worst) across every theme of the matrix” (WRVS, 2012, p.8).

 This provides a troubling vision of older people’s experience of ageing in the UK. It is contemptible that any government would seek to address this serious issue with what is a clearly ill thought out and unsustainable idea.

Older people’s experience of ageing in the UK can be improved, and it is all of our responsibility to try to achieve this.  However, we first need a coherent strategy to bring about the change desired by many who work with older people.  Government in the UK tend to address issues associated with an ageing population in individual ‘silos’.  Research from Europe suggests those countries taking a joined up approach where government consider how factors such as income, health, age discrimination and inclusion interact , the more successful policy approaches are likely to be to improve the experience of ageing.  However, any action needs first to take a long-term approach and have a strong ethical foundation founded on a clear understanding of, and agreement to, promoting older people’s equality and human rights across the political divide.

For many staying out of harm’s way is a matter of locking doors and windows and avoiding dangerous places, people and situations; however for some older people it is not quite so easy.  The threat of abuse is behind those closed doors,on the hospital ward, in the residential home or in their own homes, well hidden from public view. For those living in the midst of this violence and fear permeates many aspects of their daily lives.

Those older people deserve so much more than spin and media soundbites from any government.

Will a ‘new’ economics of care result in ‘moral deprivation’ rather than compassionate care in the NHS?

Di Galpin

As Jeremy Hunt accuses hospitals of endangering patients lives one wonders can ‘compassionate care’ really flourish in the ‘new’ economics of health and social care? Will NHS reform result in less compassion rather than more?Michael Sandel argues markets are not a mere mechanism designed to deliver goods, they also embody certain values, and the problem is these values ‘crowd’ out non market values which are really worth caring about and preserving, such as compassion’.

The Nobel prize winner for economics, Jospeh E.Stiglitz, suggests the current neo-liberal approach favoured by government is undermining a fundamental value many support, a sense of fair play. Stiglitz argues if financiers that lay at the heart of the current financial crisis felt such a basic value their actions should have led to feelings of guilt as they engaged in predatory actions that damaged individuals lives. He suggests few felt any sense of shame…

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As Hunt accuses hospitals of endangering patient lives I wonder will the ‘new’ economics of care really support compassion in the NHS?

As Jeremy Hunt accuses hospitals of endangering patients lives one wonders can ‘compassionate care’ really flourish in the ‘new’ economics of health and social care? Will NHS reform result in less compassion rather than more?Michael Sandel argues markets are not a mere mechanism designed to deliver goods, they also embody certain values, and the problem is these values ‘crowd’ out non market values which are really worth caring about and preserving, such as compassion’.

The Nobel prize winner for economics, Jospeh E.Stiglitz, suggests the current neo-liberal approach favoured by government is undermining a fundamental value many support, a sense of fair play. Stiglitz argues if financiers that lay at the heart of the current financial crisis felt such a basic value their actions should have led to feelings of guilt as they engaged in predatory actions that damaged individuals lives. He suggests few felt any sense of shame or guilt and that where making money is concerned there is ‘moral deprivation’, meaning something is wrong with the moral compass of so many working in the financial sector, and that this has changed the norms of society, allowing what might once have been deemed as unacceptable as acceptable when justified by financial gain. However, such moral deprivation is not confined to the financial sector, we just need to think about ‘Big Pharma’. The Independent reports an influential group of cancer experts warn high prices charged by pharmaceutical companies for cancer drugs are effectively condemning patients to death, claiming drug companies are “profiteering” using unethical methods.

However, faith in the free market is unshakeable across government, and is seen by many as the only way forward to address future resourcing issues. However, the re-branding of healthcare as a commodity ignores some simple ‘free market’ truths, pointed out by the economist Adam Smith several hundred years ago;  the purpose of the free market is to generate wealth for those who own the means of production, or the ‘masters of mankind’ as Smith christened them, it is not a charitable endeavour but a single-minded system driven by cash not compassion, who Smith suggested had a ‘vile maxim‘  of  “all for ourselves”.  The ‘masters of mankind’  in Smiths time were the merchants and manufacturers who supported policy that enabled them to make more profit, they were not concerned with how such policy and their actions might impact on others.  Today the ‘masters of mankind’ appear to be ‘big pharma’, financial institutions; banks, insurance companies, private healthcare providers and  international management consultants, such as  McKinsey and Company who wrote many of the proposals contained within the Heath and Social Care Act, and stand to makes several millions from their implementation.

We have already seen some of the potential problems that can arise in the marketisation of social care. At a macro level those private institutions who have already taken over some areas of care provision   have been found lacking, which does not bode well for extending this strategy accross healthcare.  Take, for example, HSBC who were fined £10.5 million last year for mis-selling care bonds to older people.  The Financial Services Authority found unsuitable sales had been made to 87% of customers, with the average age of those who purchased bonds being 83 years of age, many of whom having already died before the scandal came to light.  Whilst £10.5 million might sound a lot it’s not for a company who was recently exposed as allowing the laundering of at least 7 billion dollars of drugs money through its bank and has set aside 700 million dollars to cover fines.

The selling of care related products by the private sector can leave individuals vulnerable in a variety of ways, look at the doubling of the number of private care homes going bankrupt leaving older people without secure housing or care provision. Latest reports in The Independent suggests nothing had changed as the bailiffs are set to move in on some care home providers.

Arguably, the ‘free market’ is anything but ‘free’.  A favourite of Mrs Thatcher, economist Friedrich Hayek compared the free market to a ‘game’ where there are winners and losers suggesting trying to regulate the market in the name of social justice was a waste of time. Arguing it is not governments place to even the odds because we are all free to make choices, and should live with the consequences of those choices and not try to displace them onto others, such as government or other taxpayers.  Which in many ways I support, however, the market is not free and appears more comparable to a casino where the ‘house’ always wins.

The current government, and opposition, appear to believe there is only one game in town when it comes to the future of our health and social care sector, they are wrong.  Call me old-fashioned but for me an active State should be about taking a lead, collective action and solidarity, setting a high bench mark for all in society, not running away and hiding behind the financial sector and an outdated mantra of ‘private sector good, public sector bad’ where ‘money is the anthem of success’ like some National Anthem (Lana Del Rey). Stiglitz suggests this is an ideological battle, because economic science -both theory and history – provides a quite nuanced set of answers, and the battle plays out in every sector of the public realm.

 

The question is, are we prepared to engage in this battle to protect values such as care, compassion and fair play in our health and social care system or will we settle for values measured against cost and profit alone?

Join us in celebrating frontline social work with children and families at our FREE conference for professionals……

FREE conference for professionals who work with children and families

We recognise this is a time of challenge for the social work profession and statutory social work in particular, set against a backdrop of welfare reform, marketisation of services and austerity measures. This is why we are hosting a free conference for those professionals on the real ‘frontline’, to say thankyou for your continued commitment to a very difficult job.

We invite you to a day to stop, think, reflect and hopefully learn with your peers.

Whilst we know professional practice is not without its problems , we also know there are highly committed and motivated professionals in practice, who, in spite of the challenges they face on a day-to-day basis, seek to make a positive contribution to children and families lives. So come and meet with us, and others, to share your experiences and knowledge.

The conference is just the start, for those attending there will be further opportunity to register for another future event we have organised for practitioners focused on domestic violence.

For more details about the conference and to reserve your free ticket click here

Together we can make a difference. Please share this information, we want as many professionals as possible to be part of this event.