Category Archives: Thatcher

What is the point of choice in care, if your choice is between an inadequate care provider or one requiring improvement?

As CQC finds 32% of facilities in England inadequate or in need of improvement and says social care in ‘precarious’ state one wonders will we ever get to grips with this issue?

This latest report suggests

social care is in a “precarious” state – and according to Age UK the results leave elderly people and their families “playing Russian roulette” when they choose a nursing home or other care service. Inspectors making unannounced visits to care homes found medicines being administered unsafely, alarm calls going unanswered and residents not getting help to eat or use the toilet. Some residents were found to have been woken up by night-shift care workers, washed and then put back to bed, apparently to make life easier for staff

This is not just poor care but adult abuse.

Governments response is to promise more money for social care, however, I feel we would be foolish to rely on the same old political rhetoric. This amounts to no more than economic deception as successive governments continue to adhere to the neoliberal principles of the quality and responsiveness of free market provision and consumer choice. The current approach is failing to deliver either of these fundamental neoliberal principles as the care ‘market’ flounders.  According to research, carried out for BBC Panorama by Opus Restructuring and Company Watch, the care ‘industry is in crisis with 69 home care companies having closed in the last six months and one in four of the UK’s 2,500 home care companies is at risk of insolvency.

Anyone reading this who has sought to purchase care for their relatives can attest to the lack of ‘choice’ the current system provides. Indeed most would forfeit ‘choice’  to just have one provider who we can trust to provide decent care for our loved one’s.

What is the point of choice if your choice is between an inadequate care provider or one requiring improvement?

The primary issue, for me, is that care should never be treated as an ‘industry’ because the conflation of care and profit should never ever have occurred because marker values have altered our understanding of the value of humanity in care. Arguably, the discussion needs to go beyond financial issues to consider the greater deception of successive governments who have consistently ignored their failure to develop an ethically sustainable approach to the care and support of those requiring care, especially older people.

Let’s be honest, growing old in the UK is not for the faint hearted when we consider research and inquiries over the last decade. Action on Elder Abuse have consistently highlighted the prevalence of abuse older people experience in the community, leading in 2016 to the publishing of a ‘dosier of shame’ which outlined how the abuse of older people frequently go unpunished.

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,210). 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 all provides a troubling vision of older people’s experience of ageing in the UK.

Successive Governments in the UK tend to address issues associated with care and 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 develop more successful policy approaches, which improve our care provision and the experience of ageing.

However, any action needs first to move away from the dogma of neoliberalism and take a long term approach with a strong ethical, rather than financial, foundation.  This needs to be founded on a commitment to promoting care as a humane act rather than promoting the care of those most vulnerable as a  product to be bought, sold and profited from.

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Grenfell Tower represents the culmination of Thatcher and all who follow in her neoliberal footsteps ….. Time for change

Commentator, after commentator have made political links to the manmade tragedy that befell the innocent residents of Grenfell Tower. Within such commentaries the authors refer to the ideology of ‘neoliberalism’, which whilst well known to economists, politicians, Guardian readers and academics (like me!) is rarely thought about in wider society. Yet its impact on society over the last 40 years is immense, and for me Grenfell Tower represents all that is wrong with this insidious ideology that does more harm than good.

But, what it is?

Firstly, I think it is important to be aware of the power of  ideology, and neoliberalism, because it provides government with  a  framework which shapes its ideas, ideals, values and beliefs about the world, what motivates individuals, and provides a guide on how life should be lived, how society should be structured and our role in society.

In short it determines the nature and limits of that state, what matters and whom.

An example of the power of ideology can be seen in religion. Religious values and beliefs  shapes its organisation and provides motivation for the actions of its leaders and believers. As we know all to well religious ideology can lead to intolerable acts of violence, whether it be the Christianity of the  Klu Klux Klan or the Islam of ISIS.

Just as religious ideology can be a strong motivator in shaping thoughts and actions, so to is the  political ideology of neoliberalism.

There are a number of strands to neoliberalism which are, arguably, as relevant as the cladding on Grenfell Tower in understanding why so many lives have been destroyed. In political terms neoliberalism depends on, firstly, stigmatising those who require support and then disinvesting in the public services that provide their support to promote open unregulated markets and the transfer public services into the free market.

This has resulted not only in the deregulation and privatisation of publicly owned assets, such as housing, but also the transfer of responsibility for those requiring public services away from government, so that when, as in this case, there is a failure in the system,  holding someone to account is almost impossible due to a diffused chain of responsibility government has put between it, and the individual,  by creating a host of intermediary layers of officials and organisations , such as management companies, contractors and sub-contractors.

A key tenet of neoliberalism is the role of free market in delivering everything from baked beans to iPhone to cancer care. The free market is highly valued by neoliberals because it is viewed as a more efficient system in providing goods and services and promotes individual liberty by empowering society through consumer choice.

In the case of Grenfell Tower, the extremes and limitations of these beliefs are starkly revealed. Not least in Brandon Lewis’s comments regarding regulation to enforce the installation of sprinkler systems in tower blocks.

Mr Lewis, recently promoted to immigration minister by Theresa May, had declined in 2014 to force building developers to fit sprinklers. The coroner’s report into the 6 deaths after a fire in a block of flats at Lakanal House had recommended regulations be updated, and called for developers refurbishing high-rise blocks to be encouraged to install sprinkler systems. But five years later, Mr Lewis told MPs:

“We believe that it is the responsibility of the fire industry, rather than the Government, to market fire sprinkler systems effectively and to encourage their wider installation.”

He said the Tory government had committed to being the first to reduce regulations nationwide, pledging a one-in-two-out rule. He added:

“The cost of fitting a fire sprinkler system may affect house building – something we want to encourage – so we must wait to see what impact that regulation has.”

Even after the controversy when these comments were publicised  Micheal Gove’  still held to the neoliberal ideological line when interviewed in respect of Grenfell Tower, suggesting that it is a matter for “debate” that government should regulate so that people could have safe housing conditions.

Whilst some might find such comments incredulous, these responses are wholly consistent with neoliberal ideology, which promotes the commodification of everything from  housing to education to health, to social care and more worryingly clearly includes ‘risk’.      This combined with limited regulation of the free market and an unshakable belief that all consumers can exercise free choice  to control, or eliminate,  risk is concerning.

Those in power do not seem able, or willing, to recognise there are  flaws within the neoliberal  ideology they so zealously adhere to, that authentic consumer choice is often a facade in important areas of life, such as housing and health and social care, that individuals cannot always eliminate risk because of the governments hand in creating structural inequality, which restricts the individual autonomy and consumer choice they purport to support, unless, of course you are very wealthy.

The powerlessness of the residents of Grenfell Tower to exercise autonomy and choice is seen in their inability to challenge decisions around whether a sprinkler system should have been installed and this exposes the interplay  between the structural and personal realms of life. Peter Weatherby QC is one of Britains top lawyers, and he suggests a key action of government had been overlooked in this tragedy, the swinging cuts to legal aid. Residents of Grenfell Tower had sought to challenge  decisions being made, and residents did try to get a lawyer, however,  they could not get a lawyer because of cuts to legal aid, according to campaigner Pilgrim Tucker, speaking on BBC Newsnight

“These are poor residents – or they’re ordinary residents. They’re not 
the wealthy. They’re not the Camerons. They can’t afford private 
schools, they can’t afford lawyers. They tried to get lawyers but,
because of the legal aid cuts, they couldn’t get lawyers. ”

Other lawyers have also pointed out the role of legal aid cuts in this tragedy.

However, again, this is consistent with neoliberal ideology, why should the state fund legal aid?

This is actually structural abuse, which is defined as ‘the process by which an individual is dealt with unfairly by a system of harm in ways that the person cannot protect themselves against, cannot deal with, cannot break out of, cannot mobilise against, cannot seek justice for, cannot redress, cannot avoid, cannot reverse and cannot change’

I think this sums up the plight of the residents of Grenfell Tower pre and post fire!

Albert Camus wrote “We must mend what has been torn apart, make justice imaginable again in a world so obviously unjust….. ”, going onto suggest mending a broken world is ‘steadfast, often unglamorous work – it is the work of choosing kindness over fear, again and again…’

To mend the broken in this society,  those marginalised through poverty and  homelessness, or through age and fragility, to ensure we never subject anyone to the horrors of those lives ruined in Grenfell Tower we all need to be more aware of the ideology that underpins our current system of government and decide if it is fit for purpose, and where we find it lacking, find new ways of governing.

Replacing Theresa May with Boris Johnson or Micheal Gove or A.N . Other will not mend our broken society because politicians all seem to adhere to the same ideology – neoliberalism.  Nothing will change until this insidious ideology is revealed and challenged by us the people, and we hold our politicians to account for their actions.

Let the fate of the individuals of Grenfell Tower be a lesson to us all, and lets ensure their tragedy is never forgotten. We need real change for all our futures.