Tag Archives: experience

The ‘Big Society’ will not necessarily lead to better elderly care treatment by @dianegalpin

A fantastic blog by our senior Lecturer Di Galpin for LSE Policy and Politics Blog a recommended read!!!

The ‘Big Society’ will not necessarily lead to better elderly care treatment.

Di Galpin looks at the Big Society from a philosophical standpoint and questions whether it can be achieved without encouragement from an active state.
Advertisements

There is a million reasons why ‘big society’ and ‘choice’ are not enough when providing care to older people

Research suggests as many as 500,000 older people are abused each year (Action on Elder Abuse), in the main by those supposed to be providing their care.  Therefore, since the election in May 2010 up to one million older people may have been abused.  

This information is not new, successive governments have been aware of this issue for many years but all have stopped short of introducing a coherent legislative framework to protect those most vulnerable in the care system.  The coalition appear to believe in the power of ‘big society’ and service user and patient ‘choice’ in a market led health and social care system.  My difficulty with this approach is it offers nothing new,  it looks no further than the rhetoric of the ‘free markets’  beloved of every government since Thatcher.  Nobody appears interested in thinking deeper and developing care from a philosophical perspective.  Surely we need to understand what motivates us to care before we can reform the system ?

Historically societal attitudes toward older people have always been poor.  In ancient Greece old age was portrayed as sad with historians arguing the Greeks love of beauty marginalised the old, especially women, sounds familiar!  Cicero’s work De Senecute, written in 44BC, pointed to a variety of individual experiences of ageing, however acknowledging that for those who were poor and without mental capacity ageing is miserable.  Sadly, all of this is still true today with research suggesting those at greatest risk of abuse and mistreatment are elderly women suffering from some level of dementia.  This,  along with the fact that the abuse and mistreatment of older people is a global issue identified by the World Health Organisation over a decade ago, suggests the issue  extends well beyond political systems and party politics in the UK.

I’m with social contract thinkers Hobbes (1588-1679) and Locke (1632-1704) when they suggest as human beings we are inherently selfish and our individual pursuit of pleasure is destructive to society, suggesting the law can be used as an apparatus to modify such human desires.  In my view the  continued economic approach to health and social care has fed such selfishness, to the detriment of certain groups in society, i.e. older people,  and we now require a strong lead from government.

Successive governments since Margaret Thatcher have relied on a consumerist approach to improving the quality of health and social care provision. The question is has turning vulnerable older people into consumers improved their care?  For some yes, but for many of the most vulnerable older people in society, those older old people with dementia and who are frail, I’m not so sure.  However, what it has done is hide the abuse and mistreatment of older people from collective view for the last 30 years, and led society to engage in debate that does not move beyond the financial.  Research suggests this has had a detrimental effect on the moral health of society and academics are now suggesting the use of market mechanisms can change people’s attitudes and values, having a  ‘corrosive effect’.    Michael Sandel makes a pertinent point suggesting

It calls into question the use of market mechanisms and market reasoning in many aspects of social life, ……to motivate performance in education, health care, the work place, voluntary associations, civic life and other settings in which intrinsic motivations or moral commitments matter‘ (What money can’t buy, 2012, p122).

So what can we do? Helen Sullivan suggests ‘a big society needs an active state’.   A useful first step would be for government to accept the Law Commissions recommendations on reforming the law in respect of Safeguarding Adults without delay.  Secondly, abandon the rhetoric of ‘choice’ and ‘free markets’  and develop a meaningful dialogue based on concepts such a honesty, morality and dignity from a philosophical  rather than financial perspective. A new approach might be to have a dialogue that goes beyond party politics (and winning the next election) and begins by asking big society what it wants to afford, rather than politician telling us what we cannot afford.

I am sure many will say we cannot afford to reform the system on philosophical grounds, I would ask those individuals “can we morally afford not too?”

An adult adoptee and ex social worker describes how it feels to be a ‘service user’ as she attempts to access her adoption file

Adult Adoptees and Identity: the adoption process is currently under government scrutiny, getting it right is so important for adoptees futures. However, getting it right is not just about policy and procedures; it is also about social workers being professional and flexible in their approach. An adult adoptee, and ex social worker, describes how it feels to be a ‘service user’ as she attempts to access her adoption file.

(this is the 1st of a series on the ‘adoption file’, read ‘Lost Families’  if you want to see what happened next)

Whether who we are is determined by some invisible invention of science called genetics or the parenting skills of our parents is commonly known as ‘nature vs nurture’ and is the subject of much research. The truth is we may never know the exact ratio of influence, it may well vary from individual to individual, but it is fair to suggest both play a role in making us who we are. Whilst for many this is just an interesting debate for some, like me who have been adopted, it is a significant factor in shaping my understanding of who I am and how I feel about myself.

This blog is not written by me as a social worker or academic but as ‘adoptee me’. I was adopted over fifty years ago and have been trying to find information about my genetic family and my birth mother for thirty four years. Many years ago I accessed my adoption file in the hope it would provide me with information that might lead me to her. Unfortunately, it did not, although it did give me some useful information regarding the circumstances of my adoption.

Fast forward thirty years to August 2011 when I decide to have another look at my file in the hope that being older (possibly wiser?) it could still hold something useful that was missed before and might take me a step closer to finding my birth mother. And so with high hopes I contact the local authority where my adoption took place, hence forth known as ‘Never Never Land’. After being diverted to several departments I eventually reach the right one and speak with someone. The first question asked at this point is “why do you want to see the file?” Although taken aback, and to be honest rather annoyed to be asked this, I answer “because it’s about me and who I am, my family history”. The social worker explains the process to me. No I can not contact ‘Never Never Land’ direct to access my file I have to go through another authority, hence forth known as ‘La La Land’, and they will request access to my file on my behalf. Okay, why a third party needs to be involved is not explained. When I asked if I can have a copy of the file the response is guarded “possibly, but no third party information would be shared unless the third party agreed”. Okay, what if the third parties are dead i.e. my adoptive parents…..no reply, it felt like the worker was following a script and this question did not appear on the script, we end the conversation with one last question ”why do you want to see your file?”, “because etc etc etc……”.

My main concern at this point is who is going to decide what I am allowed to see, and will they leave out that one vital piece of information that might lead me to my birth mother? I feel powerless.

To say my first contact from the other side of the fence, so to speak, was unsatisfactory is an understatement, even after one phone call I felt frustrated and disempowered. It was clear there were hoops to be jumped through, and I was going to have to jump! I felt I had to fit the system regardless of whether it fitted me, or was appropriate.

Next step, phone call by me to ask how long the process might take, “No idea!”, followed by explanation they only worked part time, was going on leave and this was non urgent so would not be prioritised, expect a minimum of 6 months, that’s not including any delays in ‘Never Never Land’ responding. Further contact with social services is equally unsatisfactory, and still they asked “why do you want to see your file?” ………….”because…etc.etc!”

I eventually meet my adoption social worker and am pleased to report they are experienced and professional, they do not appear to stick to any particular agency approach and make me feel I am listened to as an individual, I do not feel like a service user with this social worker, this is an equal partnership.

So, have I seen my file? To cut a long story short the file is still in ‘Never Never Land’, however, it is going to arrive in ‘La La Land’ soon. Reasons for delay range from workers and mangers going sick, people working part time, supervision being cancelled and window repairs (don’t ask!!!). In all honesty, I am not interested in knowing any of this it only serves to heighten my annoyance and sense of powerlessness.

I do understand the pressures in practice, and of course the protection of vulnerable children must always come first, however, whilst not urgent it is actually very important to me. Seeing my file again is a desperate measure on my part because I’ve exhausted all other avenues, my mother is approaching eighty years of age, time is not on our side. An acknowledgement of how important this might be for me on my first contact with services would have been nice.

How does all this make me feel? Angry, powerless, frustrated, sad. My contact with services is minimal and time limited, unlike many others. The professional social worker in me knows the pressure systems, and people, are under and how my request is insignificant in the scheme of social work practice with Children and Families, but, it is important to me. Whilst at an organisational level it is just an old file, for me it is my life and about who I am. This process has made me reflect on my own social work practice, I’d do things differently now!

(This is one of several blogs, if you would like to read the complete story of what happened in my search for my natural mother you can read it in a free ibook here <a href="here“> You will need an ipad to read it)