By Gary Fitzgerald, chief executive of Action on Elder Abuse
Earlier this week, BBC Radio programme ‘File on 4’ revealed there were 23,428 safeguarding alerts about home care between 2013 and 2016*. Of those cases, 700 involved the police, but just 15 resulted in any form of prosecution. The concerns involved neglect, psychological, physical and sexual abuse.
The Department of Health’s 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, vulnerable and defenseless older people is now routinely degrading, humiliating and abusive. It is getting worse. It goes against the basic standards of humanity and it has been increasingly so for years. Yet whenever a report brings it to public attention, the government releases equally bland statements.
The occasional abusive care worker does not cause this situation. There are some horrible people working in our care services and it is too easy to gain such employment. However, most do their best in very difficult circumstances, and many provide outstanding care despite those circumstances.
This situation is systemic. The root cause is the short-term and often ideological decisions taken by successive governments, of all political persuasions, over the last decade. It is the failure of directors and councillors to uphold minimum standards of humanity and instead making cuts that will inevitably cause harm. It is also the care providers who have chased contracts at a value that could never deliver any level of quality care, but meant they remained in business for a while longer. This is a human-made disaster, not an accidental one.
‘Nurses v. care workers’
Consider these issues:
Nurses must be on a professional register and can be removed if they fail to meet expected standards. This is a proactive way of controlling who can have access to patients. However, 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 does not include every care worker who has neglected or abused an individual.
Nurses must also have a level of training verified not by the employer, but by an external body. A care worker might have the Care Certificate – lauded by government as something that makes a difference – but is in fact not legally mandatory or independently verified. The employer signs it off.
The standards care providers are inspected against have changed several times since they were 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?
Finally, elder abuse is not prosecuted. Only 0.7% of cases actually reach court, and then it is not unusual for the sentence to be community service or suspended. This is hardly a deterrent for an issue that affects over 500,000 older people. It begs the question: Why is a crime against you prosecuted if you are in your thirties, but not if you are in your eighties?
‘Fade to memory’
At the heart of 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. Everyone wants to get old because no one wants to die young, yet we still tolerate old age being subjected to inhumane and degrading treatment. We no longer recognise it for what it is.
The ‘File on 4’ programme broadcast the reality of what it truly means to be on the receiving end of services that no longer aspire to quality, but are instead about doing the minimum possible, as cheaply as possible. But unlike a programme about child abuse, it will quickly fade to 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. 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 are on the receiving end of those services?
*The figures revealed by the BBC were obtained from only half of local authorities asked – the others failed to reply.