Thursday 23 June 2011

Abuse of vulnerable adults: Why no inquiry?

Imagine if there had been a succession of child abuse stories in the media during the last six months. There would be an outcry. Every Baby Peter story that emerges, in all its grisly detail, somehow diminishes all.

The abuse of and suffering by the vulnerable affects all decent people deeply. We find ourselves asking, “how could this happen”? And “why did no one notice”? And worst of all, “what does this say about us and society”? Parents fear for their children and their children’s future. We collectively demand that something is done. Those involved become tabloid hate figures. Ministers condemn the perpetrators as evil and establish commissions to look at lessons to be learned. Our response is horror at the pain, misery and humiliation. We have a shared feeling that this abuse shames us all. And we have an angry determination that this abuse must stop.

The result is that over the years, there has been a succession of official commissions and investigations into the abuse of children. The Maria Colwell inquiry, the Cleveland inquiry, the Broxtowe inquiry, the Victoria Climbié inquiry (the Laming report) and most recently the Baby Peter inquiry.

Each tragedy has resulted in the strengthening of the law and procedures used by those responsible for protecting children. And thank goodness that this is the case. No child should suffer and it is a primary duty of us all to protect those who are unable to protect themselves.

And yet this is not always the case: not if you are an adult and vulnerable, for instance. Over the last six months there has been a succession of stories that have involved abuse of vulnerable adults in institutional care. The patient’s association, Listen to patients, speak up for change listed 17 shocking accounts of patient care in the NHS. Just read the stories and think about their suffering and the de-humanisation of them by those involved. And then ask why the names of Anne Robson, Elsie Pague, Brigid Wainwright and the other fourteen are not linked to sea changes in practice within the NHS.

Then there was the NHS ombudsman report, Care and Compassion that detailed the failings of care of older people in the NHS.

I have written about it before but it is worth repeating some of the abuse uncovered:

» Alzheimer’s sufferer Mrs J, 82, whose husband was denied the chance to be with her when she died at Ealing hospital in west London because he had been “forgotten” in a waiting room.
» Mrs R, a dementia patient, who was not given a bath or shower during 13 weeks at Southampton University Hospitals NHS trust. She was not helped to eat, despite being unable to feed herself, and suffered nine falls, only one of which was recorded in her notes.
» “Feisty and independent” Mrs H, who had lived alone until she was 88, was taken from Heartlands hospital in Birmingham to a care home in Tyneside but, when she arrived, was bruised, soaked in urine, disheveled, and wearing someone else’s clothes, which were held up with large paper clips.
Or the Panorama investigation into the systematic abuse of adults with learning disabilities at Winterbourne View in Bristol. I watched and wept as the secret filming uncovered the horrific torture of residents in their own home. Or the Dispatches undercover report Dignity in Dying that evidenced poor care of people at the end of their lives. Or the “abuse, lack of cleanliness and poor nutrition” uncovered in some care homes by consumer group Which?. Or, indeed, any one of the countless examples of poor care and abuse that make it onto news broadcasts and into our newspapers.

Just this week, the equality and human rights commission published a report into the abuse of older people’s basic human rights when they are being “cared for” at home. They identified examples of:

» People being left in bed for 17 hours or more between care visits
» Failure to wash people regularly and provide people with the support they need to eat and drink
» People being left in soiled beds and clothes for long periods of time
» A high staff turnover, meaning that some people have a huge number of different carers performing intimate tasks such as washing and dressing. In one case a woman recorded having 32 different carers over a two week period.
Of course, on the whole most care home providers are dedicated and professional and their staff provide excellent care. I have recently visited some excellent care homes where the quality of care was incredibly moving. Patients with severe dementia, who can be pretty tough to care for, were treated with dignity and respect by some fantastic staff. And most hospital care is first class and treats vulnerable patients as sentient human beings. But the stories of abuse are too common to ignore. They are already causing fear. Imagine if you had a vulnerable relative who went into care – you’d worry. Who wouldn’t?

So it is time to take a stand. Piecemeal investigations are no longer enough. Vulnerable adults deserve the same protection as vulnerable children. The government should establish an inquiry into the standards of care for vulnerable adults. It should be wide ranging: looking at staff training, accountability, rights and responsibilities. The failure of multi-disciplinary cooperation to pick up abuse should be looked at. And most of all there should be a framework set in law as to how vulnerable adults should be better heard in determining their own care.

This abuse causes pain, misery and humiliation. It shames us all. It must stop.

Posted by Peter Watt, Chief Executive of Counsel and Care

This blog first appeared on Labour Uncut on 23.06.11