I didn't watch the Panorama programme about abuse in care homes. Or rather, I watched for a couple of minutes and then had to stop. I just can't bear to sit through any reminder of my family's own experience of what passes for 'care' for some of the most vulnerable members of society in Britain in the twenty first century, and the complicit toleration of neglect and abuse that the present system of inspection allows.
I've written about this in earlier posts - http://wwwbrokenbarnet.blogspot.com/2010/06/growing-old-in-broken-barnet.htm and a follow up in February, Couldn't Care Less. These posts were about a care home still used by Barnet Council to place some of its most vulnerable elderly residents, and which was taken over some years ago by Southern Cross, the largest provider of carehomes in the UK. My father spent the last miserable year and a half of his life in this dreadful place. When Southern Cross took the home over, the manager who had caused so much difficulty for us, when we made the mistake of complaining about our father's treatment, thereby exposing him to God knows what else when we were not there, was rapidly promoted within the new company.
Despite years of continually critical reports by the CSCI, the body then responsible for standards in residential care, the home remained in business. The inspector who made these reports was taken on by the new body, the CQC, and carried on making largely the same observations, including the repeated flouting of statutory requirements.
The home remained happily in business, however, until at last, after repeated complaints, Harrow council was forced to launch a 'safeguarding adults' investigation, and for a long period the home was closed to further admissions, although the unfortunate residents placed there were left to continue in the same situation. Eventually the home was allowed to reopen, although with barely visible justification, a pattern noted in articles in Private Eye, where it was observed that the pressure on the CQC to award ratings adequate for the continued provision of much needed placements for local authorities was clearly in conflict with the need to enforce a higher standard of service.
All the commentary that has emerged in recent weeks in response to the financial meltdown of Southern Cross makes the same glaringly obvious point: that the business model used by this company was unsustainable, and the drive for satisfactory levels of profit are too easily compromised by the demands of maintaining a decent standard of care for the many thousands of dependent vulnerable elderly people in its homes.
We used to put the elderly infirm in the poorhouse, and people with mental health problems in Bedlam, providing a form of entertainment for the jaded appetites of affluent visitors at a loss for distractions from their cossetted daily lives. The poorhouses are gone, but these days we leave the keys to the asylum with property speculators and turn a blind eye to the regimes they put in place. Not much progress, really, is there?
In countless local authorities across the country, Tory councils are falling over themselves to outsource services to private contractors. There is something of a rush, because indications are telling us already that these outsourced services inevitably lead to a decline in standards, and an inadequate return for investment. In increasing numbers of cases, services are having to be returned to the authority's direct management. The lessons are clear, from the provision of traditional local authority services such as social care, or the intervention in such areas as fire safety, as seen in the AssetCo example, you cannot and should not make profit from such vital services. Neither the tax payer nor the service user benefits from outsourcing, and the private companies who enter this market can only make short term profits by providing a service that prioritises the needs of shareholders, at whatever cost to the rest of us.
The Southern Cross constellation is, ironically, a symbol of rebellion against oppression in some countries, buts its significance originally was as a vital point of navigation in the seas of the southern hemisphere. In these interesting times, perhaps, it might be reassuring, if somewhat misguided, to imagine that the light of Southern Cross is pointing the way to another horizon - somewhere where we put duty to support those in need above the opportunity to exploit their vulnerability for profit.