A Decidedly Nasty Business

The recent scandal at Winterbourne View and the planned redundancies from Southern Cross, have brought the privatisation of care to some degree of national attention.
MP’s from all parties called for such care to be guaranteed and many, rightly, have called the behaviour of staff within Winterbourne View as abominable and that they should face some kind of criminal charge.
People, regardless of profession, are just people of course; fallible, mean, cruel, herd-following, bastard people. Put people in a position of power and/or responsibility over the life of another, especially a more vulnerable one, and sooner or later those unpleasant types will show their true colours. That’s true of all walks of life, but where care work differs is in the direct, dehumanising and abusive ways in which that immorality can reveal itself.
Now you’d suspect, as a (quite probably soon to be ex-) learning disability nurse, I’d table thump and claim that if only there were more of us all of these problems would never have happened (indeed, see this: “Services on the Cheap”), but that would be, partly at least, disingenuous. Scandals and bullying happened in NHS establishments and by LD nurses, I can’t deny that, but over the years safeguarding has improved, poor staff were removed more quickly and the prevention of endemic, widespread abuse, as in Winterbourne View, became more robust.
But it’s about more than just Nurses like me and the NHS; it’s about how we as a nation provide those people who need care and support the services they require. This isn’t a new issue; it hasn’t just arrived along with the welfare-state adverse coalition. The move away from the state providing care services started years ago, the state may still commission services, but, especially in the NHS, does not provide them; that’s left to private or charitable organisations.

That situation is rapidly increasing; it’s clear the current government wants to reduce the ‘burden’ placed upon the state by those who have the temerity to have complex and often expensive needs. Additionally, private care organisations see this as a boom time and a profitable business opportunity, but there, for me anyway, is the problem. Care should not be provided by “for profit” businesses, it shouldn’t be determined by profit-margins and ‘costs per unit’, to do so results in some inevitable consequences.

Firstly, especially in recession and deficit affected times such as now, to continue to make a profit will mean having to cut costs; by having fewer properly trained professionals, lower staff – client ratios, reducing the quality of people’s lives etc. Secondly, private firms will fail, their businesses will lose money, they’ll decide to cut and run. Consequently, people will lose their homes and however good or not that home might seem to you or me, it would have been their home and once it’s gone that’s another part of life lost, with no control or choice for them. Lastly, the solution to rising costs is to dispense with quality and ideology; ditch the smaller, homely environments and go back to the larger institutional services, the old bins are not that far away, and inevitably, they’re cheaper.

The fact is, and it is a fact, not merely my opinion, that people with disabilities have a right to a good and valued life, with their needs, however expensive, met. They’re not a burden on the state, they’re not the ones who have created either this recession or the nation’s debt, yet somehow they’re the ones deemed appropriate to pay for it. There’s much talk about returning to morality and values; what greater morality can there be than ensuring those most vulnerable are supported and protected? What greater measure of a society’s civility and success?

So how to do so? Simple, Mr or Mrs taxpayer. Services for people with disabilities come back to the NHS and Social Services, not commissioned and provided by someone else, but directly funded, with none of the supposed efficiency and cost-effectiveness of tendering processes and competition; just needed and budgeted for.
When MPs called for services to be guaranteed, the answer was simple, you remove the business ideology and return to the state providing for those in need. Charities, while usually far more moral and ethical, aren’t immune from problems; if the public don’t give how will they fund their services? Remove the doubt and market forces, make it an expected responsibility of both Government and the nation, and make services for people with disabilities a right for them and their families.

In closing, this quote from Paul Burstow, Care Services Minister:
” We are engaged with the company, the landlords and the lenders and are monitoring the situation very closely …… It is for Southern Cross, its landlords and those with an interest in the business to put in place a plan that stabilises the business and ensures operational continuity of the care homes ….. This is a commercial sector problem and we look to the commercial sector to solve it. All the business interests involved fully understand their responsibilities.”
It’s not, Mr Burstow, a commercial sector problem, it’s a public one. The care of vulnerable citizens is the responsibility of us all and should be provided for by the state, they are not a burden, they are us; just with less control and autonomy. Consequently, it is surely right and proper that the quality of their lives should not be left in the hands of companies, landlords and lenders.

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