Mary Dejevsky: A system that leaves care to the lowest paid is itself sick

The bullying was off the map of what is permissible in a civilised country. But Winterbourne View cannot be reduced to an argument about public versus private

Share
Related Topics

Every now and again a television programme unleashes such public outrage that it becomes easier for the powers-that-be to do something than to do nothing. One of the first, if not the first, was Ken Loach's 1966 drama, Cathy Come Home, about homelessness. The result, beyond the outpouring of indignation, was a change in housing policy and benefits provision that remains in place, more or less, almost half a century later.

The BBC Panorama exposé of what passed for "caring" at Winterbourne View on the edge of Bristol could be on the way to exerting a similar effect. Residents, all adults with varying degrees of vulnerability, were shown being – as the commentary laconically put it – "slapped, taunted, pushed and teased". Sequences that followed made that catalogue seem a delicate understatement. Undercover film showed "care" assistants applying techniques not a million miles from what went on at Abu Ghraib. A former care manager even used the word "torture".

Even granting that some individuals, including those of sound mind and body, can be "difficult" (read nigh impossible) when they sense their powerlessness; granting, too, that even the most devoted carers can occasionally reach breaking point, the treatment meted out at Winterbourne View was off the map of what should be permissible in a civilised country. Worst of all, some of the most heinous excesses – the young man who was bludgeoned and the young woman who was dared to throw herself out of the window – were carried out with what seemed almost relish. Licensed bullying, no less.

Of course, once the programme had been aired, official responses positively rained down. The Government minister concerned, Paul Burstow, expressed shock and a determination to act. The chairman of the regulatory body, the Care Quality Commission, offered an apology, as did the health authority concerned and the private company, Castlebeck, that runs the home. Relatives expressed fears about what happens at care homes everywhere, once the visitors leave. The police made arrests. And campaign groups had a field day: had Panorama not borne out what they had been saying for a long time?

Well yes, and no. There are many aspects to the scandal of Winterbourne View – how often do such bucolic names deceive? – and some are more pertinent than others. One argument, to which this home categorically gives the lie, is that poor care mostly reflects poor and outdated facilities.

In material terms, this was a near-ideal home. It was only three years old. It was small – only 24 places – all the rooms were en suite; it was properly "accessible" for those with severe disabilities. The problem, as the undercover reporter, Joe Casey, made clear, was the "culture" that made possible and then turned a blind eye to ill-treatment. It was let down by the human factor.

A second argument, one being made vociferously, is that here we have an instructive microcosm of what happens when private business is allowed anywhere near the caring sector. The political motivation for this objection is clear: if it holds, then any whiff of extending the role of the private sector into the NHS will be doomed even more than it already is.

But Winterbourne View cannot be reduced to an argument about public versus private. And shortcomings in the "human factor" are not unique to the private caring sector. There are poor to disgraceful homes in the public sector, too. The idea that there are legions of Florence Nightingales ministering humanely to the sick and vulnerable, while struggling with the limitations of outdated Victorian accommodation, is wrong twice over.

It is wrong because the public-private partnerships encouraged by the last government produced a wave of new NHS hospitals and homes. Some of these are ostentatious monstrosities that will be liabilities for years, with vast mortgages still to be paid, enormous heating bills for unnecessarily vast spaces, and accommodation that still manages to leave patients in mixed wards with nothing like sufficient showers and toilets. These are scandals of funding, design and plain ignorance. Neither public, nor private, nor a combination is going to do the job without competent specialists and managers.

But it is also wrong because, as successive exposés in both public and private sectors have shown, the days of Florence Nightingales are long past, if they ever really existed. It cannot be assumed that staff employed to "care" are up to the job, and this is true everywhere in the system. With Winterbourne View, we have a new group of people to capture the headlines – vulnerable young adults with autism, learning difficulties or mental health problems – for whom "care" became almost the opposite.

The temptation will be to "ring-fence" this group and demand better treatment, more regulation, and more inspections for these particular homes. Spot checks, rather than the formulaic box ticking that mostly constituted the inspection regime until now, are to be introduced. Yet one glance at Winterbourne View's last inspection, in December 2009, clearly showed the place was not up to scratch. Barely one category in 10 was inspected, and one of the few found to be acceptable was "health and safety". It is hard not to suppress a cynical laugh.

The time is past for singling out one particular group of vulnerable people, and one particular type of establishment, as uniquely in need of new safeguards and inspection regimes. What began with revelations about elderly patients drinking flower water at Stafford Hospital has progressively turned up negligent and callous care of almost all vulnerable groups.

There is a sickness in the system itself that has reduced caring to a low-status, low-skilled and – above all, low-paid – occupation that "anyone" can do. Including, as at Winterbourne View, the kitchen porter. This is one misconception that must be addressed, with a complete overhaul of recruitment, training and management. Most of all, however, what is needed is a review of the whole economic structure of the "caring" sector, where everything has a price and a value – except the comfort and dignity of those who are the very reason it exists.

m.dejevsky@independent.co.uk

React Now

  • Get to the point
Latest stories from i100
Have you tried new the Independent Digital Edition apps?
iJobs Job Widget
iJobs General

Recruitment Genius: Photographer / Floorplanner / Domestic Energy Assessor

£16000 - £25000 per annum: Recruitment Genius: A Photographer/ Floor planner /...

Ashdown Group: Front-End Developer - Surrey - £40,000

£30000 - £40000 per annum: Ashdown Group: Front-End Developer - Guildford/Craw...

Recruitment Genius: Customer Service Assistant

£13500 - £15000 per annum: Recruitment Genius: A Customer Service Assistant is...

Recruitment Genius: Sales Executive - OTE £35,000

£16000 - £35000 per annum: Recruitment Genius: An ambitious and motivated Sale...

Day In a Page

Read Next
 

Letter from the Whitehall Editor: The spurious Tory endorsement that misfired

Oliver Wright
 

General Election 2015: Ed Miliband hasn’t ‘suddenly’ become a robust leader. He always was

Steve Richards
Not even the 'putrid throat' could stop the Ross Poldark swoon-fest'

Not even the 'putrid throat' could stop the Ross Poldark swoon-fest'

How a costume drama became a Sunday night staple
Miliband promises no stamp duty for first-time buyers as he pushes Tories on housing

Miliband promises no stamp duty for first-time buyers

Labour leader pushes Tories on housing
Aviation history is littered with grand failures - from the the Bristol Brabazon to Concorde - but what went wrong with the SuperJumbo?

Aviation history is littered with grand failures

But what went wrong with the SuperJumbo?
Fear of Putin, Islamists and immigration is giving rise to a new generation of Soviet-style 'iron curtains' right across Europe

Fortress Europe?

Fear of Putin, Islamists and immigration is giving rise to a new generation of 'iron curtains'
Never mind what you're wearing, it's what you're reclining on

Never mind what you're wearing

It's what you're reclining on that matters
General Election 2015: Chuka Umunna on the benefits of immigration, humility – and his leader Ed Miliband

Chuka Umunna: A virus of racism runs through Ukip

The shadow business secretary on the benefits of immigration, humility – and his leader Ed Miliband
Yemen crisis: This exotic war will soon become Europe's problem

Yemen's exotic war will soon affect Europe

Terrorism and boatloads of desperate migrants will be the outcome of the Saudi air campaign, says Patrick Cockburn
Marginal Streets project aims to document voters in the run-up to the General Election

Marginal Streets project documents voters

Independent photographers Joseph Fox and Orlando Gili are uploading two portraits of constituents to their website for each day of the campaign
Game of Thrones: Visit the real-life kingdom of Westeros to see where violent history ends and telly tourism begins

The real-life kingdom of Westeros

Is there something a little uncomfortable about Game of Thrones shooting in Northern Ireland?
How to survive a social-media mauling, by the tough women of Twitter

How to survive a Twitter mauling

Mary Beard, Caroline Criado-Perez, Louise Mensch, Bunny La Roche and Courtney Barrasford reveal how to trounce the trolls
Gallipoli centenary: At dawn, the young remember the young who perished in one of the First World War's bloodiest battles

At dawn, the young remember the young

A century ago, soldiers of the Empire – many no more than boys – spilt on to Gallipoli’s beaches. On this 100th Anzac Day, there are personal, poetic tributes to their sacrifice
Dissent is slowly building against the billions spent on presidential campaigns – even among politicians themselves

Follow the money as never before

Dissent is slowly building against the billions spent on presidential campaigns – even among politicians themselves, reports Rupert Cornwell
Samuel West interview: The actor and director on austerity, unionisation, and not mentioning his famous parents

Samuel West interview

The actor and director on austerity, unionisation, and not mentioning his famous parents
General Election 2015: Imagine if the leading political parties were fashion labels

Imagine if the leading political parties were fashion labels

Fashion editor, Alexander Fury, on what the leaders' appearances tell us about them
Phumzile Mlambo-Ngcuka: Home can be the unsafest place for women

Phumzile Mlambo-Ngcuka: Home can be the unsafest place for women

The architect of the HeForShe movement and head of UN Women on the world's failure to combat domestic violence