Jonathan Coe: How we can safeguard the care of our most vulnerable

This news is deeply shocking but not surprising. The fact that there were clearly many different instances and kinds of abuse across the care centres in Cornwall shows that the systems in place to safeguard the welfare of vulnerable people have clearly not yet worked. Of course, the vast majority of health and care workers do not abuse or exploit their clients.

Our helpline takes calls about physical, financial, sexual and emotional abuse. The fact that such terrible abuse can go on for so long within mainstream health services shows that there is still a long way to go before systems are effective in preventing abuse taking root. Time and again, inquiries have revealed the same systematic lack of respect for basic dignities alongside cultures which appear immune to monitoring.

What is needed? First of all education: making training in abuse prevention and detection mandatory for all working in health and care. Rather than seeing the reporting of concern as "whistle-blowing", not reporting should itself lead to disciplinary action. Professional codes and regulatory guidance should state explicitly what is and is not acceptable. There should be a right of access to independent advocacy which is independent of other service provision. These services must be given routine access to wards and care homes. Specialist support services for people disclosing abuse must be properly funded. Information about abuse should be given to clients, carers and the public.

It is positive that the General Social Care Council will be regulating a large tranche of social care staff. However, regulation is not a panacea. It provides better systems for complaint and accountability but it cannot of itself prevent abuse happening in the first place.

Abuse by trusted professionals causes serious and long-lasting harm. As well as the clear physical effects, it damages the fundamental trust that people rightly place in staff who are there to support, help and treat them. We work with people who have never recovered; who never received the support they originally sought and who struggle to gain the health and care support that they need. Unlike the US, the UK has no substantive tradition of academic inquiry, no properly funded aftercare services and no dedicated central funding. Perhaps policy makers need to look again at this area.

The writer is chief executive officer of Witness: Against abuse by health and care workers. Helpline: 0845 4500 300