British care home scandal deepens

By Mark Blackwood and Ajanta Silva
7 June 2014

In 2011, the BBC TV programme Panorama revealed systematic abuse and neglect of severely disabled residents at the Winterbourne View care home in southwest England. Government ministers promised to “review” the situation facing thousands of people in such “assessment and treatment units” by June 1, 2014.

Three years later the scandal continues.

In a letter to the Daily Telegraph on May 30, the families of those abused in Winterbourne View said, “Today we have seen the appalling failure of the Government, the NHS [National Health Service] and Local Authorities to meet their own deadline for moving people with a learning disability out of places like Winterbourne View.

“This breaks a promise made to the families of people who have faced abuse and everyone who watched Panorama and demanded change. But most of all, it is a betrayal of our loved ones who remain in these units, at risk of abuse and neglect, isolated and away from their families.”

Latest figures show that only 1 in 10 residents in supposedly short-term units such as Winterbourne View have been rehoused and 1 in 6 have been there for more than five years. The remainder are “frequently overmedicated, restrained and are at significant risk of abuse” or sent to units long distances away from their relatives.

Richmond Bush, who was a patient at Winterbourne View, is now cared for in a hospital near Basingstoke, 90 miles from his family in Bristol, whist the parents of 13-year-old severely autistic Josh Wills described how his health declined after he was sent to a unit in Birmingham, 260 miles from their home in Cornwall.

In the letter, the Winterbourne families say, “The time for talking and excuses is over. The Prime Minister must take personal responsibility and address this failure of national government, local government and the NHS.”

Care Minister Norman Lamb declared the situation “utterly intolerable,” and attempted to shift the blame onto the NHS. However, it is the Conservative/Liberal Democrat government that has caused the crisis by slashing NHS funding and restructuring the organisation in preparation for further privatisation. Government cuts to local council budgets have also put the future of what remains of their care homes in jeopardy.

Winterbourne View was a 26-bed hospital, and it charged the NHS a weekly fee of £3,500 for each of its 26 patients. At its height the hospital had an annual turnover of £3.7 million.

In the aftermath of the Panorama programme, six low-paid and inadequately trained staff members were jailed and a further five given suspended prison sentences. None of Winterbourne View’s executives were ever questioned, let alone charged or jailed, despite the condemnation directed at its owners, Castlebeck Ltd, by Judge Neil Ford, who stated, “It is common ground in this case that the hospital was run with a view to profit and with a scandalous lack of regard to the interests of its residents and staff.

“A culture of ill-treatment developed and as is often the case, cruelty bred cruelty. This culture corrupted and debased, to varying degrees, these defendants, all of whom are of previous good character,” Ford added.

The fact that nothing was done about running hospitals “with a view to profit” and that Castlebeck’s owners got off scot-free meant another Winterbourne View scandal was bound to follow.

In April, Panorama aired another programme—this time about The Old Deanery and Oban House, two privately-run residential care homes in the south of England—which echoed the horrifying images of its 2011 investigation.

In both places, residents’ appeals for help are ignored. In some instances they are left to sit or lie in their own excrement or urine for hours on end. Disturbing images of mocking, taunting and physical abuse by staff are shown. Particularly harrowing are the experiences of a bedridden 98-year-old female patient during her final days of life in Oban House.

Just like the previous incidents, no company owners, chief executives or directors of the two care homes have been questioned by police, let alone charged with the crimes of its employment culture. Seven low-waged care assistants have since been suspended.

Figures published by the Care Quality Commission (CQC) have shown that over a third of private homes that received warning notices in 2011 following the Winterbourne View scandal still do not meet basic standards of care but continue to operate.

The response of the care home industry to the latest Panorama revelations is to call for more regulations, harsher measures against staff charged with abuse and greater use of CCTV cameras in care homes regardless of the impact on patients’ dignity and privacy.

Chai Patel, chairman of HC-One that owns Oban House, is in the forefront in calling for CCTV cameras, declaring, “As soon as we became aware of the situation we took immediate action. Over the last two years we have had conversations with our stakeholders and our regulator about the potential use of cameras in homes to protect the health and wellbeing of our residents. This is, and always will be, our number one priority.” Care Minister Norman Lamb told BBC Radio 5 Live that “the permanent use of such cameras was among ‘weapons the CQC should consider’.”

The current situation in care homes is a product of wholesale privatisation of the care home industry, which today is worth £4 billion a year. Nearly three-quarters of care homes are now run by private providers. Privatisation began in 1979 following the election of the Thatcher government and was wholeheartedly endorsed by the Blair/Brown Labour governments from their election in 1997.

In fact, Patel was one of those individuals close to New Labour who personally profited from this process. He was involved in the development of the Labour government’s massive extension of the Conservatives’ Private Finance Initiative, which handed over chunks of the public sector to private capital and was awarded a CBE for “services to the development of social care policies” in 1999. He remains secretary to the pro-Labour Party think tank, the Institute for Public Policy.

In 2011, Patel was able to form HC-One out of the bankruptcy that year of Southern Cross Healthcare (SCH), the largest care home company in the UK, with 750 homes housing 31,000 people. SCH’s CEOs and shareholders had made themselves millions using a “sale and lease-back” asset-stripping operation whereby the company’s properties were sold off and then leased back. Patel took over 249 of SCH’s former homes to make HC-One the third-largest care home provider in Britain.

The ill treatment of vulnerable and elderly patients is a social crime. However, one cannot ignore the objective conditions driving such abuse. Care home workers and the domiciliary care workers (who visit patients in their own homes) are among the most oppressed and exploited sections of the working class. Up to 200,000 domiciliary care workers receive less than the minimum wage. Many are on zero-hour contracts and do not get paid for travelling time or expenses. Despite CQC directives, care homes operate without employing enough staff to look after patients properly. Lack of training, supervision and learning opportunities are a well-known fact.

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