Failures to care for vulnerable people: what lessons to draw?

The practices exposed by Panorama last week at Castlebeck’s Winterbourne View care home were profoundly shocking. The case continues to develop – several further arrests were made this week. Ghandi said that “a nation’s greatness is measured by how it treats its weakest members”. What we witnessed at that particular care home suggests our claims to greatness are debateable. And, of course, rumbling in the background we also have the Southern Cross debacle. There are grave concerns over the future of the country’s biggest private provider of care homes for older people. There appears to be a government guarantee on the table to see that residents are provided for, but no promise of a bail out.

Searching questions are quite rightly being asked. How can we have got into this situation? It is maybe rather late to be waking up to the issues here. Nonetheless, it is welcome that they are getting their moment in the spotlight. Let’s hope some positive changes result. But are the right lessons likely to be drawn from current troubles? Read more of this post

Cameron’s Big Society – 8/10 for effort; 3/10 for content

You have to admire David Cameron’s tenacity in the face of widespread indifference and incomprehension. On Monday he sought to relaunch his idea of the Big Society for the third time. The results of yesterday’s YouGov survey were then reported over at Liberal Conspiracy. This indicated that 62% of respondents felt they understood the Big Society “not very, or not at all, well”; a third said the Big Society sounded like a bad idea; 73% said they thought it wouldn’t actually work; and 59% thought it was “mostly hot air” rather than a “real vision”.

Reading Cameron’s speech (available here) suggests several things. Read more of this post

“Fit to work” ergo a scrounger

Quite a few media outlets (for example, here and here) are this morning reporting figures produced by the Department for Work and Pensions that show four out of ten applicants for Employment and Support Allowance failed to qualify for assistance and, hence, are ‘fit to work’. This is taken by Employment Minister Chris Grayling as further evidence of the need to reassess everyone on the old Incapacity Benefit because, by implication, there must be tens of thousands of people receiving IB when they shouldn’t be. They are, in fact, ‘fit to work’. Scroungers.

The BBC reports Mr Grayling as adding:

“We will, of course, carry on providing unconditional support to those who cannot work, but for those who can it’s right and proper that they start back on the road to employment.”

Read more of this post

Pressing on with NHS Reform – a less than rational process

The central question in the current debate over the Government’s NHS reforms is whether the “listening” exercise taking place during the recently discovered “natural pause” in the legislative process is genuine or symbolic. Concerns that the exercise is cosmetic will only be fuelled by an article in yesterday’s Guardian which cites a letter from David Nicholson, the Chief Executive of the NHS, who suggests that the implementation process should press ahead and that there is a need to “maintain momentum on the ground”.

The article includes a quote from Hamish Meldrum from the BMA who states that the BMA has:

… always maintained that changes in the NHS must not anticipate the legislative process and lead to irreversible decisions.

I’ve no idea whether the BMA have always maintained this position. But this quote highlights something very significant about the way policy is currently developing in this field. Read more of this post

Tricky business down the job centre

So it appears that the Department of Work and Pensions may not have been entirely correct. The Department initially denied that Jobcentre Plus employees were tricking vulnerable people in order to sanction them and stop their benefits, as reported in the Guardian last weekend. The Guardian yesterday continued the story with the news that:

The DWP has backtracked and released a statement confirming the practice had been going on in some offices due to a misunderstanding between the department and some jobcentre managers. It insisted this was no longer the case. Read more of this post

Private renting, quality concerns and spatial exclusion

To say that there appears to be inconsistency, incoherence or complacency at the centre of Government policy is not a particularly novel observation. Indeed, it doesn’t really narrow down what we’re talking about, given the generally rushed and badly thought through nature of current policy proposals in many fields. Nonetheless the point reasserted itself with the conjunction of two pieces in yesterday’s Observer (here and here).

A perennial problem in the private rented sector is relatively poor affordability coupled with relatively poor quality. Many private renters pay a lot for bad housing. It has been an active part of the housing policy discussions for the last 15 years at least. The Buy to Let boom of the 2000s made a difference to average quality, but not to affordability.

The fundamental issue is that landlords in Britain are unwilling or unable to provide consistently high quality accommodation for the level of rent that private tenants are willing to pay or, at the bottom of the market, able to pay. Read more of this post

The mundane malfunctioning of markets – a tale of life and death

We are currently awaiting the fourth visit from a well-known high street electrical retailer to fit a new hob in our kitchen. The first two visits led to a new hob being fitted, only to discover that the new one was faulty. The third visit occurred on the wrong day. No one was at home. When my partner phoned to point this out the company had no record of the booking. They couldn’t revisit on the date we’d agreed (today) because there were now no available spaces. So they are coming next week. Fourth time lucky?

Clearly this is not the end of the world. Rather more salad is being eaten than is normal for this time of year. And there is more oven-based cooking than typically happens. But it isn’t a disaster.

This is the mundane reality of markets. They don’t always work very well. And sometimes the consequences can be considerably more significant. Read more of this post

The ethics of the case for public sector reform

[Originally posted on Liberal Democrat Voice, 24/02/11]

David Cameron’s article on public service reform in the Telegraph was the opening shot in what could be a significant battle both within the Coalition and across the House. The case presented raises at least three important ethical issues.

First, the way in which evidence is being used to justify these proposals is deeply suspect. Mr Cameron states that publicly providing bureaucratic and target-driven services might be worth supporting if they delivered quality services: “but the evidence shows otherwise. Whether it’s cancer survival rate, school results or crime, for too long we’ve been slipping against comparable countries“. These are very partial readings of the data. These claims in relation to both health and education have already been challenged and debunked a number of times over recent weeks. Yet they continue to be advanced as a justification for change. Read more of this post

Welfare reform in the dark

Today saw the introduction of the Welfare Reform bill to the House of Commons. Initial Impact Assessments were also published. This piece of legislation has been trailed for many months, but it will nonetheless take quite a while to fathom the detail of what is being proposed across the wide range of areas it touches on. And it will take just as long to explore how it interacts with policy developments in other areas. Much of the early buzz about the Bill was the news that the Government had dropped the proposal to cut Housing Benefit for those receiving JSA for more than 12 months. This is clearly an unusual outbreak of good sense. Many are claiming it as a victory for the Lib Dems, and Nick Clegg in particular. Later in the day we were being reminded not to get carried away with this change – important though it is – because the Bill continues to embody a range of contentious proposals for seismic change to welfare provision (see here at Left Foot Forward, for example).

As those who have read previous posts will know, I am very keen on summing the parts and trying to understand the big picture (see, for example, Piecing together the housing policy jigsaw). It is something that many government are not good at. This government seems particularly poor at it. But in an era of rapid and radical change it is all the more important. Read more of this post

Bluster and belief: Blue-tinged policy in health and housing

Today brought us two contrasting news stories which give further insight into the approach to policy making under the Coalition government. Today’s Guardian contains an interesting piece by Ben Goldacre on the reform of the NHS (available here), while the BBC have been carrying an item – triggered by a statement from the CIEH – about the problem of poor standards in the private rented sector in England, where it is estimated that 1 million properties are dangerous to live in.

What is interesting about these two policy areas is the way in which “evidence” features in the policy process and what leverage it has over the direction of policy. The contrast is sharp. Read more of this post

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