Care of most vulnerable looks more like neglect


OPINION:Winterbourne View care home’s dire treatment proves we need to train staff in compassion, writes KATHRINE MURPHY

IF A society is truly judged by how its vulnerable members are treated, then ours is already in ruin. You will have read in horror of abuses at the Winterbourne View care home, most recently on page one of yesterday’s Irish Times.

That case is not isolated, but an eye-opening tip of a nastily endemic iceberg known simply as “care”.

This so-called care is given in people’s own homes, in hospitals or care home institutions often owned by profit-making organisations. Carers are minimum-wage slaves who can’t get any other jobs; or they are nurses, now armed with medical degrees that frequently don’t cover basic vocational caring.

Carers get a few hours training in how to carry out tasks, without moral or ethical parameters. You can’t imbue a sense of probity, decency or caring where there is an absence of innate morality.

For “care”, read “neglect” in so many cases. Just take your pick from recent headlines.

In Britain, a young man died in hospital from thirst. So desperate was he for water that he dialled 999. When the police arrived they were turned away. The medical staff had failed to monitor him properly.

Elsewhere, a young girl died and her parents on visiting found that rigor mortis had set in. No one had taken her blood pressure or checked on her during the night.

A simple blood test would have revealed that she had septicaemia but medics were too busy. Where did it all go wrong? How might we buck such a clearly and chillingly dangerous trend?

As with so many problems, it begins and ends with institutional failure, once efficient and effective systems swallowed up in the vacuum of management speak, with old-school action, dedicated vocations and craftsmanship destroyed in the wake.

Nursing used to be a caring vocation. Old-style matrons and sisters ran tight ships to ensure the best care for their patients without a consortium in sight.

It is hard to conceive of putting the genie back in the medicinal bottle.

As we live longer, families must inevitably assume greater responsibility for monitoring the care of their loved ones.

But it is not always easy and you can’t be on hand 24 hours a day. Good communication between those doing the caring and those who have responsibility for their loved one is vital. Time and reconnaissance are critical: we hear of patients left in their own excrement or left to starve.

Visiting a relative in hospital, I have seen meals left on trolleys at the end of a bed, out of reach of the patient, and removed later by someone who doesn’t speak enough English to ask whether the patient was hungry or not. Such things go unreported.

Accountability seems to be discharged by faceless people issuing statements of regret – “lessons will be learnt”.

But lessons are not learnt. Time and time again, we read about yet another abuse or failure.

It is this shoulder-shrugging absence of personal responsibility that allows an institutional lack of care to pervade.

Therefore, like those charged with abuse in Winterbourne View, individual nurses, medics and carers who fail in their duties should be brought to book and prosecuted.

Tempering this, one is hugely impressed by the diligence and dedication of most doctors, nurses and carers.

However, a root-and-branch reform of how carers are trained and employed is a matter of urgency. We can no longer tolerate the “hand-washing” abdication of responsibility that is becoming a defining feature of society.

Actions (and inaction) must have clear consequences, with greater incentives to do good work, balanced against punishments for those who would abuse a person dependent on their vigilant care.

As a start, how about a year long “on the job” training course for would-be carers? They would be taught how to treat patients with dignity. Some older people do not like to be addressed in an overfamiliar way by their first names.

Carers should also be tutored in how to clean and feed vulnerable patients and there should be continuous assessment in such training.

Training must instil a sense of self-worth and pride in a job well done: dignity is twofold.

Stiffer sentencing by the courts should reflect public intolerance of any abuse, thereby better protecting the most vulnerable.

Many of us are living longer lives. And so we have a common interest in living better ones too.

That starts with the standard of care we uphold for the sick, the elderly and the vulnerable.

Kathrine Murphy is a senior magistrate in the family courts in Birmingham

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