Recent reports that the family and friends test, often used in businesses to report faulty goods ( would I recommend my family and friends to buy this?) will work in the NHS is just another smokescreen for the real problems that the politicians do not want to address. Lack of appropriately qualified staff + increased demand = poor care outcomes ( is it really that simple even a nurse can work it out *~*)
I admit to checking reviews on the internet for most things I buy these days but I do not always listen to them especially if they do not meet my needs. The family and friends test will not be able to identify what my needs are by the way I would expect an expert to help me do that. Most people would agree that if you want a job doing well you would get the professionals in to do it so why are we not complaining more when the politicians think it is okay to allow the administration cowboys all over our NHS?
Of course the family and friends test will do nothing to sell the NHS only add to its demise. Family and friends will expect the best that they can possibly get regardless of what it costs, which is why they will always be biased (See the recent bad press for the Liverpool Care Pathway which is meant to inform a dignified death not hurry it up). Most professionals know when they are doing a bad job they do not need reminding of it every day. What they do need is support in making the job more effective, cutting down on the paperwork so they can spend more time with patients and spending that time in a caring role rather that a gatekeeper role, turning people away or turning their back on them is really the last thing they came into the profession to do.
Gus Vassell
January 5, 2013
I agree, lets generate another method of wrapping the job up in more checks and balances deflecting attention away from the core purpose of simply doing a role that cares!
politicalnurse
January 6, 2013
I agree Gus – it does appear to be lurching from the sublime to the ridiculous now
Bookworm
January 8, 2013
Is there anyone who the professionals on this site think has the right to comment upon their standard of work? The underlying idealogy of this site is that the politicians do not have a right to comment, because they cannot be trusted. their job is simply to sign off the cheques, and not ask questions about the size of the bill. The media, except for those groovy people in the Guardian and Independent can be discounted, after all what do they know? Oh and of course we must not listen to family and friends – they probably only want to polish off granny, and inherit the money. So who does this leave, ahhh, it leaves the professionals, we can trust them; except for a few deodgy ones who work in private practice, and in particular dodgy American private practice. Oh no we cannot trust them.
Let us look at the good old days when almost all children in care were in local authority children’s homes, and when almost all elderly people in care were looked after in local authority homes, (some of which housed 300 to 400 people), and huge long stay geriatric wards. My observation was that cruelty by the professionals towards children was commonplace, (in my local authority I would suggest that five or six out of a dozen or so children’s homes were physically abusive), and that cruelty was equally commonplace in homes for adults, (again i would suggest about six or seven homes out of 15). And the local hospital? It was commonplace for elderly people to go in with minor ailments and leave with major pressure sores and fractures. This was in the days when professional authority was rarely challenged, and there were no complaints proceedures, and local authorities and the NHS were both ruthless and effective at covering up. One of the little commented aspects of the cover up of widespread cruelty and abuse in the 1970′s and 1980′s is the role of union officials. Every residential abuser who got away with it, was protected by a NALGO representative, every act of physical ill-treatment in homes for the elderly was covered up by a NUPE representative (if committed by a member of manual staff) or NALGO, (if committed by a senior officer). In my area there are now some very senior Labour Party politicians who earned their spurs covering up physical and sexual abuse in the 1970′s and 1980′s. They also in my view should be waiting for a knock on the door, and the arrival of the forces of law.
Edna Fletcher
January 8, 2013
I could not agree more with you Bookworm. As a professional during the times you mention I unwittingly discovered in the course of my work matters hidden by professionals whom the public are expected to trust. Consent was not even considered for things you could not do today without it. The culture allowed all this.
Maybe the problem is today things appear on the surface to have changed with policies and procedures, which many professionals hide behind. Human beings have not changed their nature.
We now have the ‘dodgy’ ‘professionals’ or career ladder types covering their backs, some even to the point of doctoring records to avoid being discovered. Only a fool would whole heartedly trust any ‘professional’ these days. The complaints system too as the Health Service Ombudsman has noted does not well serve patients / families using the NHS.
So why not families and friends? They are not all abusers as some ‘professionals’ making a career in safeguarding ‘work’ would like to suggest. They are more likely to know that something is wrong and ask awkward questions, when the vulnerable / ill themselves are unable to do so. We need awkward types to ensure professional standards are what they should be.
Zarathustra
January 9, 2013
I can certainly assure you we do not have an “underlying ideology”. This site is simply a bunch of vaguely liked-minded individuals, who all of us speaking for our own viewpoints. The day we have a “party line” that has to be followed is the day I give up blogging and take up crochet.
As for the suggestion that politicians don’t have a right to comment on health and social care – of course they do. It’s just that in recent times a lot of them have been doing it very badly.
Edna Fletcher
January 9, 2013
When ‘professionals’ accuse carers / families of neglect abuse they should be listened.
When ‘professionals’ are found to be neglecting and abusing, politicians and the public should bow to their superiority not giving out what these very professionals give out in respect of others of whom they have mere suspicions- who have done nothing wrong in many cases?
Clearly a case of what’s good for the goose is not good for the gander. ‘Tis a pity fear of job loss or recrimination stops the so called ‘good’ ‘ professionals’ from being more outspoken- except for the rare ones who are often distanced by their colleagues, but not necessarily by their clients. If these were a more common species perhaps the public perceptions of social workers and nurses now being common would change- because the incompetent or harmful/ uncaring ones might not stay in their jobs.
Perhaps unlike doctors, the public do not see social work or nursing as essential to their well being or to society as a whole- but just having a specific role to fulfil which does not affect them much. If that role is done badly it is more noticed because of the MSM. Maybe doctors are more valued in general because they are so highly trained and knowledgeable and that most people depend on them and they are not so easy to produce in numbers.
Bookworm
January 9, 2013
Hi, nurses actually come out pretty well in the public estimation, well above doctors, and way above social workers. We belong to a small select group, alongside estate agents, used car salesmen right at the bottom of public esteem. The only moderately reassuring thing is that social workers always come above solicitors, a fact I often point out to the latter to wind them up. They of course have the solace of being paid £61 per hour, plus expences, and that is before the judge awards a certificate of special difficulty, in which case they simply print money.
My general point is that it is very easy if one is left leaning and working in the public sector to assume one is good.This may of course be the case, but it is not innevitably so. My point about the widespread abuse that took place in the 1970′s and 1980′s is that the many of the perpetrators were both left wing and of course public sector employees, and that the normal outcome at that time, (as in the various churches and other institutions) was that things were covered up, sometimes the perpetrator was moved elsewhere, usually with a good reference to continue their cruelties or lusts. Many left wing people were involved in this process, and they were all public sector employees.
There needs to be some acceptance of some obvious facts. I did not work in the public sector for forty years to be good or left wing. I worked for money, and given the balance of my abilities and my personality, ( I am risk averse so I was not likely to go for broke on the stock market) social work was a pretty good deal, with an ok pension at the end of it. The cost was putting up with increasing numbers of managers and other officers, each of whom, while no doubt being left wing and good, built up their personal empires and systems to hold me to account. The other cost was to see my personal moral principles breached, pretty often by good and left wing managers. Certainly the Director of Social Services involved would have seen himself in this way.
Yes you are right to point out that complaints proceedures and the multi-layers of monitoring and evaluation can be and are used in a coercive way. Any social worker knows they cannot dispute what a Reviewing Officer, (who is not their line manager) has to say, because that same reviewing officer will be investigating and more importantly ‘framing’ the next complaint against them. This is not however the fault of the public, whether children in care, their parents or families in the community – this is a professional at work. Critically however when the great child care scandals of the 1970′s and 1980′s are examined in detail, in particular the Frank Beck case in Leicestershire, and the Latham case in Staffordshire, the managment system identified those who complained as the problem. Many people who complainned in both local authorities were coerced and some dismissed and it would be wrong to suppose that those who suppressed the truth saw themselves as anything else than left-wing and good. In my view poluiticians are not particularly reliable, or the press, or indeed relatives and friends, but then again neither are the professionals – almost all human beings identify their own self interest as the public good, and this is as true of public sector employees as anyone else.
Bookworm
January 11, 2013
Edna, I have just noticed your reference to the relationship between social work and the family and carers of adults. I do not know how far adult social work has gone down the ‘protection’ route, because my adult work came to an end with the split between adult and children and families in the mid-nineteen-nineties. My understanding is that child care social work more or less ‘sleep-walked’ into the role of child protection. Before 1989 children came into care by many different routes, education proceedings, criminal proceedings, matrimonial proceedings, and of course at that time the NSPCC provided child protection teams, particularly in the county shires, (and interestingly many of their staff were not social work trained). It was the child care disasters, Tyra Henry, Kimberly Carlisle, Jasmine Beckford that planted the child protection ball firmly in the court of social workers, and I believe irretrievably changed the relationship between the family and social work. When i heard about the intention of setting up an adult equivalent I considered it likely to be disasterous for the relationship between the service users family and social work as an occupation; this being particularly sad as in the main the service user wants what adult services have to offer, and in my experience any disputes rose over the amount of help on offer. I certainly hope social work with adults avoids going down the same path. To take an extreme example you cannot in child care go into every house assuming the parent is like Fred and Rosemary West, the start off position has to be ‘these are reasonable people’, unless by their actions they prove themselves otherwise.
politicalnurse
January 11, 2013
Hey there was no intention to have a go at family and friends or professionals it was more about the non professional approach many people take to health and social care which lets the whole system down. Some of the professionals described here are by default – not being very professional. To me that means have good solid evidence for what you are doing every minute of every day. This means that we ( the professionals) are all responsible for developing our skills and knowledge. BUT when I am a member of a family or friend I want gold standard all of the time – don’t you? This would be totally unrealistic but I would need a very good/ knowledgeable professional to tell me that;-)
Now I am going back to my crochet – yes really;-)
Bookworm
January 11, 2013
In many ways I think things have improved in the last forty or so years, and some of the things which have resulted in improvement have been impossed upon professionals, kicking and screaming. Do I think that cruelty and abuse still occers in some children’s homes, yes I am sure it does; do I think cruelty is widespread, even normative, I do not think so, (and i am pretty cynical about these things). Do I think cruelty is normative in either private or public sector old people’s homes; I do not think so, though various exposees show beyond any reasonable doubt that it exists. There seems to be a combination of elements; the fact that many more people to do not respect authority, that people know their rights, at least in so far as they coincide with their own self interest; and the ease with which photographic and other evidence can be garnered by non-professional people makes a ‘culture’ of abuse more difficult to sustain. I currently do some part time care in a privately owned old people’s home. Is the care perfect, no it is not; is it abusive or neglectful, it is not that either. The state of health of the service users is very poor indeed, but they have no pressure sores, their body-weight is sustained; they have fewer falls than in the local authority run homes of the seventies and eighties. In part this is because of the seperation of responsibility – in the 1970′s the homes were for the most part run, and managed by the LA; if something went wrong there was no incentive to act, only an inncentive to cover up awkward facts.
I accept there are some unreasonable relatives, and as my job consisted in part in trying to change the child care practices of not particularly competant parents, and on occassion removing the children involved for their personal safety and well being, I accept not all carers are well intentioned. Even in these circumstances, which i would see as the extreme in professional-relative relationships, it was usually possible to come to a tolerable working relationship, (which I would describe as detente, that is agree to disagree over many things, while agreeing to work together over the few areas of agreement)