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Exploiting the Elderly - A brief account of neglect and
death in the UK Health Services By Patrick Cooper-Duffy
This
is a brief account of neglect and death in the UK Health Services of
the Elderly. I deal with a recent case - that of Violet Townsend - and
with some of the financial and political implications. I show some of
the historical legacy and the difficulties faced by reforming nurses
e.g. Charge Nurse Graham Pink and medics e.g. Dr Rita Pal. For a good
overview of some of the issues I recommend reading Professor Mike
Brogden's 'Geronticide - Killing of the Elderly'.
Violet
Townsend was moved from the home where she had lived for eight years
when it raised its fees to £463 a week. Gloucestershire Social
Services moved a woman of 88 from her Nursing Home to save the Council
£12 a day. Her doctor warned the Council that her life expectancy
would be "considerably reduced" if she was moved. He was
ignored. She died five days after leaving her old Home.
1
The
BBC carried this information in much greater depth. There had been
widespread opposition by her family and indeed the Care Home. The
decision was taken by the Department of Social Services against
medical advice. One of her relatives said: "Her doctor said
she should not be moved on account of her health but the DHSS
thought differently and she had to go."
2
The
circumstances, the names, the actors change, but a common story is
a picture of routine neglect and ill treatment.
3
History
A brief historical overview of the services in the UK might be
at the end of the Second World War. An amalgamation of the
municipal, voluntary and private hospitals took place to form the
NHS. A variety of treatments remain available by state charitable
and private means. A review of those services took place recently
under the Royal Commission into Elderly Care. Basically, the
recommendation was that those services would be free. These are
now free in Scotland and Wales, but not in England.
A four-tier system of care:
Community
Care Home
Nursing Home
Hospital Care
The provision for services is paid for via National Insurance
contributions and taxation. The services of nursing are in theory
to be provided free, but the system is complex. Hospital based
services are deemed to be free and some community services may be.
But, in principle, those services of community, care and nursing
are provided by a mixture of Local Government and private
companies. Local Government receiving a grant from Central
Government, but also with the power to raise local taxes or
community charge.
This well publicised death of Violet Townsend comes at a time
when a Health Ombudsman recently found that elderly people have
been incorrectly charged for treatment that they were entitled to
for free. They are, in effect, owed money by the State.
4
Modern Workhouses
From history, we know that the workhouse was an administrative
means of killing off the poor and elderly. Are we any better with
the warehousing of the elderly through the Residential and Nursing
Home Care Services?
This is an area that is little discussed, and the
marginalisation of ethnic minorities is ignored. One of the issues
that were covered up was the 30,000 people sent to Nursing Homes,
even though they warranted free health care under the National
Health Service. This is both unfair and unlawful.
Add to this injustice the removal of psychiatric, social and
rehabilitative services. Then, they merely provide warehousing
spaces for the young who have become physically disabled by car
and work accidents. The same is true for head injury victims,
stroke victims, the learning disabled, and among the fragile or
demented elderly. What is going to happen?
5
This institutional or systematic abuse of the elderly is not
new. Some of which is documented from 1967.
6
There has been a disturbing indictment of seven hospitals by
doctors, nurses and patients, revealing conditions of neglect and
incidents of ill treatment and brutality. There were Parliamentary
debates, which eventually lead to the appointment of seven
'Independent Committees of Enquiry' to look into the allegations
concerning the seven hospitals. Ombudsmen were finally set up by
the National Health Service Reorganisation Act 1973.
7
Even where nurses and medical staff blow the whistle the abuses
continue almost unabated, not only in the NHS but also through the
private care home industry.
8
In fact the death of a Lord in a private health institution
prompted legislation to better regulate the private health care
industry, by his wife, who happened to sit in the House of Lords.
9
It could be argued that ill
treatment and neglect remain unchanged this was the treatment of
charge nurse G Pink and indeed extended to the ill treatment and
abuse of Dr Rita Pal.
10
It is my contention that many misconceptions exist concerning
the care of the elderly in the UK and, in turn, the manipulation
of public opinion. For example, a misconception is that much of
the care is private. However, 80 % of the patients or residents
are funded from taxation.
Yet, when many of the beds were cut, the greatest number came
from the Local Authority Services. This created an opportunity for
the private sector to profit from the bed losses. Some of the
homeowners may even move the use of their property from bed and
breakfast to elderly care, depending on profit. When some
additional money (£45 million) became available, for the most
part it was diverted into the pockets of the homeowners.
Much has been made of bed blocking. A figure is given of 4000 by
elderly residents; however, little is done of the 40,000 that are
forced into elderly care homes each year incorrectly. Nor, indeed,
is there much comment or action of the 100,000 stroke patients
each year. In spite of a Royal Commission on Elderly Care, little
has been done.
11
11 Exploitation of the Elderly
The care in the Community Improvement Programme has been
ditched. To add insult to injury it has been recently found that
many elderly people have been charged incorrectly. After much hot
air in the 1970s it could be argued that Elderly Care has not
moved much further. Is the truth that no body cares very much? The
role of labour is little considered - the ill health and the
stress of working these services against a background of routine
bullying, threats, silencing and intimidation. There needs to be
better information and strategies. Some of this is now provided at
'Bully on Line'.
I do not see how Care for the Elderly can be improved without
better attention to the needs of the human beings providing that
care. A strong denial mechanism is at work and Tim Fields (Bully
in Sight) is to be thanked along with others for bringing this
into public discussion.
12
I would suggest that the Whistle blowing legislation has not
improved the situation. Indeed, the whistleblowers are as ill
treated and isolated as ever. This is a worldwide problem and
those seeking change need to know what they are up against, and
indeed survive.
13
New thinking and new organisations are needed. Part of the
solution may be new trade union bodies, coupled with social
justice movements. There needs to be a move for Democracy in
Health Care, coupled with a free flow of information and an Open
Press. Reformers may have to give up their belief in the justice
in the system and find new ways about bringing social change.
References
Socialist Worker - Friday, 1st 2003
Wednesday, 12 February 2003, 21:12 GMT BBC News On Line
Questions of Care - a review of Mrs Usable Louis (Kit) Keen
written by her son Peter Keen - December 1995
Liz Dolman - ' Sunday Telegraph' - 'The Ombudsman Report is just
what the Dr Ordered' - 23 February 2003.
News & letters, March 2002
'Sans everything, Sans Everything' - a collection of essays and
articles published In 1967
Westminster Health Care (Health Chief backs 'Sunday Express'
probe into misery At Nursing Home) - 14th April 2002
Cary L Cooper and Naomi Swanson, Workplace violence in the health
sector State of the Art, ILO, WHO, ICN and PSI 2002. ISBN
92-2-113237-4; Vittorio di Martino, Workplace violence in the health
sector - Country case studies (Brazil, Bulgaria, Lebanon, Portugal,
South Africa, Thailand, and an additional Australian study),
Synthesis report, ILO, WHO, ICN and PSI 2002. ISBN 92-2-113441-5.
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This
is a brief account of neglect and death in the UK Health Services of
the Elderly. I deal with a recent case - that of Violet Townsend - and
with some of the financial and political implications. I show some of
the historical legacy and the difficulties faced by reforming nurses
e.g. Charge Nurse Graham Pink and medics e.g. Dr Rita Pal. For a good
overview of some of the issues I recommend reading Professor Mike
Brogden's 'Geronticide - Killing of the Elderly'. 
Violet
Townsend was moved from the home where she had lived for eight years
when it raised its fees to £463 a week. Gloucestershire Social
Services moved a woman of 88 from her Nursing Home to save the Council
£12 a day. Her doctor warned the Council that her life expectancy
would be "considerably reduced" if she was moved. He was
ignored. She died five days after leaving her old Home.
The
BBC carried this information in much greater depth. There had been
widespread opposition by her family and indeed the Care Home. The
decision was taken by the Department of Social Services against
medical advice. One of her relatives said: "Her doctor said
she should not be moved on account of her health but the DHSS
thought differently and she had to go."
The
circumstances, the names, the actors change, but a common story is
a picture of routine neglect and ill treatment.