Tuesday 15 October 2013

Still Crazy After All These Years!

A few years ago, I had the pleasure of interviewing people who had worked at the North Wales Hospital in the '60s, '70s, '80s and '90s. As the principal psychiatric institution for the whole of North Wales, it was an impressive building and a major employer to the town of Denbigh in particular. The conclusions of the many interviews which I conducted are borne out in the news today. Given that the North Wales Hospital closed in 1995, that does not reflect well on anyone.

One of the interesting disclosures was the way in which government inspections were carried out. If the inspectors arrived unannounced, as they did from time to time, the man at the gatehouse quickly phoned through to the main hospital. That bought just enough time for the wards to make the necessary changes to satisfy the inspectors. That is chilling because I was also told about practices which went on there which you wouldn't even consider for a wild animal. Patients were physically chained up and regularly found themselves on the receiving end of physical methods which are unrelated to the concept of care. Those practices were put on hold while the inspectors were there though. The advent of anti-psychotic drugs such as Largactil was also handy because challenging patients could be quickly sedated in time for the inspectors.

Proposals to install CCTV cameras in to Care Homes are therefore not surprising. Its a pity that we have to consider such measures but it reminds us of the cruelty of our species. Whether or not we are talking about isolated cases is not really the issue here. What matters is that such practice goes on at all. Even a CCTV camera can be covered up though. The capacity of one man to inflict misery on his fellow man should never be underestimated and the world provides us with daily reminders in case we should need them.

Caring for challenging patients calls for incredible dedication and patience. At the core of such care should be the clear understanding that such patients have very complex needs. If we don't invest sufficiently on the back of that in terms of high quality training and education, we are doing these patients and their families a great disservice. Worse still, we have failed to move on from practices which ought to have consigned to history a long time ago.  The real issue here is to address just why the Caring Profession as a whole is so woefully undervalued by this and previous governments. The carers in our society whether paid or unpaid have always been at the back of the queue in the renumeration stakes. But neither is this argument solely about money. Indeed, I would argue that the best carers I have ever seen have been the friends, spouses, sons, daughters and parents who care for their own for no financial reward. That is where big brother might really be watching you! In some ways, this is the ideal because the motive to care is, in most cases, beyond question. Having said that, the country has a great many people dependent on care who don't have the luxury of that type of family support.

Perhaps we need to start to think about the concept of care at a much earlier stage. During my research, I found that the Care Profession and the people for whom it provides care are stigmatised by wider society. It's almost as if the NIMBY attitude is in full swing. The problem of course is that all of us will need some form of care at some stage in our lives so such denial is facile. By all means have CCTV cameras but it would be more productive to just engage with those people doing the caring. If there are strains and difficulties, it is surely better to be aware of them and act upon them before the strain becomes too great. All carers are human and all humans have a limit of emotional and physical endurance. That is an inescapable fact. We need to recognise this. I don't believe CCTV cameras are the answer any more than money is the answer.

When I spent three years caring a decade ago, what I really needed was to just have a break from time to time. A whole weekend would have been heaven. Yes, I was paid a pittance by the government but that is not my point. I was caring for someone I chose to care for so would have done so for nothing. What I would have really valued was some respite. From my experience, the day to day demands of caring are not great for a personal sense of well being. I can easily understand how some people would go on to develop mental health issues because the strain is immense. Either way, this is a problem which is only likely to get bigger as people continue to live longer thanks to the advances of medical science. What medical science doesn't always do though is to attach quality of life to those extra years. As such, the whole arena of care is now of paramount importance. To ignore that would be inhumane. To do something constructive about it would prove that we are capable of altruism even when we're short of cash. Governments always have demands made upon the monies available to them and I understand that. But faced with a choice between a fast train between London and Birmingham at a cost of at least £50 billion or getting to grips with the care sector, I know where my money would be. Care has languished for too long at the bottom of government priorities. Its time we grew up and started to act with real humanity. Bad practice will continue for as long as we allow care to sit on the sidelines.    

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