Make people accountable

DOCTOR Cyril Cohen, a much respected expert in care for the elderly, has called for “appropriate accountability” in the wake of reports of poor standards of care in hospitals and care homes, writes Janet Thomson.

Referring to the standard of long term care, Dr Cohen, an Hon. Fellow of Dundee University, retired consultant physician - geriatric medicine, a member of Age Concern Angus and former director of the Scottish Hospital Advisory Service, spoke of his sadness at, once again, hearing reports of poor standards of care for older people and those with learning disabilities.

He said: “Previously, these people were looked after in NHS long-stay hospital units, but following reports of poor standards of care, these units were closed and long-term care was provided in the private sector.

“The problem was transferred, not solved.”

He said that, following the recent reports, some staff have been arrested, some dismissed and others transferred elsewhere.

He continued: “The problem, again, has been transferred, not solved.

“The next step may well be to expand Care in the Community and look after as many of these people as possible in their own homes, and not rely on the NHS or private sector.

“But, it will be even more difficult for the Care Commission to assess standards of care - and we are told that the size of the workforce is diminishing and that there will not be enough professional carers to provide such a domiciliary service anyway.

“So, to use a diminishing number of caring staff economically, we may have to go back to long-stay hospital units and try again!”

Dr Cohen, OBE, FRCP Ed. and Glasgow, said that, whatever arrangements for care emerge, what is needed is appropriate selection of staff, training and re-training of personnel, not dismissal and transfer.

“They should be supported by clinical leadership at ward level, hospital level and Care Home level, with appropriate accountability.

“Management should provide the supporting role.

“The Care Commission should adopt a more active advisory role, assess the whole of the service on each visit, not just one or two themes, and encourage providers to improve.

“Geriatric medicine is almost 60 years old, caring for people with learning disabilities may be older, yet we still haven’t got it right!”