Editorial
| Pages | 253-255 |
| DOI | https://doi.org/10.1108/JAP-08-2016-0019 |
| Date | 10 October 2016 |
| Published date | 10 October 2016 |
| Author | Margaret Flynn,Bridget Penhale |
| Subject Matter | Health & social care,Vulnerable groups,Adult protection,Safeguarding,Sociology,Sociology of the family,Abuse |
Margaret Flynn and Bridget Penhale
Well, July was a corker of a month for students of the forces which upend our fragile faith in
corporate governance. The former owner of the BHS retail chain has been criticised by two
select committees. Although Sir Philip Green was knighted for his business acumen, Frank Field,
the Chair of the Work and Pensions Committee asked, “What kind of man is it who can count his
fortune in billions but does not know what decent behaviour is?”We learned that he
“systematically extracted hundreds of millions of pounds from BHS, paying very little tax and
fantastically enriching himself and his family, leaving the company and the pension fund
weakened to the point of the inevitable collapse of both”. His self-serving ownership was
mirrored by his successor Dominic Chappell[1].
July was a grim month for adult social care as the annual survey of the Association of Directors
of Adult Social Services confirmed that service cuts will continue[2]. Crucially there is less
investment in preventive services which enable people to remain at home for longer. There is no
longer a dedicated social care function at the Department of Health but, as the Chief Executive of
NHS England has observed, because underfunding social care adversely impacts on health
care, social care requires investment.
Given the pressures in the NHS, it is unlikely that safeguarding is in the foreground of General
Practices. As David Pearson noted in the British Journal of General Practice (No. 66, 650, p. 471).
“How do we think it is acceptable in 2016, almost 70 years after the NHS was founded, to try to look
after lists still approaching 2000 patients when the complexity of medicine has changed beyond
recognition? Why do we attempt to offer a high quality comprehensive service,free at the point of
access, tothose numbers of patientsin a society dominatedby a consumerist and litigious culture,
and not expect to feel overwhelmed by the demands placed on us? And how do politicians think
that stoking patient expectations to promise a similar serviceacross 24 hours and 7 days, with no
more resource or staffing, will do anything other than drive future doctors from these shores?
As GPs we need a new contract with the public, with patients, with professional colleagues: a
contract recognising our unique and vital role as generalists”. In this edition, Jeremy Gibson and
colleaguesbravely consider the role of the GeneralPractice surgery in safeguarding adults and the
assurance which Derbyshire’s Clinical Commissioning Groups are seeking from GPs.
In total, 84 people were killed and over 200 wounded by a 19-tonne truck which accelerated
through crowds enjoying a Bastille Day festival in Nice during July. After Charlie Hebdo and the
Bataclan tragedies, France’s involvement in airstrikes plus its secular liberalism appear to be the
incentive.It is noteworthy that those involvedin such extreme violence sharesimilar profiles, that is,
they havea track record of petty crime, they areculturally isolated in impoverishedneighbourhoods
and typically haveinsecure and poorly paid jobs. Whether it is Shia crowdscelebrating the end of
Ramadan in Baghdador Christians celebrating Easterin Lahore, terrorism is a deadly provocation.
There is no shortage of stories about cruelties and the misuse of restraint. However, shocking
footage of the children and youths in detention at the Don Dale facility outside Darwin in the
Northern Territory in Australia has prompted a public inquiry. It showed young people hooded,
bound, stripped, gassed, verbally abused and tied in a restraint chair[3]. As Gillian Triggs, the
president of the Australian Human Rights Commission observed, “when you chip away at
the rule of law and basic rights, ultimately you falter profoundly […] with [the emergence of]
a culture that has allowed this to occur in the Northern Territory”[4].
In this edition, Jill Manthorpe and colleagues consider the impact of a Panorama TV broadcast,
“Behindclosed doors: Elderly Care Exposed”oncare staff. A troubling findingis that the care home
staff interviewed felt that they would be unable to remain in homes where they raised concerns.
Japan is still reeling from the killing of 19 people at a care home by a former employee.
Satoshi Uematsu was quoted as telling the police, “It is better that disabled people disappear”.
There was a warning sign: he was a drug user and he had written to a speaker of the lower house
DOI 10.1108/JAP-08-2016-0019 VOL. 18 NO. 5 2016, pp. 253-255, © Emerald Group Publishing Limited, ISSN 1466-8203
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Editorial
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