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Human Rights in Social Care

Human Rights in social care - EHRC review and consultation

 

There has been a systemic failure to use Human Rights as a method of driving up standards

- a NW regional voluntary sector manager

As one of their jobs, the EHRC (Equality and Human Rights Commission) is responsible for the UK’s obligations under the European Human Rights agenda. They are producing a report to Parliament on the country’s current record on Human Rights.

Peter Bates attended one of their Round Table discussions (in Manchester)  which looked at the issue of Human Rights and the dignity of older and disabled people in health and social care settings. A dozen people from voluntary groups and statutory and academic organisations had a lively discussion.

The general agreement was that there were encouraging initiatives in the region, but there was still a very long way to go. The present funding challenges are contributing to slow progress, but most of the basic issues (such as changing attitudes through training and information) were there before the banking and finance crisis started to affect public and private budgets.

What people said

A summary of this Round Table will form part of the input into the EHCR's review, which should appear in December of this year. This is a personal choice of some of the points made in the discussion:

  • The term "Human Rights" has had a bad press because of associations with controversial rights for convicted criminals or for radical activists. To advocate for “human rights” (compared to talking about "human dignity" or "patient choice") was - in some places – almost guaranteed to reduce decision-makers' interest in the issue.
  • A Human Rights approach could be the way to do things better in the long run, for example involving service users in decisions and choices could make them more efficient. And "volunteers leave if you don't treat them properly". But this Business Case has either not been made (because the benefits are long-term, or the benefits turn up in someone else's budget) or has not been widely publicised.
  • Feedback on human rights violations in social care through complaints was hindered. People did not readily use the formal complaints processes. If they complain many see themselves as being a selfish nuisance rather than as a whistle-blower on behalf of the community. There is often no easy way to make a constructive, non-confrontational, complaint. The various complaints systems themselves were quite opaque. The Care Quality Commission (CQC) note complaints made to them by individuals, but do not undertake use these complaints as a spur to any particular action on their part.
  • Safeguarding arrangements should start from the assumption that a disabled person is competent - changes should be made only when that is found to be not the case: "I resent being classed as a 'vulnerable person' just because I'm in a wheelchair". There may be cases where playing safe and "avoiding risk" may really just be a question of "avoiding scandal" to the carers in the short-term, while leading to more health risk in the long term.
  • Local authorities can legitimately deflect complaints under Human Rights if what they're doing is a "proportionate response" to certain social needs. For example, locking someone up is allowed (even though that is against their rights) if that person has committed crimes. But Local Authorities have successfully argued that their budget cuts are also a "proportionate response" to national policies. They have said that making reductions in care levels is thus not something that can be objected to by using Human Rights arguments.
  • Human Rights laws only cover actions done by the public authorities - as more services to vulnerable people are delivered by private organisations or under Personal Budgets such protection will be less available – care failure would need to be addressed under consumer legislation, or contract law.