Showing posts with label public services. Show all posts
Showing posts with label public services. Show all posts

Monday, 9 July 2018

Reliant on Kindness? How Austerity is Undermining the Principle of the 2010 Equality Act



Reliance on kindness, in law and in public services, has no place in a liberal democracy based on equal citizenship - but it's the consequence of austerity.

We rent a flat and our son Tom, aged fourteen, uses a powered wheelchair.  As anyone will know who has tried to rent a wheelchair accessible property, they are few and far between.  Happily, we found a suitable flat, but the parking space is very tight indeed for a wheelchair accessible van.  In fact, when the other spaces are filled, it’s actually impossible for Tom to get into the van and to get the van in or out.

I contacted the management company to ask about possible solutions to the parking problem, and, unwisely, suggested a solution.  They replied that the proposed solution was impossible, that I was aware when I rented the flat of what the parking arrangements were, and that they were unable to assist me any further in this matter.

Like many carers and people living with disability, I was weary from fighting other more important battles. So I just shelved for the time being the relatively small parking problem.

Then a new management company took over.  Our first contact with them was when my son’s wheelchair accidently caused some damage to the wall in the lobby.  I phoned, expecting to have to pay for the damage.  The new company could not have been nicer.  No, the site manager said, it was accidental damage; we’ll make good the wall and put some kick plates on it to improve the lobby for wheelchair users.  I also mentioned the parking problem.  Within 48 hours two site managers came to visit and saw a solution.  They asked about my son; one of them said that her son has autism and she is passionate about the rights of people living with disabilities.  They asked whether the flat and access to it was suitable, and whether there was anything else they could do.

The second company’s very helpful attitude transformed my week. It was a breath of fresh air.  It was also, only what the law requires. The 2010 Equality Act would have given us protection from the attitude of the first company, had I followed it up.  That company were legally required to be more helpful; required specifically by Section 20 of the 2010 Equality Act. [CM1]  The Act applies to any person or organisation providing goods, facilities or services to the public.

The 2010 Equality Act is a game changer, in our experience:  a line in the sand, a statement that people living with disabilities and difference are equal citizens; and that reliance on arbitrary acts of helpfulness or unhelpfulness is unacceptable.

Shortly after the parking episode, Tom took part in a Duke of Edinburgh Award camping trip, run by his school.  The afternoon before the trip the local authority school minibus provider phoned the school to say that one of the minibuses that the school was planning to use was broken down and not available. 

The consequence of this would be that one of the students who uses a wheelchair would be denied the educational opportunity of going on the trip.  Inclusion is fundamental to the school and it was unthinkable that a student would be excluded.  The deputy head, who had a pile of reports to write that evening before accompanying the students on the overnight camping trip the next day, spent two hours phoning round to locate another minibus, which he eventually managed to do. 

Why was the minibus broken down and no replacement available?  Because underfunding means the education service is relying on minibuses which are old and unreliable.

A second example, this time from the NHS.  Tom is taking a pioneering new genetic drug, that’s normally delivered to our house.  A glitch when we moved house recently meant that he urgently needed a new prescription from his consultant.

Problem – we discovered that the consultant was on holiday and there was no cover for him. Oh, and his secretary was on long-term sick leave, and there was no cover for her. 

After several frantic phone calls to various hospital departments, a registrar helped us, over and above her workload.  She phoned us back at 7pm, after her shift, and met us the next day, in between her appointments. 

Tom’s basic medical need was met was through the goodwill of a public sector employee prepared to do (more) unpaid overtime.  And this is an example from genetic medicine:  how can the UK be a world leader in developing genetic medicines if the NHS is so underfunded that it relies on goodwill to deliver pioneering treatments to patients?

So-called ‘austerity’ – in other words, funding cuts – means public service users are reliant on kindness to access services to which they are entitled.

Cameron’s ‘Big Society’ idea of 2010, “to help people to come together in their neighbourhoods to do good things”, coincided with 25% cuts to public services.  The net political message was that “doing good things” could plaster over the cuts in public service funding.  After 2013 Cameron no longer mentioned the Big Society but the idea continues in zombie form. Reliance on kindness appears to be the government’s answer to the delivery of public services.

The examples given here are small, everyday incidents – but incidents like these are happening across public services every day and they impact in two ways.

On a human level, they are an abuse both of service users and of conscientious public service workers, who know that if they do not put in extra help to compensate for the lack of funding in public services, then the people who rely on those services will lose out.  The next time we saw Tom’s consultant, a highly skilled and experienced doctor, he told us that cuts to administrative support had made his job so unmanageable that he had decided to take early retirement.  The human cost becomes an economic cost as well.

On a political level, incidents like these, across public services and every day, are undermining the principle of equal citizenship in public life.  The principle of the 2010 Equality Act also underpins access to public services.  Service users are entitled to public services on the basis of being equal citizens.  Reliance on kindness, in law and in public services, has no place in a liberal democracy based on equal citizenship.  The funding of public services should reflect that.

Saturday, 17 June 2017

Paying for Budget Cuts and Outsourcing: Our Story of Special Needs Transport

This post was originally published at Open Democracy: https://www.opendemocracy.net/uk/katherine-wedell/it-s-vulnerable-who-pay-when-councils-outsource-personal-story-of-special-needs-

For several years, our son Tom travelled to and from his special needs school without incident in a minibus run by an outsourced company commissioned and paid by the County Council. One of the four students in the minibus had challenging behaviour, but he was young and still quite small, and the escort was able to manage his behaviour.

However, as this younger child grew bigger his challenging behaviour became more difficult to manage. Neither the driver nor the escort had any training at all in behaviour management. One driver had already quit the route because of this student’s behaviour.

One day in June, the student, let’s call him Barry, hit Tom in the stomach. Barry was not acting intentionally; his behaviour was related to his learning disability. It is likely that his challenging behaviour was exacerbated by going to school in a minibus – he should have had the calmness and predictability of lone transport. As Tom has Duchenne muscular dystrophy (DMD), the consequences of the assault could have been very serious, even fatal. We reported the incident to the local authority Special Educational Needs Officer and asked for the authority to provide lone transport for Tom, on the grounds of physical vulnerability caused by his DMD.

The local authority responded that the outsourced transport company had responsibility for safeguarding the students. We argued that the company had done everything within its power and that ultimately, the local authority, as a statutory public body which commissions and pays for school transport to special schools, had responsibility for safeguarding the students in the minibus.

The discussion with the local authority continued until the end of the school year. During this time, I was taking Tom to and from school myself. The local authority argued that they would consider lone transport for Tom only if there were no other alternatives. They changed the seating arrangements in the minibus, devised a different system for getting into and out of the bus, and decided that Barry should wear a Crelling harness, otherwise known as a ‘Houdini’ belt. They proposed that this arrangement should be tested for four weeks, starting in the Autumn term.

We, and Tom’s school, argued that the long-term use of a Houdini belt contravened accepted good practice in restraint and was inappropriate for a young person of the age that Barry now was. Also, given variations in the personnel staffing the bus, and their complete lack of training, we were concerned that ‘safe’ systems for seating arrangements and getting in and out of the bus would not be applied consistently. However, the trial period with the Houdini belt went ahead.

At the start of the Autumn term, another student joined the minibus. Let’s call this student Mandy. Mandy also had challenging behaviour. On the morning of the fourth day into the new term, when the minibus called for Tom, we got out of the house to see Mandy wrestling with the driver, who was trying in vain to get her to put her seat belt on. Barry was throwing soft toys around the bus. The escort, who had tried to calm Mandy and Barry, stood on the pavement. We watched a stuffed giraffe sail out of the open door of the minibus. I said ‘That’s it. That’s the end.’

We contacted the local authority. One option was for Tom to join another minibus route. For Tom’s safety, we could only agree to this if we had a guarantee from the local authority that the new route would not include children with challenging behaviour, neither now nor in the future.

The Special Educational Needs Officer who had dealt with the case in the summer term was now on long term sick leave. Junior staff were dealing with the issue. They didn’t appear to have direct contact with the council’s transport team – they didn’t know what the council’s procedures were for allocating students to routes and suggested that we, as parents, should talk to the transport team directly. Senior staff were then called in – staff who should have been spending their time and mental energy on the service as a whole, not on individual cases.

We discovered that minibus places were allocated according to where the children lived and did not take any account of challenging behaviour or physical vulnerability. This made the routes cheaper to run. The local authority had a system for gathering information about the students to give to the outsourced company, but this was haphazard and delivered months after the students had started using the minibus.

When it was clear that no minibus route could be guaranteed as safe for Tom, it then took the local authority three weeks to arrange lone transport: ten days to okay it and a further ten days to put the job out to tender. All this time, Tom was not going to school. The school complained to the authority that Tom was now officially a child missing out.

Eventually a local taxi company won the tender. In the first four days there were four different escorts, none of whom were trained or had any information about Tom. We supplied them with information ourselves. On the fourth day the transport arrived late and it was a black cab without proper wheelchair restraints. The driver said he had ‘had a phone call last night’ from the taxi company asking him to do this run. After further complaints to the authority Tom got one consistent driver and one consistent escort and a car with proper wheelchair restraints.

The authority told us that they would pay for lone transport just for one term. The Christmas holidays arrived with no word from the authority on what provision would be made for Tom in the new term. The first day of the spring term arrived and no transport turned up.

But by then we were already planning to leave: refugees to another authority, which does not outsource school transport and where the training and safety of drivers and escorts is backed by their membership of trade unions.

Let’s just summarise how in this case budget cuts and outsourcing to the lowest bidder led to a gaping hole in safeguarding.

First, the location of responsibility for safety was initially disputed between the local authority and the outsourced company. Was this because it was unclear, or because the local authority did not want to pay for the cost of safety? Or both?

Second, within the local authority, long term sick leave, absence not covered, delegation to junior staff, and senior staff diverted from their planning and overview work, speak of budget cuts leading to high work load, high stress, lack of adequate knowledge and understanding of accountability by some staff, breakdown of (already poor) lines of communication, lack of overview, and lack of adequate and pro-active monitoring of services.

Thirdly, it costs money to provide training in behaviour management and an allocation of transport places which takes account of challenging behaviour and physical vulnerability. In an unregulated market situation, no company which provides these safeguards can be the lowest bidder.

Fourthly, the local authority in this case tried to persist with an unsafe system, apparently in order to save money. The lack of safeguards puts at risk both the service users who need the transport and the workers staffing the minibus. God forbid that a young person with special needs and/or disabilities in this local authority, or a driver or escort, is killed on a school bus – but budget cuts and the policy of outsourcing to the lowest bidder mean that there are no safeguards which could prevent it.

Let us consider the larger political and economic choices which led to this situation. None of the individuals involved acted with deliberate malice or were out to exploit the situation to their own advantage. What we witnessed is the false economy and the injustice of massive budget cuts and the ‘marketisation’ of public services.

Competition is justified in terms of saving money. Outsourcing to the lowest bidder is the logical conclusion. But this situation creates very serious risks. Any one of those risks could end up costing the local authority huge amounts of money.

Competition is also justified in terms of getting value for money. But where there are massive budget cuts and a policy of outsourcing to the lowest bidder, competition is only a race to the bottom. For those who subscribe to this ideology, the question becomes how low you can go in the service you provide. The gutter press demonise those who are reliant on public services. It is a slippery slope to attitudes which are Victorian or worse.

Monitoring is sidelined. You don’t want to look too closely at the quality of a service if you are committed to outsourcing to the lowest bidder. The focus is on competition and marketisation, not on providing an adequate or coherent service. The market decides. The local authority remains legally responsible for the service, but its provision and quality move outside their control. Those local authority workers who can’t stand what is happening whistle-blow to deaf ears and/or go on long term sick leave, retire early, leave, or doggedly try to work with the situation for the sake of service users.

What happened to the families living in Grenfell Tower has blown open the false economy and the injustice of massive budget cuts and the ruthless competitive outsourcing of public services. The risks are risks to people. In this case, the risks were borne by low-paid workers and young people, like our son, living with disabilities. Public services cannot be run adequately in this way and there is no moral future for a society which treats some of its members as collateral damage.