Friday, 22 February 2013

CPEA and The Corporate Neglect Report

CPEA’s Margaret Flynn and Vic Citarella have written a section for the 'Corporate Neglect Report', a briefing paper by Former Care Services Minister Rt Hon Paul Burstow exploring how corporate bodies could be held criminally responsible for abuse and neglect that takes place in hospitals and care homes. As the authors of the SCR into Winterbourne View Hospital, CPEA’s Margaret Flynn and Vic Citarella discuss their experiences; we include the section from the report below.

In early 2011 staff at Winterbourne View Hospital in South Gloucestershire were secretly filmed by a journalist for the BBC’s Panorama programme. They were caught mistreating and assaulting patients with learning disabilities and autism. These acts triggered public revulsion at the cruelties perpetrated at this hospital, and exposed the hospital’s poor management and external oversight structures.

Knowledge that the average weekly fee for care at Winterbourne View was £3500 prompted questions over the stewardship of public money. In 2010, the 24 bed hospital had an annual turnover of £3.7 million. Considering the lack of financial transparency and co-operation that we experienced when compiling the Adult Serious Case Review (ASCR) established in the wake of the scandal, it is still hard to determine how much of this revenue was actually used for the running of the hospital and how much was consumed by the hospital’s parent company Castlebeck Ltd.

So, why couldn’t an Adult Serious Case Review (ASCR) access this kind of information? The answer is threefold:

1) An ASCR is a non-statutory instrument commissioned by a local Safeguarding Adults Board and whilst there are advantages to its current model as, unlike children’s SCRs where template reviews have not resulted in the promised learning envisaged, and therefore they can maintain their 37 independence and ingenuity, co-operation with ASCR is a voluntary process, so neither individuals nor agencies can be compelled to contribute or to accept the recommendations.

2) Because of the non-statutory nature of ASCRs, where there is no compulsion to co-operate or provide evidence, Castlebeck’s circumscribed their more significant contributions under the guises of “commercial sensitivity and confidentiality”. This therefore limited the scope of our investigation.

3) It requires forensic accountancy skills of the variety summarised by Private Eye (1327, 16 November 2012) to make sense of Castlebeck’s operations, “The company that owns Winterbourne View…is itself part of a group called CB Care Ltd, which itself is owned, via Jersey, by Swiss-based private equity group Lydian, backed by a group of Irish billionaires.”

Winterbourne View’s ASCR expressed concern that Castlebeck appeared to have made decisions about profitability, over and above decisions about the effective and humane delivery of a service. Whilst former staff were tried and convicted, Castlebeck’s opaque organisational hierarchy has been spared the attentions of the criminal justice system. We argue, therefore, that perhaps there is a case for developing a “hierarchy of liability” to buttress the concept of “corporate neglect”. Had there been such a hierarchy, ex-patients’ families might have challenged the commissioning PCTs for failing to ensure patients’ health and wellbeing, and the commissioning PCTs might have challenged Castlebeck for such a bracing indictment of “assessment and treatment.”

Many commissioners placing adults in Winterbourne View Hospital used Castlebeck’s own contract. In the future this inattentive place-hunting has to be replaced by intelligence-led 38 commissioning which does not fund a service that declines to share information about how monies are spent on the basis of “commercial sensitivity.” Contracts with providers should specify, inter alia, that co-operation with any investigation concerning the safety and wellbeing of patients is a prerequisite.

One of the main recommendations from our review, which Castlebeck failed to ever respond to, is that corporations should be liable for the costs associated with the ASCR, which in this case were wholly borne by South Gloucestershire Council. Surely it is wrong that a local council paid for an ASCR into abuse in a private hospital owned by a corporate body making phenomenal operating profits largely funded by the tax payer?

The report, in full, is available to download here.

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