People make Communities, not politicians. There is too much 'leave it to the experts' to sort out. Whenever the available funds are provided to ordinary people, to use to the benefit of the community, we always get better value for our money.

If ordinary people are empowered to look after their own interests, with professionals limited to playing an enabling role and ensuring fairness and equality, we usually see the talents of ordinary people flourish. Bureaucrats hate to lose that control though. They have often restricted these freedoms.

Unfortunately, Institutions invariably place so many constraints upon initiatives that they then become paralysed. The original 'enabling' role of community and social care professionals is now often 'disabling', because of the fearful and controlling nature of 'Nanny' bureaucrats.

This is not what most committed professionals want and it is certainly not leading to the re-building of our communities, especially in rural areas. To do that we need to take the initiative ourselves, demanding the physical resources and opportunities to create 'person centred' and positive, outcome focused and enabling services.

How did we lose so many talented People in our Communities?

Margaret Thatcher and her US counterpart Ronald Reagan, did all they could to destroy all kinds of viable communities. Local Communities, Business Communities, Banking Communities, Trade Communities and even balance of the international communities. Highly competitive, deregulated commerce produce short-term gains for a few.

We are now experiencing the consequences of the de-regulation of International Banking & Trade and the over-regulation of ordinary people’s lives. The anti-poll-tax rallies were the last UK's stand against the disempowerment of ordinary people. The false sense of security throughout the 1990's, is showing the 'delusional' cracks in 2000+.

Thatcher, Reagan and others were protected in their eventual 'demented' state by the wealth they accumulated from promoting 'selfish interests'. Those with similar conditions, within our saddened communities, do not enjoy such luxuries and unrestricted freedoms.

Those who worked to protect their old age now pay for their diminished, over cautious and restrictive care. The international law and national legislation, designed to protect people's most basic rights, are used to keep the institutions and bureaucrats safe from being sued for failures. People are often paying for their ‘restricted’ lifestyles.

The explanation of how this can happen is quite simple.

The Law requires us to protect people who cannot protect themselves. That is quite proper and requires us to 'prove' a person is not capable of understanding the risks they face; so that they clearly act against their own best interests and out of keeping with 'their' usual, or established way of life.

To protect the person in this way, we are required to choose the least restrictive method available to us. This is usually domiciliary care, or care in the person's own home, that is made ‘more safe’ for that purpose. In good practice, this is what is chosen by the person and then provided by professional services.

How is the law applied dishonestly? Professionals can be pressured, or tempted, to interpret the law in a more 'aggressive' way. This is usually to protect them and their employers from the possibility of being criticised, or sued, for failing to make a considered choice, which may prove wrong, as is always possible in life.

This is called 'risk averse' behaviour. Some people are naturally risk averse (fearful of taking chances) and some enjoy taking risks (hang gliding, getting drunk, picking a fight, or all 3). Most of the rest of us are somewhere in the middle. Life has risks, even with our simple enjoyment of it.

Institutionalised, one size fits all residential services are cheaper than more ‘personalised’ group living. 'Person centred' support in the community is often cheaper still and less even less restrictive. The more 'restrictive' services are proven detrimental to people’s mental and physical health.

Statutory services, which knowingly choose the cheaper, risk averse options, are often purchasing inferior services, knowing these serious and proven consequences. The decisions make no sense, other than to avoid criticisms for failing to do the ‘least restricting’ job properly, in accordance with proven Best Practice.

The other consequence of 'restrictive' forms of residential and hospitalised care is the agitated and sometimes aggressive behaviour that often results (see the article to the left). The other consequences are depression, high anxiety and 'reactive' paranoid behaviour.

The mini-institutions that provide these services are sometimes just doing what they are ‘required to’, others are driven to providing inferior services because the statutory services refuse to pay appropriate fees, needed for more personalised services (which demand better staffing levels).

Most importantly, the statutory services and the regulating authorities, pass on these 'risk averse' and 'unlawful' requirements to the residential and nursing care agencies, in the same way as is done with the professionals who are engaged to 'protect' people in the community.

More worrying, these intolerable and disabling restrictions are undermining many voluntary and charitable initiatives, especially if they are partially funded by the local authorities. These have often been the foundations of improving best practices in health and social care.

Very defensive Local Authority bureaucrats, auditors and solicitors, sometime with limited and dubious professional ethics, impose these same restrictions on the voluntary & charitable sectors, as part of the conditions of them providing the funding. The piper plays the tune of the paymaster, not in the interests of those providing the funds (us).

Check out the Government web sites. Central Governments challenge this behaviour, as do International Courts of Human Rights. All Party, Government directives explicitly prohibit these kinds of conduct. It is at the local level that the injustices and unlawful practices can be found. If people ‘feel’ restricted, they are restricted.

This is where the balance of the funding must be found and this is where the use of those funds is so badly managed, by inexperienced people, operating by third world business strategies, directed by professionals, operating strategies of more than 20 years ago.

Are you going to individually sue Local Authorities for their failures of duty. Are you able to find a solicitor willing to take a 'class action' against the discriminatory practice towards people with learning disability, dementia, brain damage, stroke and socially induced mental ill health? No? This is what local, statutory agencies rely upon.

Research Experience:

I have experienced first-hand, over many years, the frequently 'punishing’ repercussions of acting in the person's best interests and seeking to provide less restricting services. Professionals are pilloried for 'advocating' for clients and for challenging poor decisions.

The 'competition' that was supposed to provide more cost effective services has been abused by some providers of services and also by the local health and social care authorities who are purchasing those services. There is no transparency. The decisions are (local) political.

This is the reason that I got out of the market early, although I had repeatedly established a proven, high quality, enabling service. It is also the reason I have avoided returning to Management. It is becoming increasingly difficult to provide 'enabling' professional services.

The pressures to compromise ethical principles and good practice are too great and I have seen too many good professionals destroyed in the process of trying. Our 'customers' know the consequences of this and are brave enough to complain. Individual Professionals are sometime unjustly shamed, but the professional bodies must take some responsibility.

Even in the process of attempting to provide good quality, direct professional service, keeping to the well-tested and lawfully directed requirements, generates serious professional and personal repercussions. It is too challenging to those 'in control', who are in a double bind of their own making.

Ordinary members of our Communities have to accept some responsibility also. Few positively speak up and many find people with various disabilities 'inconvenient' and 'embarrassing'. Prejudice towards 'difference' is incredibly disabling and undermines human rights. Carer’s are often disempowered by these ‘excluding’ attitudes.

Our culture worships the cult of The Celebrity, the 'perfect body’, the frightening 'monster' and the entertaining 'exocentric' on the video screen. When people see these less attractive differences 'off screen' people's inexperience and intolerance generates abuse and prejudice.

If you feel your taxes are too high and the aggression and insecurity you experience is too distressing, you have to take some responsibility. Our failing communities exclude people in distress and this generates the resentments that we now increasingly see.

The costs and consequences are a significant result of intolerance of difference, fearful ignorance and blaming others for our own failures. Passing the buck is very expensive. In doing this you make the vocational work of carers very uncomfortable and unattractive. It also make the commitment of voluntary and charitable workers near impossible.

To top it all, many members of our failing communities then complain at the influx of people from other cultures, many of who are willing to do these jobs for us, having driven our own people out of trying to care. God help those of you (and the carers), with these opinions, in your old age and disablement.

You will not be joining Margaret Thatcher in her relatively comfortable, slowly dementing, ignorant bliss of the injustices and distress caused by selfish and prejudiced behaviour. You will be cared for by some of those underpaid, undervalued and abused people that you humiliated.

Best of luck! - © Terry Couchman  (20th April 2010)