Cllr Paul Bell | Working for Telegraph Hill

Here is what I said at full council last night to support my motion (in red)...

“In light of the serious concerns regarding the care provided by some private providers, this Council calls on the Executive Directors for Community Services and Children and Young People to advise on the measures being taken to ensure the quality of care provision in all care homes used by the borough and calls upon the Care Quality Commission and OFSTED to implement a programme of non-announced inspections of all care homes providing residential care facilities for people with disabilities and older people.”

Furthermore, it calls upon the Healthier Communities Select Committee to undertake a review of Lewisham's commissioning, monitoring and the arrangements for the inspection of these services.

Because commissioning is a political and not just a technical issue, the involvement of elected members is critical. Councillors have a statutory duty to put in place arrangements that will result in the continual improvement of service delivery with reference to economy, efficiency and effectiveness (Local Government Act 1999).

However, the recent cases of two private sector providers has shown how fragile some parts of the private sector is and as Lewisham commissions these services it has a duty make sure that the residents are benefiting from the best possible care.

The recent outing of Castlebeck to the media by Panarama, a company that Lewisham places two residents out of the Borough and its sister company Barchester which runs Westwood House in Sydenham, has demonstrated the pitfalls of some larger private sector providers. Furthermore, the example of Southern Cross is particularly bitter to swallow as for executive short term gain they sold their profit portfolio and leased it back, thereby potentially destabilising the group…but why would they care, the public sector will always pick-up the tab. Right?

However, the inhumanity in the Winterbourne View unit [Castlebeck], near Bristol made me sick to my soul and it is not acceptable for the private sector to simply wash its hands of its responsibilities, by apologising. But as with all things in life, bad practice has to be discovered and cannot simply be found. The Winterbourne unit is purportedly an assessment hospital for adults with profound learning disabilities or autism, but most of the patients had lived there for more than a year – each at a cost to the public purse of £3,500 a week.

For those here who did not see the programme, here are some of the recorded incidents:

In one scene in the programme, a male support worker seems to goad a female patient to throw herself out of a second-floor window. He says: "Go on, do it now I'm here. I'd love to see you try it: you will go flying. … When you hit the floor, do you reckon you will make a thud or a splat?"

In another scene, a second male support worker is seen to act as a Nazi camp commandant, repeatedly slapping a patient across the face with a pair of leather gloves and saying: "Nein, nein, nein!"

Staff, sometimes with qualified nurses watching, used forms of restraint that an expert described as closer to martial arts rather than any approved technique.

A female patient is seen pinned beneath a chair for more than 30 minutes with one support worker sitting in the chair and keeping his foot on her wrist, while a second worker kneels on her legs.

So what of my motion? Well I am told that the Care Quality Commission is responsible for the inspection of care homes, but this organisation has recently been rolling back its inspection and monitoring provision.

The Care Quality Commission conducted 2,008 site visits between the beginning of October 2010 and the end of March 2011, compared with 6,840 for the same period 12 months earlier – a 70% fall. [Community Care May 2011].

In February 2011, Adult care directors sought "urgent" talks with the Care Quality Commission over concerns that a new ratings system for providers will reduce scrutiny of services, to the detriment of users.

The government has proposed replacing the quality ratings system, under which the CQC graded all registered providers as poor, adequate, good or outstanding, with a voluntary "excellence standard" for the best providers, in consultative plans to overhaul the adult care performance system.

However, the Association of Directors of Adult Social Services warned that the proposed system failed to provide the same degree of "assurance" and transparency as quality ratings.

CQC is also now under more scrutiny since the Panarama programme; critics have seized on the fact that the CQC's annual budget of £164m is 30% less than the combined funding of the organisations it succeeded in 2009, even though it is being expected to do more. As well as NHS trusts, care homes, care agencies and dental practices, the body is due next year to start regulating GP practices. According to Dame Jo Williams, chair of the Care Quality commission each of the full quota of 900 inspectors – and until recently there have been up to 130 frozen vacancies – handles a mixed portfolio of some 50 different provider units and makes judgment calls, based on evidence of relative risk, about when and how often to visit. Bad practices can therefore be missed.

Even in the unlikely event of the CQC receiving a big boost to its budget, Williams emphasises that the primary responsibility for safeguarding the welfare of people in the care system will always rest with the care provider. "My challenge,” she says, “is to every provider who watched that programme is: 'How do you know that the people you are offering services to are getting a service that protects them, promotes their welfare and helps them develop and enjoy a quality of life?' However, all commissioners have a role to play.

So how do we make sure that Lewisham residents have confidence in a private sector, whose motivator is profit. Well that is where Lewisham has the responsibility. It is worth noting that the CQC has admitted inspecting Winterbourne View three times in the past two years.

The examples of Southern Cross and Castlebeck do not fill me with confidence; but more importantly, if the council commissions services it has a responsibility to make sure the private sector is performing not just for best value, but the quality of the care. Making profit out of the care needs of older people or people living with disabilities I believe to be wrong, but that is the society we live in. What we should not do is let the pursuit of profit undermine the quality of care.

Capitalism always talks about choice...well choice depends on the freedom to choose and when you are shackled to debt, you don’t have the freedom to choose.

Debt is in many forms: mortgage, tuition fees, credit cards and loans...so don’t go thinking you are free.

People in debt become hopeless and hopeless people don’t vote.

Keeping people hopeless and pessimistic is a way of controlling them. In fact there are two ways of keeping people controlled:

•             By fear
•             By demoralising them

An educated, healthy and confident nation is harder to govern. And deceive. That is why the Condems are attacking education and the NHS to make us less confident and less engaged in democracy. Democracy and the enfranchisement of working people has brought social advances that the wealthy would never give through "choice" or a social duty.

Why is it that people put up with 1% of the world’s population owning 80% of the world’s resources?

The poor and demoralised think perhaps the safest thing to do is take orders and hope for the best.

Now the debate around the cuts has quietened down apart from the impact they will have on workers and residents in Lewisham, I thought I would write about my perspective of the process and the past year as an elected councillor.

At public meetings, I do get asked about why the council did not vote for an illegal budget and defy the government. My answer is always the same: there was no desire within the Labour Group and the Mayor to do it. Party politics is about consensus and the Labour Group on Lewisham Council debates and votes for particular policy directions. Despite having an elected Mayor, he listens and adds to the debate and then we vote on the group view. This is hard and is probably the biggest difficulty, as I end up voting for things, as a lay member of the Labour Party, I would be campaigning against. During the process, I questioned everyday and at every debate as to was I doing the right thing? I will not specify the answer here, but suffice to say I was uncomfortable with my responses in the council chamber. I made speeches advocating discomfort but the vote you place is the one that defines you.

Any political group is a broad church of opinion. I make no apologies for the fact that I am a more left wing member. I am a trade unionist and I set about trying in my own way to defend public sector jobs and fight outsourcing, along with other members. However, there is no doubt that the former Labour government did embrace the market in a way I opposed at every opportunity and not because I am a “Trot” but because I believed allowing the private sector to run services in the public sector would be a mistake. An example of this is Medirest, part of the Compass Group, who have catering and cleaning contracts in the NHS. This company along with similar companies do not pay sick pay, i.e. an occupational sick pay scheme to their workers; workers who are low-paid are therefore forced to make a choice between coming into work sick or staying at home and not getting paid. These workers clean intensive care wards; children’s cancer wards and we wonder why hospital viruses are in the news almost on a weekly basis. This is the supposed efficiency. Workers terms and conditions, numbers and quality of service make way for profit.

So the past year has been compromise and heavy debate. We have some excellent councillors who care about services to our community and whom hate tearing down progress made by Labour. Setting an illegal budget would have been pointless and futile, except to pamper to our own ideas of self-worth. While it appealed to my radical side, my progressive left-wing politics recognises the practical application of decisions made based purely on belief and ideology.

We can still make progress, as this is one of the ways we can resist this ConDem government taking us back into the past. We must continue to fight for every social advancement at whatever level, small or large. I still hold the same beliefs and will not sacrifice those for anyone but have to realise I am not the Mayor or know everything.

Being a politician is a tough job, as you are pulled in various directions. It is easy having one position on a belief and to stick to it, when you don’t have to convince others with power. I envy that. My father always uses the expression, “I have a tongue in my head,” and I use mine quite a lot. Nearly a year of being a councillor has taught me some valuable lessons which I shall use during the next year.