This scandal has already broken

An aerial picture of a large stone country house with a tall roof in a wood, with a church and steeple in the foreground.
Whorlton Hall, County Durham, where staff were filmed abusing patients in 2019

“It’s a massive scandal just waiting to break” (Morning Star, 6th Jan 2022)

This article, by the feminist writer “Dr EM”, most of whose articles are on fringe feminist websites, attempts to expose the issue of serious sexual abuse by male care home staff against vulnerable female ‘patients’, among them a severely disabled woman who became pregnant after being raped by a male care worker who was jailed in February 2020 and two women suffering sexual abuse which was exposed when they or their relatives installed hidden cameras. The root of the problem, she believes, lies in the practice of allowing male carers unsupervised access to vulnerable women, particularly those who cannot speak up for themselves, which should end:

Continuing the practice of allowing male carers unsupervised access to female patients is being deliberately blind to evidence of a pattern of risk. Not all men, but it is enough, and we must safeguard vulnerable women. The alternative is to say the potential sexual abuse of women is acceptable to placate the feelings of men.

She makes a few valid points, among them that care homes are often run for profit and their owners have an interest in covering up abuse, and that elder abuse is not taken seriously because many people cannot fathom why anyone would want to abuse an old person, while child abuse is nowadays well-acknowledged. I agree that it is a right of anyone who requires care to specify the sex of who is employed to give it, and for the vast majority of women and probably most men also, that will mean women (though some men will require male caregivers). However, she looks at just one type of abuse, the sexual abuse by male caregivers of severely disabled women, in isolation. She continually refers to abusers as “male perpetrators” or just men as if she regards their abusive behaviour as just the consequence of their sex. The fact is that sexual abuse is just one of many types of abuse that disabled people in institutions are vulnerable to, and excluding men, or restricting their access to some female patients, will simply cut out a lot of care without doing much to remedy many of these problems.

She quotes a series of statistics about the elevated risk of assault and sexual abuse that disabled people, especially those with learning disabilities, are exposed to but does not look into where these risks come from; it is often partner abuse, as disabled people find it less easy to leave environments where they are being abused and are often forced into financial dependency on their abusers. She writes that “people with disabilities are often forced to live in institutions away from public scrutiny without access to police, support services or advocates”, but in fact the numbers of disabled adults living in care homes has declined over the years; disabled people want to live in their own homes, or with their families with support. Care homes for disabled adults have closed one after the other over the years; it is not an option for many people, even in the unlikely event that they would still want it to be. Very often, an admission to a care home is a temporary solution while a permanent home is found and set up.

Not every woman who has to be admitted to a care home, or any kind of inpatient environment (and care home residents are not patients), wants to live in an all-female environment. Many women have lived with men all their lives. They may want any intimate care done by women, but they want men and women to talk to, to eat with, to play games with. In a mixed environment like this, it is not always going to be practical to ensure male staff members never gain access to places where the most severely impaired women live, especially given the layout of some of the buildings used. Besides which, there may be men living there who become friends with some of the women. In most circumstances, it’s neither possible nor desirable to ensure an all-female environment for any woman deemed vulnerable who is in a care or nursing home. (In inpatient mental health environments, women generally want all-female living spaces where male patients cannot get access, sometimes because of pre-existing trauma and sometimes because of the behaviour of some of the male patients. The move to mixed wards in these hospitals caused a lot of distress.)

She quotes one Jackie Pritchard as saying that sexual abuse in care homes is “a massive scandal just waiting to break” but for “government funding to prove it’s as bad as we know it is”. She is quoting from an article from 2001 in the Observer, which was published before criminal records checking was introduced, as the article indicates. At the time, a list was being prepared of people who had been dismissed or disciplined while working in care homes as an existing list did for people working with children, but it would not have included those who left under a cloud when they noticed they were under suspicion. She notes that there was a lack of professional qualification or training for care workers, which seems to still be the case, not only in care homes but also in mental health environments, particularly those affecting people with learning disabilities. (And as that article demonstrates, sometimes the abuser owns the place.)

The scandal, in fact, broke years ago. Many of us, both in the media and in the online disability community, both disabled people and their relatives and friends, have been working to expose abuse and neglect in both care homes and hospitals (especially hospitals, where people are often confined and have no control over who comes into or goes out of their lives), to get people out when they have been detained inappropriately and into suitable community settings (or sometimes back living with their families), to bring to justice people responsible for death and injury. There are so many problems in these environments — neglect of patients’ needs and of upkeep and hygiene, cruelty, violence, needless restrictions on people’s lives and interference with family relations, lack of privacy, degrading treatment such as deprivation of sanitary protection, summary evictions — and straightforward sexual abuse or rape probably happens, but it seems to be one of the less common problems. While poor recruitment practices are fairly well-documented, it seems to attract a lot of other kinds of unsuitable carers who might have been recruited on the grapevine and are there for the job, not because they are committed to making people’s lives better, and these are not just men. This was the case right back to the days of the asylums. (While it is widely acknowledged that care work is easy to get and poorly monitored beyond criminal records checking, I have heard on more than one occasion of people with autism in inpatient environments finding that the most understanding of autism were those with the lowest professional qualifications or none, including healthcare assistants and other patients, and that higher-grade staff made no attempt at understanding.)

A few years ago, there was a scandal in which a women’s mental health ward at a hospital in Lancaster, the Orchard, was temporarily switched to accommodate men; women were sent to the mental health ward in Burnley, some 45 miles away. A Twitter campaign led by a local radical feminist who had been in both hospitals attracted the attention of similarly minded people, leading to a piece in the New Statesman by ‘Glosswitch’ about the obvious misogyny, and how important it was for mothers to maintain contact with their children while in these units. Many of us had been campaigning against long-distance mental health care for years; people were (and still are) being sent far further from their homes and families than that, sometimes hundreds of miles, and while not all mothers, many of them had families whose support they needed and were being cut off from. So, it’s another case of feminists jumping into an established campaign against abuse and for justice in healthcare, and making it all about them, when it affected everyone.

Of course, preventing sexual abuse in care homes is important. But it’s not the only kind of abuse disabled and elderly people are vulnerable to, and simply barring men from unsupervised access to disabled women and girls will not prevent other types of abuse that could be carried out by women as well (at both Winterbourne View and Whorlton Hall, female staff were shown abusing patients and joining in with abusive male staff). There should be supervision of all staff, especially newcomers without a proven record in care, and such matters as a staff member taking an unhealthy or unusual interest in one resident or patient or a resident being obviously uncomfortable being around them should be taken note of and acted on. Abuse thrives when those in authority look the other way, when no care is given to who is paid to care and when those cared for are considered a burden rather than as valuable human beings. It’s not as simple as half the population being deemed unfit to care.

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