Archive Page 2

Violence against women and children in diverse contexts: FRS special issue

FRS 2013 [FC]Nicky Stanley, Ingrid Palmary and Khatidja Chantler, editors of the special issue of Families, Relationships and Societies, detail the content of the issue and explain why examining both differing and shared experience of violence and abuse is essential.

“Violence against women and children is a global phenomenon but experiences of violence and abuse and their impact are shaped by local settings and factors specific to particular societies and communities.

This special issue of Families, Relationships and Societies explores varying forms of violence and abuse in different parts of the world, including the United Kingdom, South Africa, Iran and South East Asia. Bringing these papers together highlights differences but also reveals what is common in the experience of violence and abuse, in the ways we investigate and understand those experiences and in the service response. This recognition of both differing and shared experience of violence and abuse is increasingly important as communities everywhere become more diverse. Any campaign or service aimed at preventing violence for women and children needs to take account of specific and local factors as well as those aspects of violence that are widely shared.

This special issue comes out of a research workshop held at the University of the Witwatersrand, Johannesburg, in March 2015 that was funded by the British Council.

University-of-Witwatersrand-March-2015

Nicky Stanley, Ingrid Palmary and Khatidja Chantler with special issue contributors and workshop participants, March 2015, University of Witwatersrand, Johannesburg, South Africa

Thirty-five researchers from UK and South Africa came together over four days. Their interests covered gender and violence across diverse contexts and explored the connections between gender based violence, migration and political violence. Participants came from social work, public health, psychology, sociology, social policy, health studies and anthropology with both early career researchers and experienced academics contributing. The workshop included mentoring sessions and career development opportunities as well as the papers that formed the basis of this special issue.

Two research centres led the workshop and have edited this special issue: the African Centre for Migration & Society (ACMS), University of the Witwatersrand, South Africa, and the Connect Centre for International Research on Interpersonal Violence and Harm, School of Social Work, Care and Community, University of Central Lancashire, UK. AMCS is an Africa-based centre of excellence dedicated to shaping global discourse on human mobility and social transformation. The Connect Centre works with a wide range of international partners to make connections and to challenge fragmented thinking on violence and abuse and its impact in order to develop new research and services.

The wide variety of forms of sexual and interpersonal violence, and the way in which gender and other positions of marginality, including migration, interacts with these forms are explored in this special issue. Nadia Aghtaie’s paper provides new insights on rape in Iran. Aghtaie’s study illustrates that, within an Iranian context, rape is often sanctioned implicitly and explicitly through culture, laws and policies that provide impunity for perpetrators and normalise violence against women. Similarly, Ingrid Sinclair’s paper explores the ways in which notions of women’s morality, derived from marital status, shape the responses of the South African Police Service to women who experience abuse from their partners.

Rebecca Walker’s paper in this special issue describes how structural violence is experienced by migrant mothers who sell sex in Johannesburg. Walker’s paper reveals the intersection of gender and class as predominantly shaped by the women’s marginal migration status: basic survival for themselves and their children is dependent on mothers selling sex. Women’s status as sex workers shapes public sector workers responses to them. Their often oppressive responses are legitimised by populist notions of who is and is not entitled to services. The paper by Rebecca Dudley’s also draws attention to the intersections of domestic abuse and state structures, specifically the immigration rule of No Recourse to Public Funds (NRPF) in the UK. Her UK study explores the impact of this rule and the State’s complicity in trapping women in abusive relationships. In common with other contributors, she identifies the hostility that migrant women may experience from service providers as a key factor.

Patricia Hyne’s paper explores processes of trust and mistrust in accounts of displacement and asylum drawing on analysis from different research projects over a 25 year period. She reports practitioners’ experiences working in Thai refugee transit and processing camps and Burmese refugees as well as drawing on research conducted with in the UK refugees, asylum seekers and trafficked children. Hynes provides examples of when it is ‘safe’ to trust someone and where mistrust is essential for survival. Deborah Allnock’s UK based study on childhood disclosure of sexual abuse, examines the relationship between memorable life events (MLEs) and disclosure of sexual abuse in childhood. She provides a framework that illuminates those contexts that can inhibit, alter or reverse decisions to disclose abuse.

In relation to researching ‘hard to reach’ groups, the paper by Lorraine Radford, Nancy Lombard, Franziska Meinck, Emma Katz and Stanford Mahati includes a case-study from each author’s research on children and young people’s experiences of violence and adversity across the different contexts of the UK and South Africa. Each researcher used different methodologies and concepts but shared a common understanding of the social construction of childhood and the centrality of cultural and social contexts for understanding what constitutes violence. They report considerable ethical challenges and dilemmas were experienced in gaining ethical approval and in conducting the studies. This paper highlights the importance of researching with children rather on children. Similarly, the paper by Vearey, Barter, Hynes and McGinn provides rich illustrations of the ethical dilemmas of researching gender based violence. The article draws on diverse examples including: research on the Burmese-Thai border; research in Ireland on intimate partner violence and research with school children in a number of European countries. This paper provides detailed accounts of real life problems encountered during research and the complexity of establishing an ethical response in contexts where the outcome of actions can be difficult to anticipate.

Sharma and Marsh’s Open Space piece offers an analysis of group-work at Safety4Sisters, Manchester, UK, by workers who facilitate a group for women with experiences of abuse with NRPF and insecure immigration status. Their contribution brings to life the harshness of the immigration and asylum process and the fragility of the women’s existence. In their Open Space piece, Elsa Oliveira and Jo Vearey, researchers based at the African Centre for Migration & Society, University of the Witwatersrand, discuss creative research approaches with migrant sex workers in South Africa. They are founders of the MoVE:method:visual:explore project, and their paper highlights the importance of doing research differently with marginalised groups. The emphasis is very much on working with marginalised groups through media that allow marginalised voices to be articulated. In achieving this, the boundaries between research and activism are blurred and overlap.

 

FRS 2013 [FC]Find out more about Families, Relationships and Societies on our website.

To submit an article consult our instructions for authors.

For news about all the latest issues and free articles sign up for our newsletter and follow the journal on Twitter: @FRSjournal

Ask your librarian to subscribe or sign up for a free institutional trial.

10 ways we can reverse inequality in Britain

Professor Roger Brown Book launch Liverpool Hope 16.4.13

Roger Brown

Roger Brown, author of The inequality crisis, explains how economic inequality in Britain and other advanced Western countries has got so bad, and highlights the measures we need to undertake that will start to reverse this devastating trend.

“Almost every day now the media carries stories about inequality and its effects.

In the past few weeks, the Department for Health has confirmed that the health gap between rich and poor in England is growing.

Reports by Lloyds Bank and the Social Market Foundation have drawn attention to our disparities in wealth, with a tenth of adults owning half of the country’s wealth while 15% own nothing or have negative wealth.

Respected independent ‘thinktanks’ like the Institute for Fiscal Studies and the Resolution Foundation have repeated their warnings that, at a time when wages generally are only growing slowly, the combination of tax cuts and cuts in welfare benefits means that income inequality will increase further over the next few years.

“Economic inequality has increased in nearly every advanced Western country…”

This is not just an English or British issue. In March, International Monetary Fund (IMF) researchers estimated that the US economy had lost a year of consumption growth because of increased income polarisation. And of course inequality was a major factor in the Brexit vote and in the election of President Trump.

My interest in the subject was first aroused by my work on the introduction of markets into higher education. I found that the associated increase in competition through mechanisms like tuition fees had exacerbated the inequalities between universities and the constituencies they serve, without any significant compensating benefits. This led me to wonder if there might be parallels in the economy and society more generally.

What I established was that economic inequality has increased in nearly every advanced Western country over the past thirty or so years, and that this has led to a huge range of costs and detriments. Moreover, these costs and detriments are not only social. As the IMF research confirms, increased economic inequality has an economic cost as well. Above all, growing inequality is disabling democratic politics as the concentration of economic power is increasingly reflected in a concentration of political power (as can be seen most clearly in the US).

“Growing inequality is disabling democratic politics…”

But whilst nearly everyone agrees that – to paraphrase Dunning’s famous 1780 Parliamentary motion, economic inequality has increased, is increasing, and ought to be reduced – there is no agreement on how this should be done.

Broadly speaking, there are two schools of thought:

One – the ‘market’ view – is that increased inequality is the inevitable outcome of underlying structural developments such as globalisation, skill-biased technological change, and financialisation (the growing economic role of such processes as banking and securities trading) over which individual countries and governments have little control. These changes are leading to what have been termed ‘winner-take-all’ markets where those at the top gain rewards out of all proportion to their contribution to society.

The alternative, ‘institutional’, theory is that it is due to the political choices made in individual countries, and especially the neoliberal policies of deregulation, privatisation, tax reductions, welfare cutbacks and deflation pursued in most Western countries since the mid- to late-70s, but particularly associated with Margaret Thatcher and Ronald Reagan.

I believe that it is the combination of these underlying structural developments with those neoliberal policies that has driven the post-80s rise in inequality, with the US and Britain well above the other wealthy Western countries in the extent to which inequality has grown there over that period.

So the key to reversing, halting or slowing inequality lies in the first place in reversing these neoliberal policies, but without losing the benefits of properly regulated market competition in sectors where it is appropriate.

The following is a short list of measures that would start to reverse inequality in Britain:

  1. Require the potential impact on inequality to be a major test of every other policy or programme introduced by the Government.
  2. Show that we are serious about tax avoidance by reversing the long-term decline in the number of professional HMRC officials.
  3. Progressively adjust the balance between direct and indirect taxation (VAT), increasing the former and reducing the latter.
  4. Increase the income tax rates for higher earners (say, above £60,000).
  5. Introduce some form of wealth tax.
  6. Begin the rehabilitation of the trade unions by repealing most of the 2016 Trade Union Act.
  7. Reverse the cuts in welfare benefits made by the Coalition and Cameron Governments.
  8. Introduce measures that really will force companies to take account of interests wider than those of top management.
  9. Begin to end segregation in education by removing the charitable status of the private schools.
  10. Focus macroeconomic policy on demand and wage growth rather than inflation and corporate profits.

The Labour election manifesto has some proposals on these lines, but no political party has yet really got its mind round the full range of measures that are needed to combat inequality.

Until they do, inequality will continue to increase.

 

The inequality crisis by Roger Brown is available with 20% discount on the Policy Press website.  Order here for just £10.39.

Find out more about impact, influence and engagement at Policy Press here.

Policy Press newsletter subscribers receive a 35% discount – sign up here.

The views and opinions expressed on this blog site are solely those of the original blog post authors and other contributors. These views and opinions do not necessarily represent those of the Policy Press and/or any/all contributors to this site.

What’s next for poverty?

Barry Knight 3

Barry Knight

Barry Knight, author of Rethinking poverty: What makes a good society?, explains why we need to change the way we frame ‘poverty’ in order to make progress.

“Progress on poverty has stalled, in fact the proportion of people living in poverty in the UK has remained the same since 2005. This applies both to absolute and to relative poverty.

Poverty campaigners know that they need a new language if they are to make progress. Justin Watson from Oxfam has suggested that charities are getting it wrong:

“There is growing consensus that the narratives used by the third sector, however well-meaning and ‘right’, have been rejected. Take ‘poverty’ for example, a term that is politically divisive, laced with stigma and highly contested to the point of still having to persuade people it exists at all in the UK.”

Reports on poverty may raise awareness but, as Olivia Bailey, Research Director of the Fabian Society points out, “talking about a problem doesn’t generate enthusiasm for a solution”. Leading journalist Simon Jenkins has recently written that endless research into Britain’s growing gap between rich and poor is a waste of time. We need to set aside partisan politics and act.

Yet, solutions are hard to come by. The traditional remedies of the post-war settlement – work and welfare – are no longer sufficient. Social security payments leave many people struggling to make ends meet, while economic development produces low paid jobs.

So, how do we end poverty when the traditional means of doing so no longer work?

Technocratic policy fixes treat symptoms, rather than address the complex processes that produce poverty in the first place. Moreover, such an approach wastes effort in repairing an old system that seems incapable of eradicating poverty. We can no longer rely on public and private sectors to guarantee people’s well-being and there is little sign that anything in present arrangements will make our society better.

“This approach redesigns our society so that poverty becomes obsolete.”

We need to reframe our approach. Rather than addressing what we don’t want – poverty – we need to develop what we do want – a society without poverty. This approach redesigns our society so that poverty becomes obsolete.

To do this, we need to draw on a sociological tradition originally deriving from the work of C. Wright Mills, and modernised by John Paul Lederach, in which we use our moral imagination to develop the society we want. Research by the Webb Memorial Trust shows that the society people want differs markedly from the society we have. Rather than opting for a society based on current political categories, they want a society where social factors come first, where relationships are given priority, and the economy supports people in their lives, rather than the persistent drive for ‘growth’.

The model of how we develop a good society needs to change. This can no longer come from the elites as something done to us. Rather, it involves us doing it for ourselves. ‘You can’t go around building a better world for people. Only people can build a better world for people. Otherwise it’s just a cage’, wrote Terry Pratchett in Witches Abroad. Nowhere is this truer than the ending of poverty, a process that now can and must involve the poor being their own agents of change.

“The way forward lies not in a set of transactional policies that shift resources, but rather in the development of transformational relationships that shift power.”

The way forward lies not in a set of transactional policies that shift resources, but rather in the development of transformational relationships that shift power. Young people understand this and that is why working with them to help them take power must be the first goal of social policy.

Rethinking poverty [FC]The pdf of Rethinking poverty by Barry Knight is available to download free via OAPEN. The paperback is available with 20% discount on the Policy Press website.  Order here for just £7.99.

Find out more about impact, influence and engagement at Policy Press here.

Policy Press newsletter subscribers receive a 35% discount – sign up here.

The views and opinions expressed on this blog site are solely those of the original blog post authors and other contributors. These views and opinions do not necessarily represent those of the Policy Press and/or any/all contributors to this site.

Challenging the politics of early intervention

Nicola Horsley

Ros Edwards

Val Gillies

The past decade has seen a rash of early intervention programmes targeting mothers of young children.

Reports by the World Health Organisation and UNICEF, and early years policy and service provision in the UK and internationally, are now characterised by an emphasis on early intervention in the belief that pregnancy and the earliest years of life are most important for development. It has become the orthodoxy in a whole range of professional practice fields.

The idea of being able to intervene in parenting to ensure better life chances for children feels constructive and positive, but there is little evidence to suggest that it works. Moreover, early intervention doctrine ultimately holds mothers accountable for poverty and other social ills.

“…there is little evidence to suggest that it works.”

Pressure on mothers

Early intervention is directed at mothers as the core mediators of their children’s development. The significance of mother-child relationships in the early years often is underlined through reference to the developing brain. For example, the website of the influential Harvard Center on the Developing Child refers to mothers as ‘buffers’ between their children and adversity. As buffers, they are held personally responsible for inculcating what the Harvard Center terms ‘a biological resistance to adversity’ in their children.

The quality of mother-child relationships is posed as a decisive lever in building children’s brains, and is a core principle structuring the everyday work of many early years intervention programmes. In one UK early years intervention initiative that targets young and marginalised first time mothers, the Family Nurse Partnership programme, practitioners provide mothers with a sheet headed ‘How to build your baby’s brain’ featuring a list of activities claimed to enrich neural connectivity, such as reading books, singing rhymes, and playing on the floor.

“The deprivation facing poor working class families is posed as a result of poor mothering.”

The responsibility loaded onto mothers is especially pronounced in relation to low income, working class mothers and Black and minority ethnic mothers, as both cause of and solution to their children’s marginalisation and poverty.

The deprivation facing poor working class families is posed as a result of poor mothering and consequently the stunted brains of their offspring, at the same time as they are positioned as buffers who can mitigate against and overcome the effects of a harsh wider environment for their children. Early intervention programmes such as the UK’s Family Nurse Partnership, the Solihull Approach, and Parent-Infant Partnerships, overwhelmingly are delivered in areas of deprivation to poor mothers.

Ideas about brain science are used to legitimise interventions in the child rearing habits of working class families, protecting children brought up in poverty from any effects of their disadvantage and promote their social mobility. The social and structural causes of hardship and need that are being experienced by these families in the present are effectively masked, placing mothers as hidden buffers against the effects of privation on their children.

The developing world

Globally, UNICEF brings together early years development and parenting to offset children experiencing war and hunger on the basis of the speed of new neural connections formed in the brain in the early years, asserting that good parenting will help children overcome multiple adversities such as violence, disaster, and poverty. Despite the overall paucity of evidence that early years intervention works, initiatives are being rolled out across the developing world, in the belief that improved mothering will surely benefit the state of the nation.

For example, the ‘Fine Brains’ (Family-Inclusive Early Brain Stimulation) programme seeks to promote parental stimulation and interaction to improve children’s brain architecture in sub-Sahara. It asserts that mothers in these countries are ill-equipped to maximise the benefits of interaction, need to be trained, and then to train their husbands to parent properly. The complex and diverse historical, economic, political, social and religious contexts of sub-Saharan Africa are obscured in favour of a focus on individual mothers as able to overcome poverty, conflict and post-conflict, engrained gendered inequalities, and so on, through improving their knowledge of child development and home engagement practices.

“Despite the overall paucity of evidence that early years intervention works, initiatives are being rolled out across the developing world.”

 

A meritocratic construction

The policy and practice preoccupation with how poor mothers and deprived families bring up and nurture their children relies on a meritocratic construction of the wealthy and privileged as having better developed brains. This is a statement that many of us might find offensive. But within the confluence of brain science and early years intervention, success is naturalised and unproblematically correlated with brain structure and intelligence. From this perspective, the solution to poverty is to make people smarter. Working class mothers, black and minority ethnic mothers, and mothers in the global South can enable their children to think their way out of their predicament.

The idea that hardship and discrimination is to do with how much attention of the right sort that mothers give to their children, and the notion of countering global traumas and inequalities through parenting, is jaw-dropping. It demonstrates why early intervention policy and practice deserves more critical scrutiny.

 

Challenging the politics of early intervention by Val Gillies, Rosalind Edwards and Nicola Horsley is available with 20% discount on the Policy Press website.  Order here for just £18.39.

Find out more about impact, influence and engagement at Policy Press here.

Policy Press newsletter subscribers receive a 35% discount – sign up here.

The views and opinions expressed on this blog site are solely those of the original blog post authors and other contributors. These views and opinions do not necessarily represent those of the Policy Press and/or any/all contributors to this site.

What makes for a strong Voluntary Sector Review paper? Eight points to consider

Rob Macmillan, Nick Acheson and Bernard Harris, editors of the international Voluntary Sector Review journal, present 8 tips for submitting a strong paper. 

Rob Macmillan, Nick Acheson and Bernard Harris

As editors of Voluntary Sector Review (VSR), we attract a wide range of international article submissions, covering the whole range of topics around voluntary and community action, non-profit organisations and civil society. We often reflect on what makes for a strong paper.

Full-length research articles in VSR, normally no longer than 8,000 words in length, may focus on empirical findings, methodological issues, scholarly or theoretical inquiry, and applied analysis of relevance to practitioners and decision makers. We welcome submissions from all parts of the globe, and encourage all of our authors to highlight the international implications of their work.

We know that the whole process of submitting a paper can be daunting and onerous for authors – something you’ve been working on for a while has finally been given over for an external judgement of its potential value. Preparing a good paper for submission is an art rather than a science, and through our experience as editors and authors we have drawn together a list of eight helpful points to consider before you submit your paper.

1. What is the paper about and why is it important?

Be very clear on what the paper is about, starting with a clear statement of the issue that it addresses, together with an explanation of why the issue is of interest to and important for readers of the journal. You need to provide good reasons for readers to read on and subsequently remember your article.

2. Critical understanding of the literature

Embed the issue the paper addresses in the relevant literature, with a critical understanding of the most important and influential previous articles and books in this area.

3. Intellectual, theoretical, policy or practice context

Make sure you set out clearly the intellectual, theoretical, policy or practice context that informs the article.

4. Methods

Where you are reporting empirical findings, make sure the research design, data collection methods and analysis techniques used are described in sufficient detail for readers to be able to understand how the study might be replicated, and on what basis the conclusions are being drawn. Where prior literature provides the basis for the article (in addition to or instead of empirical findings), explain how it was sourced, selected and reviewed.

5. Key findings

Set out the key findings relevant to the issue addressed in the article in a systematic way, relating them to earlier work covered in the literature review. Authors often try to say too much here, overloading their submission with empirical findings such that the point of the article is obscured in empirical detail.

6. Contribution to knowledge

Identify the extent and ways in which the findings and discussion contribute to new empirical knowledge about the issue or better theoretical understanding of the topic. There is a balance to be struck here: be confident in the conclusions you draw, but don’t overstate the case.

7. Implications for future research, policy or practice

Draw out the implications of the study for future research, policy or practice – in the country which is the primary focus of the article, but also more broadly where appropriate.

8. Argument, structure, and signposting

Finally, check to see whether there is a clear, well-signposted, structure and thread of argument running through the paper, so that readers can quickly gain a secure sense of the paper’s development from introduction to conclusion.

On receipt of a submission, we will always make an initial editorial judgement before we send a paper out for review, and we may ask you to revise the paper before doing so. We encourage reviewers to provide constructive feedback to authors in order to help improve papers, and we will provide guidance on how to proceed if the decision is one of ‘revise and resubmit’. The peer review process can be exacting but it is rigorous and invariably leads to better quality papers.

We would encourage you to get in touch if you have an idea for a paper but are not sure of its suitability. We’ll always aim to provide helpful guidance, though, of course, we cannot provide any guarantees of publication.

If you would like to submit a paper you can find the Journal’s aims and scope, and instructions for authors on the Voluntary Sector Review website. You will also find further information about submitting Policy and Practice articles, along with details of the relevant editors for these sections.

 

More about Voluntary Sector Review

To submit an article consult our instructions for authors.

For news about all the latest issues and free articles sign up for our e-newsletter and follow the journal on Twitter @VSRjournal

Ask your librarian to subscribe or sign up for a free institutional trial.

Why we need social entrepreneurs

Chris Durkin, co-author of Social entrepreneurship; A skills approach, reflects on his experience of redundancy and how the uncertainty it brings is representative of life in the ‘gig economy’. He highlights the urgent need to teach new skills, creativity and resilience and how social entrepreneurs can show us the way.

Christopher Durkin

I have been very lucky throughout my working life and only recently experienced the indignity of being made redundant. What was apparent was that redundancy has a formality, which goes through various stages – notification, ‘consultation’ and final notice – a process that involves you in attending various meetings, both as a group and as an individual.

What sticks out for me on a personal level was that throughout the process there was a high level of uncertainty, a complete loss of confidence and a feeling of anger, loss and failure; feelings that are both natural and individual.

Continue reading ‘Why we need social entrepreneurs’

TripAdvisor helps us choose hotels and restaurants – so why not where we end our days?

Originally published by The Conversation on August 1st 2017. 

Tony Walter

My 91-year-old mother was deeply unhappy at the geriatric hospital in which she found herself after breaking her ankle.

But we knew little of the alternatives. Official inspection ratings offer impersonal information. So how were we, her children, supposed to gauge the quality of other establishments offering care?

Our saviour turned out to be Alison – my mother’s hairdresser. As a specialist in older, housebound clients, she had continued to do her customers’ hair as they moved to various hospitals or care homes.

Alison gave us the names of three places nearby that our mother might prefer, and we arranged her transfer within 36 hours. It was a move which transformed the quality of her last few months of life.

Unlike formal inspectors, Alison was an unthreatening, secret observer of each of the institutions she visited. She proved to be a knowledgeable and reliable guide. Without her, my mother’s life could have ended very differently.

The trouble is, not every family is lucky enough to know an Alison.

In the UK, people are expected to make their own choices about their own care in the final months and years of life. But how can people become well informed about different care providers, especially when a crisis forces decisions to be made at short notice? Alison revealed the importance of informal contacts and social networks in allowing individuals and families to make good choices.

How could her role be made available to all families seeking similar information? Care settings for those nearing the end of life are, in terms of inspection, a bit like restaurants. Technical medical and nursing procedures, like a restaurant’s kitchen, need inspecting by technical inspectors. But most of the care provided at the end of a person’s life is not of the technical kind. It involves hard to measure factors like respect, a sense of belonging, and relationships with staff. It is in many ways like assessing a restaurant’s ambience. In the hospitality trade, this is something best considered by mystery customers who collectively author good food guides, or by informal online ratings like on TripAdvisor.

Such assessments rightly abandon the myth of objectivity embedded in formal inspections. Potential consumers perusing TripAdvisor ratings understand them as subjective experiences to be taken on balance.

So collective, honestly subjective, online ratings should be available for families to make informed choices about different care settings. For well-being over the course of life, we need to be able to read about customer experiences of health and care agencies just as much as we need to read about experiences of restaurants, hotels and holidays.

A great example of what is needed is carehome.co.uk, which gathers and publishes reviews of care homes, along with other information provided by the home. Many of the care homes listed, however, have no reviews. Care at home is reviewed by the online database homecare.co.uk, although the vast majority of organisations that look after people in their own homes have no reviews.

Those two websites are funded by industry subscriptions. Proposed reviews are authenticated and vetted before publication, and reviewers are advised not to publish complaints but send them direct to the agency. These safeguards should eradicate vexatious reviews, although they may also present an unrealistically positive overall view of user experience. The sites are, however, a step in the right direction.

Of course, TripAdvisor-style ratings for the “last journey” tend to come not from the actual service-user or patient. Most reviews are from family and friends, which could be an issue. Complex family dynamics – such as guilt at putting parents into care, or anxiety that care costs are eating up the inheritance – can mean families are rarely the baggage-free observers that Alison was.

Reviewing the situation

Of more concern is that even the most loving, attentive and observant family member may know little about the person’s experiences at the hands of their paid carers. This might only be achieved by CCTV cameras, but do we really want care homes, hospital wards and (in the case of home care) even the person’s own home to become zones of electronic surveillance?

No way of monitoring or collecting information will be perfect. And we should acknowledge that the trajectory of frail elderly dying is always uncertain. No one can predict how they will feel as bodies and minds fail, so all choices will entail a degree of guesswork.

Rigorous formal inspection – and public enquiries when things go dramatically wrong – are of course essential. But if people nearing the end of life (or their families) are to adopt the prescribed role of informed consumer, comprehensive collations of user experiences are vital.

End of life care is more important than booking a restaurant or the next holiday – so information needs to be just as good, or better.

What death means now by Tony Walter is available with 20% discount on the Policy Press website.  Order here for just £7.99.

Find out more about impact, influence and engagement at Policy Press here.

Policy Press newsletter subscribers receive a 35% discount – sign up here.

The views and opinions expressed on this blog site are solely those of the original blog post authors and other contributors. These views and opinions do not necessarily represent those of the Policy Press and/or any/all contributors to this site.


Enter your email address to follow this blog and receive notifications of new posts by email.

Twitter Updates

Archives

Creative Commons License

Republish our articles for free, online or in print.

The work on the Policy Press blog is licensed under a Creative Commons licence.