Tuesday, February 26, 2008

The drugs don't work....?

A new study from the University of Hull suggests, apparently, that the new generation of anti-depressants have 'little effect'.

At least, this is how it has been reported on the BBC website.  The actual findings suggest that a placebo is just as effective as certain SSRI's in cases of mild to moderate depression, which is not quite the same thing as saying that the pills don't work. In cases of severe depression, anti-depressant medication is considerably more effective than a placebo. 

So, the breaking news guys is that placebos have....well, presumably  a placebo effect.  

The story here seems to be less about the efficacy of SSRI's, and more about lazy journalism, scientific illiteracy and our insatiable desire to sensationalise every bit of news that comes our way. 

(I can't believe I just wrote a post in defence of the pharmaceutical industry. I may need to lie down for a while.)

Monday, February 04, 2008

Crisis? What crisis?

Our social care system is in crisis, according to the annual review published by the Commission for Social Care Inspection this week. Disabled people and the frail elderly face a postcode lottery as local authorities tighten the screws ever further on the provision of social care. The report revealed that councils are implementing increasingly strict eligibility criteria, excluding many vulnerable adults who would previously have been eligible for support.

Fewer frail elderly people are being supported in their own homes, despite a 3% increase in those over 75. Shockingly, some local councils are excluding those who are unable to either wash or dress themselves independently. The burden of care is falling on female relatives families who are under increasing pressure to provide both social and personal care for their elderly relatives.

The social care minister, Ivan Lewis, has made loud noises about the system being both ‘unfair and inconsistent’ and has announced a government investigation into the findings. You might even be convinced that the government was unaware of the shambolic way we support those with social care needs, although personally I think he doth protest a little too much. Try a little experiment. Google ‘social care crisis’ and you will see similar reports going back at least a decade. Or ask a social worker.

Why are we failing so spectacularly to support those members of our communities with high care needs?

As an ex-social worker I have heard many, many (and then some more) complaints and back-of-a-fag-packet explanations from people who are appalled to find that they fail to meet the eligibility criteria for support. A small selection:

  • This bloody tory council doesn’t give a toss about disabled/elderly people.
  • This bloody labour council is too busy giving its money to lesbian basket-weaving classes.
  • This bloody lib-dem council couldn’t organise a piss up in a brewery.
  • Various explanations involving anyone in possession of a foreign accent or dark skin.

I suspect the real reason is more complex, and one that we all ultimately have to take responsibility for.

Anyone over 40 may remember a quaint old thing called consensus politics. Between 1945 and 1979 the major political parties had a tacit consensus regarding the role of the state and its responsibilities. The welfare state and the national health service were born, and subsequent governments understood that the state would provide social and health care to all its citizens, to be paid for through direct taxation and national insurance contributions.

In 1979 we voted overwhelmingly for a woman who sought to abandon the political consensus with her zealous commitment to free-market monetarism. ‘There is no such thing as society’ declared Thatcher, and then proceeded to dismantle the mechanisms which supported it. Rampant individualism replaced the concept of a co-operative society in which the economically active members support the needs of those who are vulnerable through frailty or disability. Apparently we were only interested in government's ability to run an efficient economy. Apparently, we still are.

The simple truth is that as a society we appear to not want to pay the taxes required to maintain a half decent standard of social care. We complain bitterly at increases in our council tax, and vote according to who will give us the lowest tax burden and maintain an efficient economy. We just don’t seem to care about the frail elderly or disabled people, and local government becomes the scapegoat as it struggles to manage with increasingly tough settlements from the centre.

Social care has been in crisis since case law established that local authorities have the right to meet the needs of vulnerable adults within available resources. This was roughly 16 years ago. Perhaps it is time for us to have a full and frank debate as to whether we are genuinely willing to pay for a decent social care system. And if we aren’t, please let's be honest and quit the disingenuous whingeing.