Campbell:failures of care for those with mental disabilities

Hard to imagine a more disturbing insight into the treatment of the vulnerable than the Health Ministry report on Te Roopu Taurima o Manukau. The Ministry has found that the country's only kaupapa Maori intellectual disability residential care provider has been “seriously dysfunctional.” Reportedly, the organization has about 300 people under its care, and employs about 500 staff in 54 separate homes in Auckland, Northland, Waikato and Canterbury.

In information supplied to RNZ in conjunction with the release of the report, the Ministry indicated that the alleged failures of care over the past two years had included 14 accusations of assaults of clients, two of abuse, 17 escapes (some of its residents have been directed by the courts to be held in what are supposed to be secure sites) a fire, a medication error, and a car accident. According to RNZ:

The ministry says the business has failed to recruit and retain quality staff - and says the kaimahi (caregivers) that have been employed are seriously unsuitable for the job, lacking basic knowledge. But Te Roopu Taurima o Manukau doesn't get all the blame. The report says there's a significant gap under disability laws to ensure there's oversight by qualified clinical professionals.

As the report says, some of the people being cared for by Te Roopu Taurima o Manakau have serious mental illnesses and some of them exhibit “extremely challenging behaviour.” Regardless, the report finds there has been “serious failings in the care provided by the centre in both the surveillance of its patients and in delivering the support they needed.” (There were allegations of assault of residents by staff and by other residents, and of incidents of sexual assault and bullying between patients) If the Ministry has failed in its oversight role – and the buck for that has to stop with the Minister Tony Ryall, not with his officials – a good part of the reason appears to have been economic. Again from RNZ:

From 2010 the organisation changed its priorities, towards growing the business and away from patient support – which the report says should have been its core objective. Also it says management decided to investigate only serious complaints rather than responding to all of them - which meant that basic abuses such as bullying and assaults had slipped through the cracks…

At the staffing level, there had been related failures in the areas of training and retention – partly driven again, one assumes, by economics as by any cultural imperatives:

This meant that patients were poorly supervised. There were instances where staff were placed in caregiver roles when they had little or no understanding of the job, but had been hired because of cultural appropriateness. Also three members of one family held managerial positions, which the report says, stopped proper checks and balances. In these situations, staff can be caught between being loyal to the family and doing what’s best for patients.

It would be unfortunate if the response gets bogged down in arguments over cultural relativism. Go back to the part of the report that signals the existence of a significant gap under disability laws to ensure there's proper oversight by qualified clinical professionals – because serious problems have been also alleged by the Ministry about facilities such as Parklands in Auckland, sparking media reports with headlines such as “Boy Left To Eat Grass at Horror Home”:

Clients at Parklands, a residential facility in Pukekawa, south of Auckland, were forced to live in crowded, dirty conditions surrounded by more than 35 small dogs, fed inadequate food, neglected by untrained staff, provided with no meaningful activities and denied access to their own money, according to the Ministry of Health.

Similar accusations have been levelled at a Mary Moodie home in Christchurch:

The Ministry of Health has appointed temporary managers to the Mary Moodie Family Trust facility in Ferry Rd after at least 16 complaints from concerned family members in the last six months. The Press reported on Monday that parent Fay Gillman was angry no action had been taken by the trust or the Health Ministry after her daughter Leanne, a resident at the facility for about 20 years, was allegedly assaulted by two staff members in separate incidents earlier this year. Gillman claimed there had been issues of neglect and abuse at the facility "for a long time". A statement sent to The Press by the trust's board yesterday said the comments were "misleading and unhelpful".

No doubt, there are many private sector facilities for those with intellectual disabilities that are run well. Yet equally, there are a recurring instances where the introduction of market incentives into the care of the most vulnerable is harming them, in a climate where there is an absence of adequate regulatory oversight by the Ministry. Call it the Pike River syndrome. No doubt, in the current climate, the people supposed to be carrying out that oversight role were seen to be part of the backroom bureaucracy have been done away with in the name of economic efficiency. The Ministry (and its Minister) need to show more willingness to employ and to fund an adequate regulatory fence at the top of the cliff, rather than sending around the ambulance after vulnerable people have been harmed. As things stand, the system is failing the mentally ill – and too many are being treated as collateral damage in an increasingly market-driven system of care.

How Do You Solve a Problem Like Murray–Ah ?
Apologies to Julie Andrews, but what can be done about Foreign Affairs Minister Murray McCully? Keep him at home and he wrecks the likes of the Tourism Board and the Ministry of Foreign Affairs. Send him abroad to meet with US Secretary of State John Kerry and he embarrasses the nation. (How do you find a word that means Murray- ah? A flibbertijibbet! A will-o'-the wisp! A clown!)

Frankly, its hard to tell the difference between this report in the NZ Herald about McCully’s visit to Washington and this satirical report on McCully in The Civilian. That’s because in the allegedly straight reportage, we get this gem:

Mr McCully offered New Zealand's support in the eventuality that Mr Kerry achieves a breakthrough in peace talks between Israel and the Palestinians for a two-state solution. "If we get into a situation where there is any Middle East peace process fashioned, clearly there will be a need for international support on the development and the security front."

Not that we’re in that situation, mind. In case no-one noticed, peace is not about to break out between Israel and the Palestinians, but boy if ever it did, John Kerry can rest easy at night knowing we’d be there to help:

"At this stage what we've agreed to do is to keep talking because we're not at a point where there's anything taking particular shape yet.

Ah huh. Then this killer line from McCully: “But the fact that he's going back for a fourth time tells us he's deadly serious." Wooo…four times to the Middle East by a US Secretary of State. Really racking up the frequent flier miles. Must be some serious statecraft afoot! Well…I hate to be the one to break the news to McCully, but John Kerry is not heading to the Middle East right now to broker peace between Israel and Palestine, but because all hell is raining down on the US strategy over the war in Syria. That’s S-Y-R-I-A for the benefit of our Foreign Minister. Kerry is trying to broker a peace deal about S-Y-R-I-A.

And what are Kerry’s current problems with the US “leadership from behind” strategy towards Syria? Well…for starters, the well trained and well armed Shia Hizbollah militia from Lebanon has just come in on the side of Iran and the Assad regime, and against the Syrian opposition forces and their Sunni mates in al Qaeda – and this is having an immediate effect on the ground, as evidenced recently in the fighting for the strategic town of al-Quasir.

Meanwhile, one of the Syrian opposition’s main jihadi fighting groups (Jabhat al-Nosra) may have just split apart because the Iraqi faction of the Al Qaeda franchise has been trying to exert too much control over the jihadi fighters inside Syria. In a further headache for Kerry, Assad is trying to provoke Israel (in the wake of Israel’s attacks near Damascus) so that Israel will massively respond, and thus make it that much harder for the jihadis to keep on attacking Assad in apparent unison with their declared arch-enemy, Israel. Somehow, Kerry has to try and urge restraint on the Israelis, so they don’t fall into the trap that Assad is laying for them and thereby even further screw up the US support for whatever faction the US thinks it can arm this week, without you know, handing weapons directly to the local squadrons of al-Qaeda. Oh, and the Russians are also coming in on the side of the Assad regime…

Kerry must be thinking - can the US just concentrate on brokering a peace deal that includes Assad and these Syrian opposition bozos and get the hell out of here? Meanwhile, this idiot from New Zealand is saying that he wants to send NZ troops to police a peace deal between Israel and the Palestinians? What’s the matter with him - don’t they get CNN down there?

ENDS

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