Having been away from twitter for a week or so, I thought
I’d try and catch up a bit on what’s been happening with some of the people I
follow. I’m now thoroughly bemused and depressed by what I’ve read. I’m certain
that I haven’t caught up all with the relevant exchanges and blogs, but it
seems that a segment on Victoria Derbyshire Live last Monday linked to the 5th
anniversary of the Panorama undercover programme about Winterbourne View has
been followed by a lot of debate (some of it quite vituperative), largely
directed at @GeorgeJulian (and by extension the #JusticeforLB campaign) on the
basis of George asking some questions of the Mencap representative @dan_scorer
during the TV segment.
There are a few things about how this debate has played out
that confuse me, to say the least, and this blog tries to set out some of the
basis for this confusion. Upfront, I do want to say that any charity worthy of
the appellation should be welcoming the kind of questions George raised with
open arms, rather than seeing them as a threat to their corporate brand. [As an
aside, the unpreparedness of Mencap to respond to these questions suggests that
questioning and challenge isn’t a part of the internal culture of the
organisation either, which doesn’t augur well]. I’m not sure that being late to
this debate helps or hinders, to be honest, but here goes.
The first thing that struck me was the sense that asking
questions about Mencap was in itself
not a legitimate thing to do. It wasn’t that the questions that George asked
received adequate answers (and they are
questions that are being asked about a lot of big charities, particularly those
who are also big service providers); for some people it seemed to be that
questioning Mencap at all was somehow to impugn their virtue or to
negate/insult anything positive that they do. Personally, I’m not convinced
that charity status should automatically confer a shawl of unquestionable
virtue, for a number of reasons.
First, surely the example of Kids Company should be enough
to make anyone want to see transparency and accountability in the charity
sector, and to worry about any charity that takes on the mantle of virtue to
the extent that any challenge to its operations is seen as sour-faced and
illegitimate.
Second, there are inevitable (and
perhaps sharpening) tensions between any charity that functions as a service as
well as a campaigning organisation (and in an English context Mencap is a large
provider of a wide range of services for people with learning disabilities). To
what extent can any such charity bite (rather than lightly nibble) the hand
that feeds it, and how do Mencap’s campaigns negotiate these tensions?
What should be the expectations
of a large charity providing services for people with learning disabilities, to
justify its charity status (including the ensuing tax breaks)? My personal list
would include something like the following (although this list is not
exhaustive, and some non-charitable service providers manage at least some of
these better than Mencap):
- A commitment to human rights (with strong, publicly available evidence that their services are showing a commitment to this routinely, day by day).
- An open, transparent culture of continuous learning to make their services the absolute best possible – to rigorously evaluate how good their services are, to be honest about where things aren’t going well, and to be curious about how to make them better. A quick look at the CQC website shows that, while most inspected Mencap services are rated as good (87, I think), a substantial number (12) require improvement and 1 service was rated inadequate. No Mencap service was rated outstanding.
- Evidence that people with learning disabilities and family members are central to deciding how the charity is run (including how the services are run), what the campaign priorities are, and what the goals of these campaigns are.
- Public evaluation and reflection on whether the campaigns have met meaningful goals, with ongoing debate about the effectiveness of their campaigning activities and what this means for achieving meaningful change.
- Supporting, taking part in and contributing resources to other campaigns and campaigning organisations led by people with learning disabilities and families.
- Generally, ‘being the change you want to see’ (not Mahatma Gandhi, apparently) – for example, if you’re going to campaign about the employment of people with learning disabilities you should be an exemplar employer of people with learning disabilities yourself.
- Supporting people with learning disabilities and families to develop compelling new narratives and policy proposals for a comprehensive, positive alternative agenda for how people want to live their lives and to be supported in doing that.
From an outsider perspective, it
is impossible to know how much Mencap are doing any of these things.
The central Mencap communications
strategy appears to be really quite corporate and ‘on message’, with very
little meaningful engagement with other people outside the Mencap circle. Social
media statements are relentlessly cheery, with lots of openings of things,
fundraising activities, repeats of Mencap campaign statements, and
congratulations to Mencap services getting a ‘Good’ CQC rating. Occasionally there
are calls for the government to do something (although, beyond actions that
result in increased funding for the type of services that Mencap provides,
these calls for action are relatively non-specific). What I haven’t seen from
Mencap is anything when a Mencap service gets a CQC rating of ‘Requires
Improvement’ or ‘Inadequate’, or any reflection on the potential difficulties
and pitfalls in trying to run a large network of services, particularly in
financially straitened circumstances, or indeed any reflection on whether
trying to run a large network of services is itself an obstacle to supporting
people well.
Instead, any inconvenient news
about Mencap is simply ignored (Mencap are adroit users of silence as part of
their communications strategy – the last week being a supreme example). If
ignoral looks like it’s not working, then attempts are made to move public
critique to a private realm (either via statements that are sent to people
individually rather than made public, or via offered ‘private conversations’ to
certain people – I was offered, and turned down, one of these, after I wrote a
blog about the initial Bubb’s breakfast debacle). An alternative strategy is to
deflect accountability by passing the buck to local Mencap branches (as with
the involvement of a Mencap governor on the Southern Health Board of Governors,
or the continued patronage of MP Stephen Crabb of his local Mencap branch).
To me, this seems like the behaviour
of a controlled and controlling corporation, and it makes it hard for me to
look at Mencap’s campaigning without applying a lens of corporate
self-interest. If Mencap wasn’t a charity but was an independent sector service
provider of similar size, would we see these campaigns as a branch of
self-interested lobbying? The strapline Mencap uses for itself, “The voice of
learning disability”, implies a market sensibility – are other voices of
learning disability competitors to be squeezed out? (only one organisation can
be ‘The Voice’, as Saturday night TV has taught us). This is quite apart from
this strapline ignoring People First campaigning over many years (the recent
glossy launch of ‘Learning Disability Voices’ – all service providers,
including Mencap – shows the direction in which voices can apparently be
stretched).
Who sets the terms of Mencap
campaigns? What are these campaigns trying to achieve? How would we know if the
aims of these campaigns have been achieved? The final question in particular
may be impossible to definitively answer, and from my particular glass house of
questionably pointfull activity I don’t wish to throw stones, but I do think
it’s fair to expect public reflection, engagement and challenge on these
issues. It’s hard to know about any of these quandaries from looking at the
Mencap website – there is little public reflection or debate on any of these
issues, and the public face of Mencap campaigns seem to follow the same
corporate logic as the rest of their activities. There is also little evidence
that Mencap support other campaigns which they have not initiated and do not
control (such as #JusticeforLB or more recently #7daysofaction), either in
terms of visibility or putting their muscle to work in support of these
campaigns.
Third, a number of people have
suggested that then (the 5th anniversary of the Winterbourne View
Panorama programme) was the wrong time for George to ask questions about Mencap.
There seemed to be a couple of issues here. One was that this apparently diverted
attention from the Winterbourne View families (although 4 families signed the
letter organised by Mencap, none appeared on the Victoria Live programme and I
don’t know why this was, although another family member of someone who had been
in an inpatient unit did appear) and the issue of inpatient units in general.
Another issue was that asking questions about Mencap diverted attention from a
valuable media opportunity to hold the government to account. I have a few thoughts
about this:
- There has never been a ‘right time’ to enter into a debate with Mencap about any of these issues. Such questions about Mencap (as about a number of large charities) have been rumbling around for some time, and Mencap has never engaged with them, consistent with their corporate communications strategy above. When would have been a good time?
- I don’t think the ‘hook’ of the 5th anniversary of the Panorama programme was particularly significant to the government (although it should have been) – they generally seemed no more concerned than on the 3rd or 4th anniversaries, and a range of issues concerning the scandalous mistreatment of people with learning disabilities seems to be making it into press, TV and radio less infrequently. Any political imperatives lie elsewhere (particularly with pledges Simon Stevens of NHS England made to the Commons Public Accounts Committee, for example, in my view), and a generalised call ‘to the government’ suggests campaigning is being performed without any specific aims in view.
- The ‘resilience’ of inpatient services in the face of policy strictures, concordats and programmes to reduce their number is grimly impressive in its way, and the #JusticeforLB and emerging #7daysofaction campaigns (see this excellent new documentary from @DimitriadiSophi https://youtu.be/n3hqZ2jkvns ) are right to focus attention and action on this. Both campaigns are strongly of the view that inpatient services cannot be seen in isolation, however. They are the end-station of a system that does not support people and families in their aspirations, treats human rights as optional extras, and is less than indifferent to people’s early deaths. I think people generally (and need to) see more than one thing at once.
Fourth, I’m very confused by the
opprobrium heaped on George for undermining the ‘unity’ of the ‘voice of
learning disability’ by asking questions and expressing a different viewpoint
(isn’t this exactly the ‘thought diversity’ beloved of management wonkers?). As
a number of people have pointed out, such diversity is both inevitable and to
be welcomed, rather than suppressed. For me, unity does not mean doing whatever
Mencap says (again, the totalising ambition of being ‘the voice’). My limited
reading about the processes by which ‘successful’ civil rights and other
campaigns have operated included diverse groups agreeing and working together
on a small number of central campaigning aims and strategies, while disagreeing
about a lot of other things. If this is right (and I’m on very shaky ground
here), then Mencap and other large charities would be only one of many ‘voices’
around any such table, and would be contributing their resources to rather than
controlling any such campaign.
This brings me to my last point,
which was raised by George in the Victoria Live discussion and has been
mentioned by other people too, that people with learning disabilities were the
objects of the discussion rather than active participants in it. Part of my
reluctance in writing blogs like this one recently (as opposed to blogs describing
information) is that they occupy space that should more properly be occupied by
people with learning disabilities. I am lucky enough to have met a substantial
number of people with learning disabilities who are more than ready to take on
the leadership of a national campaign, developing the kind of alternative
positive vision needed and making it happen in practice. What are the elements
of that vision, and what should the strategies and tactics be? I don’t have a
clue, and it’s not for me to say. It’s for people with learning disabilities to
come together and kick some serious political butt, with others only
collaborating/contributing if they are called upon.
Compared to many/most organisations involving people with
learning disabilities in England, Mencap has worked very hard (through
continuous fundraising) to get to a point where they have undoubted campaigning
resources and muscle – for example in their connections with politicians and
elements of the media. I would say that some of their campaigning has been
really important in raising issues that had been (and continue to be) swept
under the carpet, notably ‘Six Lives’ (death by indifference). Many (but by no
means all) of their services provide good support to people with learning
disabilities, and Mencap have provided invaluable support to some families (but
not to others). Wouldn’t it be great if Mencap put some of that muscle at the
service of emerging groups of people with learning disabilities working to take
power, rather than seeking to control everything they are involved in? If they
don’t, I can see politically savvy people with learning disabilities simply
bypassing Mencap altogether and treating it as an establishment irrelevance. The
voices of people with learning disabilities will not be denied.
Small point that echoes one of yours about conflict of interest- a few years back I was involved in a local campaign to keep open a specialist autism unit that was part of a mainstream school. I approached two local LD charities, one of which was Mencap, to ask for their support. Both refused, with Mencap citing funding by the local authority as the reason why it refused (both charities were funded by the local authority). The unit was eventually closed, and autism services for children in the area got worse. The charities are still in existence and still being funded by the LA though.
ReplyDeleteThank you for sharing this. Wonder how common this sort of practise is across big service provider charities.
DeleteWhile I agree with a substantial part of this blog, I do think there is a specific point in the interview that generated the heat and escalation of argument that followed. I don't think it has been articulated in the fall out.
ReplyDeleteIn the interview, George offers a number of valid criticisms of Mencap. The problem I feel is that George conflates criticisms of Mencap's involvement in the concordat with their actions as a service provider. This creates an aspersion on Mencap motivations rather than holding them to account for their concordat involvement. This is where the heat is generated.
The implication (intended or unintended) is that because they are crap at service provision, their involvement in the concordat must be in bad faith.
Now Mencap, as you point out Chris, is a big professional organisation working in a tough environment. There are many factors involved in creating good service delivery which involves multiples agencies, funding streams etc. Mencap don't deliver services in a vacuum. If good intentions produced good services then we would live in a much better world. In reality it is difficult especially with the austerity being experienced by public bodies.
Yet many people experience good service from Mencap and meet a lot of good, well-intention people within the organisation. They don't view it as an organisation of bad faith. That they felt defensive about the implication of that conflation is understandable from my perspective. Equally people are very protective of the Justice for LB campaign.
I do feel that the prism of Southern Health needs to be handled with caution when it comes to other service providers. That a service is found to need improvement or inadequate by the CQC does not mean that this is as a result of bad faith. The key thing is what occurs to make improvements when services do drop below good standards for whatever reason. The lesson with Southern Health is the continued failure to make improvements and the lack of aggregation by the CQC until it exploded into the public arena through the Justice for LB campaign. Delivering services isn't easy and problems will occur because these are services run and delivered by people. Its the response to those problems that we should judge organisations on.
My regret from this fallout is that there was a lost opportunity to challenge Mencap on the concordat itself. It is very much a non-action document that commits to more studies and information gathering but very little in the way of tangible objectives (Mark Brown's Cold Rage blog addresses this non-action very well). I don't see how anyone can look at the concordat and think it would lead to significant change. When your man from Mencap stated that they signed to hold people to account, exactly what were they holding account to? That everyone got tea and biscuits at the meetings?
I think that it is fair to challenge Mencap on their expectations for the concordat. I also think it is fair to challenge Mencap on their service delivery especially when things go wrong. Its the conflation in this interview that is problematic and generated the heat and fallout afterwards.
I wholeheartedly endorse your last point Chris. Mencap is a voice but its model is being challenged by LD people themselves. Without getting all Bob Dylan, the spectrum of disability rights has expanded significantly and that gives me hope amid the good intentions and non-action.
This is really useful John, thank you. It's the closest I've got to understanding why I received so much negative energy (repeatedly) especially from one or two people who I asked to explain further, but left me more confused than ever. So thank you, for your interpretation and analysis.
DeleteI wasn't intending to conflate the two issues (and apologise for doing so), and I did ask Dan what exactly Mencap had been doing with regards to their commitment to the concordat. I agree with you that it was a pointless document, little more than an opportunity for 51 organisations to get some PR for their intention to do something, that then turned into doing very little. There has been a lot of 'calling for' since then, and little positive change.
At the risk of doing the same damage, so I tread here carefully, I do think Mencap should be providing safe and indeed outstanding services. The fact they they aren't (always safe and have yet to be deemed outstanding), especially in a post WV-era, while calling on the government to do X, Y and Z does trouble me. The unsafe service, Drummond Court, remained unsafe on re-inspection six months later too with CQC inspectors witnessing distressed residents.
The quality of Mencap services, and their actions as a signatory of the concordat, are related in my mind at least. The observation from Chris about there never being a right time to engage in these debates with Mencap, is spot on, as is the observation that they fail to support other campaigns - just yesterday they remained entirely silent as a parliamentary debate took place into failings of governance at Southern Health, an organisation that has had a Mencap appointed governor throughout the period in question.
I'm glad we can all agree on the final point though, and I look forward to the launch of LD England next week. Thanks again and onwards.
Thanks very much for this John. I was stumbling into this late and feel pretty sure I didn't catch all the aspects of it. Even when it comes to an individual, let alone a large organisation involving thousands of people, on the whole I find talking about a motivation for a set of actions tricky. My motivations aren't always clear to myself, are sometimes mixed/contradictory, and I've done some catastrophic things in the name of my good intentions at the time (that don't look the same in retrospect). So I'm in a weak position to make statements about an organisational intention (if you can even talk about such a thing), although I suspect the campaigning communications more closely reflect a central/senior strategy/'intention' than what people working in Mencap services do on a daily basis, which I don't get to see.
ReplyDeleteI agree with you that people with learning disabilities taking up the cudgels (so to speak...) gives me the most hope - which is also why I need to shut up!