by Stephen Cowden, Senior Lecturer in Social Work, Coventry University (June 2011)

The recent BBC Panorama programme about the abuse of learning disabled people at the Winterbourne View Hospital run by Castlebeck is a moment in which we need to begin to start talking, yet again, about the way these issues have been facilitated by the privatisation of Adult Social Care.

One of the most shocking things the Panorama programme showed, aside from the abuse and torture itself, was the failure of the regulator, the Care Quality Commission to firstly notice any of these issues during their inspections, and secondly to have refused to investigate the complaints that were made by the Senior Nurse who made clear allegations of abuse.  It is salutary to note that if the BBC Panorama team had not made this documentary, all of those things that were shown on this programme would still be going on, with the public none the wiser.

The BBC programme implicity exposes a major crisis in the inspection system – though for anyone who has seen the tickbox approach adopted by many inspectors this might not probably come as that much of a surprise.  The Grapevine learning disability charity’s proposal of User-Led inspections represents an important reform which SWAN could debate and campaign for (

In a discussion of these issues in 2008 in the British Journal of Social Work Professor Malcolm Carey noted that “key sectors of social care are now dominated by business interests, many of which, in principle, seek to gain profits” (2008:919):

Within the private sector dominated market of residential and nursing home care, complex and convoluted rituals of mergers, take-overs, sales and closures have continued…As a consequence such markets have helped to generate unstable (and therefore potentially unsafe) living and ‘support’ environments for many residents.  For example, recent research has highlighted how many private sector providers have failed to meet basic standards of care...Also recent plans by the Commission for Social Care Inspection to reduce the number of care home inspectors, including children’s homes, suggests that presently unacceptable standards may fall even further (2008:923)

(Carey, M (2008a) “Everything Must Go?  The Privatisation of State Social Work” in British Journal of Social Work 2008, 38).

What we are now seeing is the consequences of the things Professor Carey predicted in 2008.  Even more concerning in the light of this is the way the present government’s proposals for the NHS will elevate the role of private providers to an even greater extent, where they will be competing with state run services on cost.  We know from experience that this will be a race to the bottom – with the regime of low pay low skill no training that was used by Castle Beck in Bristol, and is used throughout the Adult Social Care sector, being used to an even greater extent if this bill goes through.

We need to think about ways in which we can use the Panorama programme to alert people to what are in effect the consequences of privatisation.


(Leading SWAN members are among the signatories of a letter to the government calling for action on the issue of the abuse of people with learning disabilities. You can read the letter here and in accessible format here.)

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