79. Memorandum from Help the Aged
1. INTRODUCTION
This Memorandum from Help the Aged explores
the difference that a Human Rights Commission could make to the
lives of older citizens. It sets out some key areas, notably in
health and social care, where the human rights of older people
are currently at risk.
Action being taken by the Government to promote
age equality in employment is very welcome. There are no proposals
at present to extend these measures to protection from discrimination
with regard to goods, facilities and services. However, even if
the proposed equalities legislation were wider in scope, this
would still not provide adequate protection for human rights.
The Government has also taken determined action
to improve the quality of health and care services for older people
and has set new standards, both in the Care Standards Act and
in the National Service Framework for Older People. It has also
reviewed the inspection and regulation system for these services.
These too are welcome steps. However, Help the Aged believes that
they need to be complemented by concerted action, not only to
ensure that individual rights are protected but also to achieve
a change in the underlying culture of the relevant institutions
(both public and private) to one that can systematically protect
and promote the human rights of older people.
The Memorandum explains that older people whose
human rights are violated are often not in a positionor
do not chooseto take action themselves. Indeed, the 1998
Human Rights Act[19]
has been little used to date in relation to health and care issues
affecting older people. We consider how a Human Rights Commission
might offer possible remedy.
The Joint Committee on Human Rights has called
for evidence of unmet needs in relation to the promotion and protection
of human rights in the UK, to which a Human Rights Commission
could provide a remedy. It wishes to know what difference a commission
could make to the lives of citizens, especially those who do not
at present enjoy their full human rights, with an emphasis on
the practical benefits that would ensue from the existence of
such a commission.
The Memorandum seeks to inform this debate.
2. EQUALITIES
PROPOSALS
The EU Equal Treatment Directive requires that
all Member States introduce measures to combat discrimination
on grounds of age by 2006, alongside (in the UK) the existing
grounds of sex, race and disability, and the new grounds of sexual
orientation and religion or belief (where measures are due to
be in force by the end of 2003). However, this applies only to
employment. There are no proposals at present to provide protection
from discrimination for older people beyond the field of employment
and training.
The UK Government is currently consulting on
the establishment of a single equality body to promote equality
across all strands affected by discrimination. The aim is "an
equal, inclusive society where everyone is treated with respect,
and where there is opportunity for all".[20]
Employment
Anti-discrimination measures on age with regard
to employment are not due to be introduced until the end of 2006;
there is to be a further round of consultation during the spring
of 2003.A poll[21]
carried out in December 2002 by the MORI Social Research Institute
for the Government's Age Positive campaign showed that age was
felt to be the most prevalent form of discrimination in the workplace.
A third of those who said they had experienced discrimination
in the workplace felt that this had been due to their age.
Strong measures will need to be taken to ensure
that a hierarchical approach does not develop within a single
equality body. The fact that age will be the last strand of the
Framework Directive to be implemented through domestic legislation,
together with the lack of any existing case law in relation to
age, could tend to minimise its impact. It will require determined
positive action to offset this tendency. The structure of the
proposed single equality body will be significant in ensuring
that age is not marginalised. Whether that structure is functional
or strand-specialist, expertise and understanding on age issues
need to be developed, and the appointment of senior staff with
specialist age-related expertise and responsibilities will need
to be a priority.
Goods, facilities and services
There is considerable evidence that older people
are discriminated against not lust in the workplace but in health,
social care, social security, education, insurance and other fields,
some of which have a bearing on employment and some of which do
not. Much of this evidence is anecdotal as yet, but there is a
growing body of research (especially in employment and health)
which bears this out. [22]For
instance there are significant differences in the average cost
of social care to older and younger adults. The average cost of
an older person receiving home care is £72 a week, while
for younger adults it ranges between £91 and £203 a
week With day care, spending on older people averages £50
per person per week, while for younger adults the average ranges
between £89 and £203 per person per week Residential
and nursing home costs in respect of older people average £338
per week, whereas for younger adults they range between £418
and £663 per week. [23]
These figures are averages only, and might reflect
a lesser level of need amongst older people. However, that seems
unlikely, as social care for older people is heavily rationed
and eligibility criteria have been becoming tighter and tighter
year by year. Such differences in expenditure inevitably impact
on the availability of help generally (how easy it is to access),
the amount of help individuals receive (hours per week), the quality
of that help, and the choice available. It seems inevitable that
the nature and quality of social care for older people will continue
to lag behind that for younger adults while such spending disparities
exist.
It is our belief that action on discrimination
should be extended beyond employment to goods and services for
older people, as it already is for those affected by discrimination
on grounds of sex, race or disability. The positive duty on public
bodies to promote equality enshrined in the Race Relations (Amendment)
Act 2000 should be extended to cover all fields including age,
as it is in Northern Ireland, where it is having a significant
impact.
Single equality legislation, building on the
best and most far-reaching provisions of existing law, is therefore
a high priority and would establish greater consistency and a
level playing field between the different strands of equality.
Policy initiatives
Even without the benefit of legislation, however,
the Government has taken action on age discrimination with regard
to health and care services. Standard 1 of the National Service
Framework for Older People, published in March 2001, says:
NHS services will be provided, regardless of
age, on the basis of clinical need alone. Social care services
will not use age in their eligibility criteria or policies, to
restrict access to available services. [24]
A series of milestones have been established
which require NHS bodies to examine written policies and change
any which show evidence of age discrimination; analyse the levels
and patterns of services for older people in order to compare
them with those in comparable areas; and move towards best practice
benchmarks. The extent to which trusts are pursuing anti-discrimination
measures variesthere is evidence that in some trusts, this
standard is not being pursued as vigorously as other targets set
by the National Service Framework for Older People or other priorities.
However, there is no statutory requirement on health trusts generally
to promote compliance, other than through the clinical governance
reviews to be undertaken by the Commission for Health Improvement.
Social care bodies are required to review their
eligibility criteria for adult social care to ensure that they
do not discriminate against older people. Guidance[25]
has been issued under section 7(1) of the Local Authority Social
Services Act 1970, which requires local authorities and care trusts[26]
to act under the guidance of the Secretary of State and so, in
relation to social services authorities, it has some statutory
force.
Action is going on nationally and locally to
understand and identify both direct and indirect age discrimination
in health and care services; to determine when and where distinctions
on the basis of age may be justified and when they may not, and
to consider where changes in practice and behaviour need to be
addressed in order to root out discrimination. No specific resources
have been identified for either health or social care to remedy
age discrimination where it is found or to bring services for
older people up to the expected standard of those for younger
adults.
However, it should be noted that even the most
extensive application of equality measures will not impact on
most situations where older people's human rights are at risk.
3. HUMAN RIGHTS
ISSUES
There are a variety of circumstances where older
people's human rights are at risk. Those to which we wish to draw
attention largely concern the health and social care systems.
This is not to say that these systems are particularly at fault,
but rather reflects the fact that it is at the point of contact
with the health and social care system that older people are most
vulnerable and most heavily dependent on others.
The following examples of potential human rights
violations are illustrative only, and do not attempt any exhaustive
account of the range of such issues affecting older people.
Medical care in care homes
Lack of access to medical care and suitably
qualified staff in residential and nursing homes can put the lives
of older people at serious risk. An inquest in Eastbourne in October
2002 found that an elderly woman with Alzheimer's Disease died
of dehydration after a week in a care home, because no one understood
that she needed help with drinking and eating. In another case
in north London, a man with mild dementia was taken off medication
for his heart condition when he went into a care home, in spite
of detailed instructions left by his wife. Instead Temazepam (a
short-acting benzodiazepine normally prescribed to prevent insomnia)
was administered. His health deteriorated rapidly and he died
a few weeks later.
In this second example no inquest took place.
There is no available research, but we suspect that deaths in
care homes are often assumed to be natural and expected, solely
because of the age of the residents, and thus that investigations
are rare. The organisation Inquest has been approached by families
following care home deaths and has been able to persuade coroners
in these cases to carry out an inquest, but shares our concern
that these are the exceptions and not the rule. In some circumstances,
depending on the level of involvement of the local authority or
trust, the failure to investigate such a death adequately would
breach the requirements of Article 2 of the Act (the right to
life). Whilst these requirements can be satisfied through the
inquest system, the right to life of older people in residential
care currently appears not to be adequately protected.
Closure of homes
Local authorities and private proprietors not
infrequently wish to close a care home because it is no longer
financially viable or because it does not meet the required environmental
standards. There is strong research evidence to show that when
frail older people are moved from a care home in which they are
living, there is a significantly increased risk to their health
and, indeed, an increased risk of death. "Good practice"
standards on the closure of care homes exist which are intended
to minimise the risk to residents, but the residents themselves
have no say in the matter and good practice is not always followed.
Older people in these circumstances also lose
the company of friends amongst the staff and other residents,
and the familiarity of a way of life and an environment which
has become their home, which seriously affects their quality of
life and wellbeing. Home closure is one of the very few areas
in which older people's human rights have been considered by the
courts. The recent case of R (on the application of Madden)
v Bury MBC[27]
confirmed that the Human Rights Act requires the local authority
explicitly to consider whether Articles 2 and 8 (the right to
respect for private and family life) are engaged by any closure
decision and, in the case of Article 8(1), whether any likely
breach can be justified under Article 8(2). It was not enough
for the council to assert that human rights had, in general terms,
been considered. However, the courts have not yet developed a
systematic approach to dealing with human rights issues in this
social and economic sphere.
A telling example is that of the proposed closure
of Granby Way, a local authority care home for older people in
Plymouth. The Court of Appeal found no point of legal principle
to decide in R (on the application of Cowl) v Plymouth City
Council[28]
and encouraged the parties to resolve matters through an "extraordinary
complaints panel" comprising a former judge, a care expert
from Help the Aged and a former social services director who is
currently chair of a primary care trust.
The findings of the panel were not expressed
in the language of the European Convention on Human Rights, but
nonetheless in effect upheld the residents' complaints that the
decision to close their home did not take account of the threat
to their right to life (Article 2), to protection from inhuman
and degrading treatment (Article 3) and to respect for private
and family life (Article 8).The panel concluded, among other things,
that "Growing old is not an illness, and people's age must
not be used as a justification for restricting their rights in
any way? It appended to its report draft guidelines for local
authorities when considering and implementing closure of a care
home. These guidelines place responsibility for safeguarding older
people's human rights at the heart of the process. This positive
recognition of the rights of vulnerable older people goes much
further than the courts have gone thus far. Whether the recommendations
of the panel will be adopted by way of formal statutory guidance
remains to be seen, but the case is illustrative of the sort of
work that could be undertaken by a Human Rights Commission.
Family separation
It is not uncommon for older couples to be separated
against their will when the local authority says that it cannot
provide sufficient care to one of them to enable them to continue
living at home, and he or she must instead go into residential
care. In a case in Oxfordshire in November 2002, an older couple
were placed in two different homes, though the situation was soon
rectified after it was exposed in the press. This flagrant disregard
for the Article 8 rights of older people indicates the lack of
any systematic, conscious application of human rights in this
area and underlines the need for a change in the culture of care
planning.
Funding panels
Local authorities operate funding panels, through
which they attempt to balance demand for care with the resources
available. The eligibility criteria applied vary from authority
to authority, [29]but
are typically strict due to the need for local authorities to
manage their resources. Nonetheless, older people who do meet
local authority eligibility criteria for support and are thus
entitled to services do not necessarily get them. They may be
told they will have to wait or pay for services themselves regardless
of their income because the local authority has "run out
of money".[30]
This unlawful practice is unfortunately commonplace.
Individual cases are settled to avoid threatened litigation, but
the widespread use of funding panels to ration care continues.
Individuals then find themselves unable to access essential services
they have been assessed as needing, thus forcing them to live
in conditions which, in some cases, may be sufficiently severe
as to constitute inhuman and degrading treatment within the meaning
of Article 3 and potentially put their lives at risk. There is,
as far as we know, no monitoring of how many people die in their
homes or following emergency admission to hospital because they
have been denied a service they were assessed as needing.
Personal expenditure
The level of the Personal Expenditure Allowance
which is intended to meet personal costs over and above care home
fees (set to rise to just over £17 in April 2003) is not
sufficient to replace clothing or other significant items. Ordinary
needs and pleasures, such as a trip out or a bottle of wine or
a gift for a relative or friend, have to be carefully budgeted
for and many have to be foregone. Furthermore, there is research
evidence that, in breach of Article 1 of Protocol 1 (protection
of property), some older people do not receive their Personal
Expenditure Allowance, because it is being used towards the cost
of their care or for other purposes. [31]
Hospital care
There are numerous examples of poor treatment
of older people in hospital, ranging from rudeness and lack of
attention to downright neglect and abuse. [32]Again,
in some cases this attains a level of severity that constitutes
inhuman or degrading treatment. The following are quotations from
letters received by the Dignity on the Ward campaign. [33]
A nurse unceremoniously lifted her shift garment
they had put on her and exposed her completely in front of my
son and I. It seemed terrible to me for her to be treated in such
an undignified and humiliating manner.
The nurses insisted that he get up and out of
bed, and, despite his poorly condition and his helpless protestations,
they insisted on ramming him into a wooden "high chair"
with a bar across to keep him in position, quite oblivious of
the fact that he had a cracked vertebra, in addition to curvature
of the spine, and there he had to sit in agony until he was released.
Every day without fail and regardless of my
time of arrival I had to change my father as all his clothes were
permanently soaked in urine.
She was most upset because she kept on asking
for a bedpan and no one arrived, or on many occasions, arrived
too late and she wet herself. She was both embarrassed and hurt
at the reaction she got to having wet the bed. She ended up with
no dignity at all.
There are also particular issues with regard
to people with dementia being treated for an acute medical condition
on an ordinary hospital ward, and the need for a proper understanding
of their care. [34]
With regard to the care required by older people
from minority ethnic communities and the protection of their human
rights when in hospital, the issues of privacy and dignity raised
echoed those above. For instance, one person reported being left
"soiled for ages" which made her feel "embarrassed
and angry", while others reported having no privacy. However,
issues of language, diet and culture, and sometimes racism, created
additional problems. Appropriate food remained a big problem,
as did a lack of interpreters and the inability to communicate
with medical staff. [35]
Restraints
There are areas where the application of human
rights is not straightforward and rights may be in conflict. These
difficult ethical areas require investigation and clarification.
For example, the use of restraints is not uncommon in some care
settings. These restraints may be physical, taking the form of
locked doors or chairs placed in such a way that the person sitting
in them cannot rise or move elsewhere. They may be chemical and
take the form of drugs which have a calming or sedative effect.
They may be electronic and take the form of "tags" which
enable people to be tracked when they leave a particular building
or environment. While there are professional guidelines about
good practice in the use of restraints (though these may not always
be followed), the application of human rights dimensions to these
practices requires urgent and independent consideration. [36]
There are other situations where older people
face discrimination in relation to enjoyment of a particular human
right. One example is the distinction between the scope of disability
benefits available as between Disability Living Allowance and
Attendance Allowance. However, for the purposes of this Memorandum
we have concentrated on highlighting areas where human rights
protection is needed in absolute terms, rather than where these
rights overlap with equalities issues.
4. PRIVATE OR
CHARITABLE PROVIDERSWHO
IS RESPONSIBLE?
Increasingly, the provision of residential and
nursing home accommodation for older people is made through contractual
arrangements between the local authority and private or charitable
providers. This contracting out of service provision leaves older
people vulnerable and currently unable to enforce rights under
the Human Rights Act since the Court of Appeal confirmed the view
of the Administrative Court in R (on the application of Callin
and Heather) v The Leonard Cheshire Foundation[37]
that the activities carried out by the care provider did not constitute
public functions because the local authority's public law duties
were not delegated to the Leonard Cheshire Foundation by the arrangement.
Although Lord Woolf expressed the view that
"it would arguably be possible for a resident to require
the local authority to enter into a contract with its provider
which fully protected the residents' Article 8 rights" (to
respect for private and family life), this is unrealistic at an
individual level. Individuals will not know in advance that they
need this protection, nor wilt they be in a position to protect
their human rights by way of a contract.
There is an urgent need to safeguard this vulnerable
group of older people. It is not, in our view, adequate to leave
the responsibility for securing the protection of human rights
to individuals to exercise at a time in their lives when they
are powerless and facing many difficulties. The necessary safeguarding
of human rights, particularly those protected under Articles 2
(the right to life), 3 (to protection from inhuman and degrading
treatment) and 8, must be secured by the positive actions of the
state if they cannot be protected by individual redress to the
Act. This can be achieved through directions or through statutory
guidance, but the work of a Human Rights Commission would help
to ensure the effectiveness of any such guidance or directions.
"Self funders" (older people who meet
the full cost of their care themselves) are particularly vulnerable
to human rights abuses. Many people within this group go into
care homes without the involvement of the local authority, often
because the authority, knowing they will not be responsible for
funding, encourages the individual and their family to make their
own arrangements, thereby avoiding having to undertake assessments
and make the necessary arrangements to accommodate under Part
III of the National Assistance Act 1948. In these circumstances,
this group would not have the protection of any human rights compliance
clauses in the local authority contract with its care providers.
This group could be protected, under existing law, if social services
authorities were required to assess and to make arrangements to
accommodate "self funders" so that they too could benefit
from such contract clauses.
However, perhaps a more reliable method of ensuring
that human rights are respected by care homes is to require express
incorporation of human rights standards and statements on compliance
as a pre-condition to registration under the Care Standards Act.
The urgent need for action following the decision
in the Leonard Cheshire case is underlined by the alarming findings
of the British Institute of Human Rights in gathering evidence
of the impact of the Human Rights Act. In relation to older people
the report observes that "the interviews conducted . . .
suggest that the Human Rights Act has so far made no difference
to the quality of care in residential homes." [38]
5. OLDER PEOPLE
WILL RARELY
COMPLAIN
No matter what their experience, older people
who are subjected to abuse will rarely complain. Help the Aged
ran a two-year campaign between 1999 and 2001, called Dignity
on the Ward, to improve the quality of care given to older people
in hospital. Over 1,300 complaintssome of which are quoted
abovewere received from members of the public. The complaints
ranged in severity from dirty wards and lack of respect to abusive
treatment and downright neglect However, the great majority of
those complaints came from relatives or friends of the abused
person, and often only after that person had died. It was very
common for the older person not only to remain silent, but to
plead with relatives "not to make a fuss", while relatives
themselves often felt that complaining would only put the person
concerned at even greater risk. [39]This
experience is echoed elsewhere:
Many relatives were phoning to discover what
could be done to help a victim who could not contact the helpline
themselvesfor example, because they lived in a care home
and had no access (or no private access) to a phone or they had
dementia or another disorder which meant that they had communication
difficulties. [40]
Action on Elder Abuse, a specialist voluntary
organisation, classifies abuse under five headings: physical,
psychological, financial, sexual and neglect. In 2000, Action
on Elder Abuse published an analysis of 1,421 calls made to its
confidential helpline between 1997 and 1999. A quarter of the
calls concerned abuse in institutional settings such as hospitals,
nursing homes or residential homes; the remaining three-quarters
concerned abuse in people's own homes (including sheltered housing).
The number of calls concerning abuse in care homes was disproportionately
large, given that only around 5 per cent of people over 65 live
in such settings. The greatest number of calls reported a care
worker as the abuser, with nurses the second largest group.
There are a variety of possible reasons why
older people may resist making a complaint:
Physical reasons include lack of
energy and feeling ill: just keeping going from day to day may
require all someone's determination and willpower. Some forms
of illness, such as a stroke, may restrict the ability to communicate
either verbally or in writing, and poor eyesight or hearing can
also impede communication. Inability to speak or understand English
and lack of literacy are also clearly additional barriers.
Around two-thirds of older people
in care settings have moderate or severe dementia, resulting in
increased powerlessness and vulnerability. At times, this may
be sufficiently severe to result in mental incapacity. Furthermore,
when someone does complain, they may not be believed.
Psychological reasons contribute
to an unwillingness to complain: older people share with other
victims of abuse the emotional reactions of depression and shame
and may have a desire to keep the abuse hidden. They may fear
the consequences of exposing "private" experience to
others and setting in motion reactions over which they have no
control.
In some care settings, for example
in hospitals or in residential homes, individuals may lack easy
access to a telephone or to the necessary privacy to use that
phone or talk to visitors in confidence.
Older people may be uncertain of
their rights, lack access to information about these and may not
know who to contact. Older people without close relatives may
have no visitors concerned about their welfare, and no one in
whom they can confide or who is in a position to protect their
interests. Advocacy schemes which focus specifically on the needs
of older people are scarce, and even where they exist, knowledge
about their role and how to contact them may not be available
to those who need them most.
Older people and their relatives
may fear retribution or repercussions whether from paid staff
or from others, especially in situations where the older person
concerned is particularly powerless and dependent on others. This
could be either in their own homes, and therefore behind closed
doors, or in a communal setting such as a hospital or care home.
In these circumstances, leaving the individual
to assert their human rights through the courts is very rarely
a realistic option.
6. WHY A
HUMAN RIGHTS
COMMISSION IS
NECESSARY
The evidence above demonstrates that, despite
the incorporation of human rights into domestic law, many older
people do not have the protection of the law at a point in their
lives where they most need it.
In summary:
To expect human rights law to be
enforced by individual action is unrealistic and fails to protect
those older people most at risk.
Moreover, litigation is an inadequate
and expensive way of bringing about change. It relates only to
specific instances, generally limiting its impact to the facts
of the particular case, and is both unpredictable and very slow.
Some abuses of human rightsfor
example regarding funding panels or the closure of homesare
"built into the system" and therefore require systemic
change. There is an urgent need to ensure that human rights dimensions
are incorporated into the policies and practices of health and
care service providers.
The majority of residential and nursing
home provision and around half of all domiciliary care is now
contracted out to the private or voluntary sectors. However, the
human rights of older people are not at present protected under
anything other than a public function. There is currently a lacuna
in the law that leaves older people in receipt of care from a
private or charitable provider exposed to risk and deprives them
of the protection of the law.
There are debatable areasfor
example regarding the use of restraints of various kindswhere
it is unclear where human rights are at issue and how the Human
Rights Act should be interpreted.
Most of the examples described above
would not be remedied by even the most comprehensive equality
legislation. We cannot envisage a context in which such legislation
could adequately protect the fundamental human rights issues facing
older people.
The functions of a Human Rights Commission
A Human Rights Commission is, in our view, essential
to developing an effective method of promoting a human rights
culture for the benefit of older people and remedying some of
the wrongs we have identified. A commission could:
Assist and support the Joint Committee
on Human Rights in advising the Government with regard to the
implementation of the Human Rights Act.
Monitor national policy to ensure
that it conforms to the requirements of the Act and maintain a
strategic responsibility to identify and investigate areas where
further action may be required.
Provide information, education, guidance
and advice to public bodies and private organisations operating
in similar fields to enable them to incorporate an understanding
of human rights into their policies and practice.
Promote awareness of human rights
amongst the public, and provide education to those organisations
offering information, advice and guidance to the public.
Bring proceedings on behalf of individuals
or groups which are unable to take action themselves, referring
individual cases, and, in public interest cases, support individuals
wishing to take legal action with regard to their rights.
Undertake public inquiries in areas
of doubt or dispute or where it seems that human rights are not
being upheld.
At present implementation of human rights depends
on older people taking individual action through the courts. This
is not a realistic option for many of those most at risk, as we
have demonstrated above. Further, it is unlikely that older people
themselves will be in a position to take legal action on all the
fronts required. At best this would take time and would leave
many people at risk while the application of the Act to these
situations was established. A Human Rights Commission could short-circuit
this process and ensure that the rights of older people established
under the Act could be brought into play more quickly and effectively
and with less need for recourse to litigation.
There are no alternative ways to ensure that
the human rights of older people are upheld and to provide effective
remedies where they have been violated. The Local Government and
Health Service Ombudsman's jurisdiction does not extend to the
investigation of complaints of Human Rights Act abuses.
Voluntary organisations advocating for older
people are not allowed to take action on their behalf or in their
name as this can be done only by those who are direct victims
of the abuse. The potential for voluntary organisations to play
a role in public interest litigation in this area by assisting
the court as either third party interveners or as amicus curiae
only arises if individual cases reach the court in the first
place.
The evidence also demonstrates that a human
rights culture does not yet exist in those fields where older
people's rights are most at risk. Some of the circumstances described
above relate not to individual actions but to an abuse of human
rights which is built in to the system. Disregard or violation
of human rights resulting from the decisions of funding panels
or from a public or private provider deciding to close a home
are examples of "systemic" problems. It indicates that
those responsible for operating the systemdevising the
policies, managing the services and training and managing staffdo
not as yet appear to take the principles of the Act fully into
account.
Anti-discrimination measures regarding age are
due to be brought in 2006. These will cover only employment. However,
even if the law on equality were to be extended to goods, facilities
and services, as we would advocate, equality measures alone would
not be sufficient to tackle most of the situations described above.
A duty on public bodies to promote equality (as in the Race Relations
(Amendment) Act 2000) might, if extended to age, go some way further,
but would still not cover human rights issues where these do not
have an equalities dimension.
The Government has introduced new care standards
and inspection arrangements for health and care services, which
will undoubtedly improve standards in the longer term. The publication
of statutory guidance[41]
on protecting vulnerable adults from abuse is another welcome
initiative in paving the way for a more positive approach to human
rights obligations. However, these need to be backed by an understanding
of the human rights dimension and the integration of this into
the standards. By promoting a human rights culture and encouraging
health trusts and local authorities to integrate a human rights
perspective into their practice, a Human Rights Commission would
help to ensure that these standards were realised and delivered.
In this Memorandum we have not examined possible
institutional arrangements for a Human Rights Commission, nor
looked at whether it should be free-standing or included alongside
equalities in a single commission to cover both. We will do so
in responding to the Government's consultation on a single equality
body in February 2003, since the issue is specifically raised
there.
However, we believe the case for a commission
to ensure the implementation of the 1998 Human Rights Act to be
very strong. Indeed, we believe it is essential for the protection
of older people at a time in their lives when they may be at serious
risk.
January 2003
19 1998 Human Rights Act (1998). London: The Stationery
Office Back
20
Office of the Deputy Prime Minister (2002) Equality and diversity:
making it happen. London: ODPM Back
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