Independence or Protection - does it have to be a choice? Reflections on the abuse people with learning disabilities in Cornwall

This commentary will use recent events in Cornwall to highlight the ongoing abuse of adults with learning disabilities in England. It will critically explore how two parallel policy agendas – namely, the promotion of choice and independence for adults with learning disabilities and the development of adult protection policies – have failed to connect, thus allowing abuse to continue to flourish. It will be argued that the abuse of people with learning disabilities can only be minimised by policies which reflect an understanding that choice and independence must necessarily be mediated by effective adult protection measures. Such protection needs to include not only an appropriate regulatory framework, access to justice and well-qualified staff, but also a more critical and reflective approach to the current orthodoxy which promotes choice and independence as the only acceptable goals for any person with a learning disability.

Future Selves: Career choices of young disabled people

There is growing recognition that gaining the views of young people is crucial for understanding issues that affect their lives. However, to date, very little is known about the way in which disabled children, make sense of their identities, and create a sense of their past and their imagined futures over time. This three year study, funded by the European Social Fund, and conducted by Dr Sonali Shah and colleagues at the University of Nottingham, used various methods to explore how physically disabled students, in full-time special or mainstream education, make choices concerning their occupational futures. It identified the factors that shape their educational and career related choices and chances, and explored how social relations, social processes, and social policies influenced the extent to which their aspirations were achieved. This study presents disabled children and young people as critical social actors who are telling their own stories of how social structures and processes shape their choices and aspirations for their future selves. It illustrates the importance of consulting children and young people about issues concerning their lives, and not rely solely on adults’ conceptions of childhood. The young disabled people’s experiences and views can be used to develop a new flexible system which offers the benefits of mainstream and special education, and facilitates young disabled people’s self-determination to make choices to participate in and contribute to their independent futures.

Human motivation and professional practice: of knights, knaves and social workers

Efforts to improve the efficiency and responsiveness of public services by harnessing the self-interest of professionals in state agencies have been widely debated in the recent literature on welfare state reform. In the context of social services, one way in which British policy-makers have sought to effect such changes has been through the "new community care" of the 1990 NHS and Community Care Act. Key to this is the concept of care management, in which the identification of needs and the provision of services are separated, purportedly with a view to improving advocacy, choice and quality for service users. This paper uses data from a wide-ranging qualitative study of access to social care for older people to examine the success of the policy in these terms, with specific reference to its attempts to harness the rational self-interest of professionals. While care management removes one potential conflict of interests by separating commissioning and provision, the responsibility of social care professionals to comply with organizational priorities conflicts with their role of advocacy for their clients, a tension rendered all the more problematic by the perceived inadequacy of funding. Moreover, the bureaucracy of the care management process itself further negates the approach's supposedly client-centred ethos. The definitive version is available at www.blackwell-synergy.com