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‘I am an worried woman’Dr Margaret Kennedy (PhD) firstname.lastname@example.org
I and my twin sister have a rare neuro-muscular degenerative disorder: Caused by… • Mitochondrial disease Resulting in… • Parkinson’s/parkinsonism • Dystonia • Muscle myopathy
Who am I? • A former nurse • Former Social worker • Former social work lecturer • Specialist/expert on Disability & Abuse • Campaigner on Clergy Sexual Abuse • Disability equality activist • All of these plus my new role… • Service User / Disabled woman
How do you go from being a PhD …university lecturer…speaking at the EU…in the Oireachtas…world wide…to ‘Service – User’ in an age of the Troika imposed austerity?’ It is a profound SHOCK
Being a service user in an age of austerity Brings • Humiliation • Degradation • Loss of self-esteem • Loss of self • Loss of status • Loss of role • Loss of power • Great fear and anxiety Fight Fight Fight
Nessa Childers MEP • ‘throughout the ‘bailout’ countries, [the EU, ECB, and IMF Troika] • …imposition of health cuts is at the heart of their austerity agenda”. • “ shameful dismantling of our health services” • 27thOct. 2013
Research has shown that [in Greece] infections, infant mortality and mental health problems has escalated as a result’. • ‘Doctors from Portugal, Spain, Ireland & Greece sent an open letter to European political leaders and health authorities deploring the effects that financial and economic decisions… are having on the health of their countries. They called for immediate action to reverse this situation’ ignored
‘Groupthink’Irving Janis (1972) Governments unable to see the plight of another group Senior Professionals (HSE managers)unable to see the plight of clients (usually under pressure from Government policies)
Groupthink is … • when a group makes faulty decisions because of group pressures [Troika] • This lead to a deterioration of “mental efficiency, reality testing, and moral judgment”. • Scapegoating of ‘expensive’ clients/service users • [welfare recipients or perceived ‘non-productive, not contributing members of society]
Groups affected by ‘groupthink’ • ignore alternatives and tend to take • irrational actions that • dehumanizeother groups.
Vulnerable groups Clients/ • service users Those with power: Government Troika power
Abandonment • Of perceived ‘less valuable’ members of society • Less productive • Most expensive Elderly Sick Disabled Young adults
accusations of ‘cheating’ the benefit system. • Scrounging • Using our disability for fraudulent purposes • Exaggerating our difficulties. • Disability hate crime. • Abuse, assaults, abandonment
Neurology care 700,000 people with neurological disorders in Ireland Ireland has 7 rehabilitation consultants; if we had 50 we'd still have the second lowest per capita rate in Europe. If we had 150 consultants, we'd have fewer per capita than Serbia, Czech Republic, Estonia, Latvia and Croatia
Professor OrlaHardiman, consultant neurologist: “that with only 33 neurologists in Ireland, Mongolia has more than Ireland has, despite having (1m) fewer inhabitants” Mongolia better than Ireland
She also said, • a number of her patients [with motor neurone disease] who had been awarded medical cards are having them withdrawn, maybe two years into their illness with six to nine months to live.
My recent ‘clinical care team’ meeting only managed to make me feel as if I was a complete ‘object of concern’ not a truly participating adult in my own care plan. More humiliation
Some professionals also engage in ‘group-think’ • The alignment of managers to the government policies of the day…even if they harm the client • The denigration of clients who ‘protest’ because it is THEY who are making the professionals life ‘difficult’. • Scapegoating of clients who do not ‘help’ senior managers keep budgets to Troika/Government demands.
Groupthink professional practice which dehumanises • Conjecture/assumption about client’s wealth or capacity • Malicious judgement about clients • Assessments based on budget constraint not on client need • Breaches of confidentiality • Blaming client when things ‘go wrong’ • Reports/assessments written to fit ‘groupthink’ [austerity politics] rather than reflect reality.
How can we ‘build alliances, defend services’ when two groups are now at war, seen as adversaries rather that collaborators?
Austerity has severe Impact on professionals… scarce resources, fewer workers, Compromising vocation/service ‘care’ resulting in • Sick leave • Rudeness • Phone calls not returned • Blaming clients • Ignoring clients • Scapegoating clients Creating ‘double-binds’ That are intolerable
In the files of Mrs Brown Power-abuse My research ‘Living Well & coping in Co Wicklow in the age of austerity’
Assumptions ‘The architect and I were of the impression that she had private funds as she had allowed him to draw up elaborate plans which she kept changing’(OT) The OT and Architect became the ‘in-group’ over the ‘out-group’ client…even in her own home! The belief was the client was withholding information ; defrauding state!
“Will she need a level access shower in future? If so who will fund it?” (OT) • The ‘in-group professionals’ were aligning with the ‘in-group politicians’. Taking on the rhetoric that the client is ‘expensive to the state’. Decisions based on funds not on need
Social Worker writes on notes: “There is always the issue with Mrs Brown that if she protests enough she will get what she wants” This social worker also admits: “there is a vacant social work post in this area” Client viewed as ‘manipulative’ for requesting a social worker.
Mrs Brown complained about the services she was receiving and was then deemed by HSE to have • ‘unreasonable complainant behaviour’ • Without ANY process or without following any procedures laid down concerning complaints. Scapegoating & Harassment
We must now accept that in Ireland today, poor, sick, disabled and elderly people are slowly being ‘poisoned’ by this government , by the troika, by austerity in all sorts of ways… • Such that life itself becomes precarious… EARLY DEATH is our fear
Our health and welfare services are no longer ‘fit for purpose’, we are on our knees , in fact the whole of the HSE services are falling apart; deliberately dismantled by the troika’ People are dying, will die…or die early or at their own hands in despair.
We have to see the reality of Austerity politicsIt is the intent to save a nation but in doing so annihilating the vulnerableWe saw this in the 1930’s & through the WWII, where ‘out-groups’ were scapegoated and killed. Are we seeing eugenics by stealth?... This is why I am a worried woman.
Poverty • Fear • Anxiety • Hunger • Scapegoating, abuse, abandonment • Cold • No access to health services • Death Austerity more humanly affects, in reality; poorer, vulnerable groups.
I ask you to consider…. • What do I do with the power I have? • Am I working for & with my clients/service users or am I working for the government/Troika? • Because of pressure from austerity policies do I inadvertently ‘dehumanise’ service users?
What can we do? • There must be a respectful alliance between service users and professionals • Positive power with service users is possible • We must return to collaboration with service users… above all
We must ensure that our moral and ethical base is sound and strong • And underpins everything we do • With utter respect for the ‘out-group’
BECAUSE Equality is not for cutting – Human Rights, Human Life
References • Janis, Irving L. (1972). Victims of Groupthink. New York: Houghton Mifflin. • Janis, Irving L. (1982). Groupthink: Psychological Studies of Policy Decisions and Fiascoes.Second Edition. New York: Houghton Mifflin.