Vulnerable Adults – Who’s Abusing Them, Who’s Protecting Them?

BBC News Wales is reporting a rise of 11% in the number of investigations into alleged abuse of vulnerable adults in Wales last year

This news report covers a variety of angles and mentions neglect as well as physical, emotional, financial and sexual abuse. Age Cymru as well as Welsh Women’s Aid are quoted and Welsh Women’s Aid boast that they are currently delivering training to health and other public sector professionals to help them identify ‘vulnerable women’ who are at risk of or experiencing abuse’, to enable these women to be ‘signposted’ to specialist services for help. A Welsh Govt spokesperson commented that it would ‘explore the data with partners’ to establish why there has been a rise in numbers. They added that they ‘must remain vigilant and ensure measures are taken to prevent abuse and neglect’. They also mention that the Social Services and Well-Being (Wales) Act ‘strengthens arrangements to safeguard children and vulnerable adults’.

There’s the ever-present elephant in the room here – what happens when it is health and welfare staff doing the abusing rather than the protecting? The Welsh Govt mentioned safeguarding children – have they forgotten that the biggest child abuse scandal ever to hit Wales was the north Wales child abuse scandal that involved a paedophile ring being run through and concealed by Gwynedd and Clwyd Social Services? And that the mental health services in north Wales were happy to section and discredit some of those children who complained of abuse when they got older? Can I also recommend that someone from the Welsh Govt reads this blog and the account of what happened to me at the hands of the north Wales mental health services for thirty years – I was of course classed as a ‘vulnerable adult’. Oh hang on, the Welsh Govt don’t need to read the blog – I wrote to them repeatedly telling them what was happening to me and I still have the e mails to prove it. The Welsh Legal Services also had access to all the documentation that I am now using to write my story – documentation that details again and again the mountain of evidence demonstrating that there was serious abuse of patients in the north Wales mental health services dating as far back as 1985. Perhaps the Welsh Govt’s legal advisors didn’t understand the complexities of medical negligence cases? Well that’s a little odd, because who was the Welsh Govt’s Counsel General between 2011-2016, when my documentation was made available to them and when the threats and harassment from Martin Jones et al at the Betsi were raining down on me like there was no tomorrow? None other than Theodore Huckle QC, who had previously been a medical negligence specialist… Were the Welsh Govt perhaps having to deal with a particularly tricky situation at the time of Theodore’s appointment that might have pivoted around medical negligence? (Presumably Carwyn and Theodore forgot that the person involved in that case really enjoyed research and writing!)

There are only two brief acknowledgements in the BBC report that health and welfare staff may be the ones abusing the vulnerable adults rather than protecting them. It was admitted that regarding people who had been victims in their own homes, ‘staff’ were most likely to be responsible for the abuse and the spokesman for Age Cymru mentioned that abuse could take place in ‘care’ settings. Of course, the most high profile case of elder abuse in Wales since the Ely Hospital scandal in the 1960s was at Tawel Fan, a ward at the Ablett Unit at Ysbyty Glan Clwyd, run by the Betsi. No-one has yet been disciplined or held to account for that and it was reported only a few weeks ago that staff at the Betsi were refusing to co-operate with the external investigation being conducted by Donna Ockenden into events at Tawel Fan. And Darren Millar is the only politician who does not mince his words regarding the horror of this scandal. Events at Tawel Fan came to light through the actions of a whistleblower who made an undercover recording in 2013 – when Theo Huckle was still Counsel General and by then fully aware that there was some gross malpractice happening in the mental health services in north Wales…

Interestingly enough, during the run-up to the last Welsh Assembly election, Carwyn faced an audience in Llangollen (where I was living at the time) and was bombarded with angry questions regarding the state of the NHS in north Wales. He looked a bit sheepish and eventually mentioned that the Betsi was put into special measures in the wake of Tawel Fan and that when the Welsh Govt knew there was a problem they had ‘acted’. You certainly did act Carwyn – you knew there was one hell of a problem because of what you were told was happening to me in 2011, so you appointed Theodore to give you legal advice. Meanwhile, the abuse and deaths continued and still seem to be continuing…


The Tawel Fan Scandal

Tawel Fan was an EMI ward at the Ablett Psychiatric Unit, Ysbyty Glan Clwyd, run by the Betsi Cadwaladr University Health Board. On December 23rd 2013 BBC News Wales briefly reported that Tawel Fan had been closed amidst concerns regarding patient care and safety. It was reported that an investigation was underway, that some staff had been removed from clinical duties, that patients had been moved elsewhere and that the North Wales Police had been called in. Eventually the background to the story emerged and a major scandal broke which led to UK-wide media coverage eg.

Covert filming had revealed appalling conditions and standards of care at Tawel Fan, described as ‘institutional abuse’. Staff had discussed their sex lives whilst on duty, had sworn at patients and had ‘restrained’ them using furniture. Patients were left to crawl around naked on floors covered in urine and faeces. Patients had unattended injuries and one patient was found to have a broken arm. Anti-psychotics were heavily and inappropriately prescribed. It transpired that there had been complaints about the ward that had not been acted upon. A member of staff had raised concerns only to be confronted by a doctor who told them that he didn’t want any more complaints.

A subsequent investigation and report produced in September 2014 by independent investigator Donna Ockenden revealed just how dire conditions and care on the ward were

The media picked up on the obvious abuses described in the Ockenden report, but people familiar with the mental health services in north Wales may have noticed other points. Ockenden details how staff described a whole range of activities on the ward for patients – yet these activities didn’t exist. Patients were either left to watch television or wander around the ward aimlessly. Staff described themselves as experts in mental health and this appalling ward as a centre of excellence. Relatives who complained were sleighted. (At the height of the bad publicity staff from Tawel Fan even gave interviews to the Daily Post, defending conditions on the ward and smearing the relatives who had raised concerns.) Such attitudes and conduct in the face of serious complaint were entirely characteristic of the north Wales mental health services. Complaints were met with hostility and defensiveness, bare-faced lies were told about standards of care and facilities, mediocre negligent staff would describe each other as ‘experts’, ‘excellent’ and even ’eminent’, and complainants would frequently be subjected to an all out character assassination and refused further services.

The Tawel Fan scandal resulted in the departure of Trevor Purt, the then newly appointed CEO of the Betsi (which was fairly pointless because he hadn’t actually been in post whilst the ward was in operation) and the placing of the Health Board in special measures by the Welsh Government. At the time of writing this, the Health Board remains in special measures, there are two ongoing investigations into events at Tawel Fan (due to report in 2017) and a number of staff have been referred to their professional regulatory bodies but as yet remain undisciplined. The police brought no charges against anyone. So to date, no-one has yet been held to account for one of the biggest mental health scandals for many years. Angela Hopkins, the Director of Nursing whilst this disaster happened, has been awarded an honorary Chair by Bangor University.

Update on Tawel Fan Scandal – Sept 16th 2016

Until 2013 there existed in the Ablett Psychiatric Unit, Ysbyty Glan Clwyd (near Rhyl), a now notorious EMI ward called Tawel Fan. Undercover filming revealed staff discussing their sex lives, swearing at patients and ‘restraining’ patients with furniture. It was alleged in the extensive UK-wide media coverage that followed that complaints had been made about the ward but had been ignored and that one doctor had responded to a member of staff raising concerns by confronting them saying that he didn’t want anymore complaints. Subsequent investigations revealed that patients had been left to crawl around naked on floors covered in urine and faeces, that patients had been left to fight each other, that patients had unattended injuries (one patient had a fractured arm), that patients were not washed and that there had been inappropriate use of anti-psychotic drugs. A truly damning report was compiled by independent investigator Donna Ockenden and the Betsi Cadwaladr University Health Board also asked the Health and Social Care Advisory Service (HASCAS) to carry out an investigation. The North Wales Police were called in. Despite the appalling abuse detailed by Donna Ockenden the police did not bring criminal charges against anyone (why are we not surprised?). A number of staff were suspended and some were redeployed. I have yet to hear of any dismissals or staff being disciplined by their regulatory bodies in the wake of Tawel Fan. The Daily Post today is running a story maintaining that yet more families of Tawel Fan patients are to be interviewed and that there are now two investigations running simultaneously regarding Tawel Fan, both due to report in 2017

I was interested to read in the Ockenden report that, when interviewed, staff detailed a full range of non-existent patients’ activities at Tawel Fan – in reality patients were left to stare at the television or wander aimlessly around the ward. Staff also maintained that they were ‘experts’ in mental health and described this dreadful ward as a centre of excellence no less. They attributed the complaints and media outcry entirely to a small number of difficult relatives (the staff of Tawel Fan also further shot themselves in the foot when the scandal broke by giving interviews to the Daily Post vigorously defending their dreadful standards of ‘care’ and smearing the relatives who’d dared complain). These attitudes were entirely consistent with the attitudes that I had routinely encountered in the north Wales mental health services for decades – barefaced lies were told about facilities and standards of care, people who dared complain were told that they were ‘troublemakers’ and that everyone else was completely satisfied with the ‘service’, and mediocre negligent doctors and nurses told each other that they were ‘excellent’ and indeed in some cases even ’eminent’.

From the reports that I have read so far it would seem that all the people responsible for the abuse at Tawel Fan are still working in healthcare. The CEO Trevor Purt was suspended and then left the Board in the wake of the scandal – but the irony is that Trevor Purt was a new appointment and hadn’t been working for the Board when the Tawel Fan abuse was happening. Despite the avalanche of bad publicity and expressions of deep shock by anyone who happened to find themselves near a journalist at the time, no one has been held to account over Tawel Fan.