Should protection and safety trump privacy and dignity? Changing my mind about covert surveillance...
Is it time for a rethink on the use of surveillance cameras and the like to promote quality and drive out poor practice? This topic does seem to polarise opinion. I have been doing my own survey by asking people what they think whenever I visit care services. My impression from this small random sample is that very few people sit on the fence! Those in favour are quite often relatives of people in care homes who tend to highlight protection, safety and reassurance for the individual and their family whilst those against tend to refer to concerns about privacy, respect and dignity. So, should safety trump dignity?
In the past I have argued against cameras as I see them as infringing rights to privacy and independence. Since then there have been a series of TV programmes that have used covert cameras or undercover filming to bring into the open some significant abuses we might not have otherwise known about or have been able to deal with. And identifying just one abusive and neglectful situation has to be a good thing – right?
My fear has always been that routine use of cameras would be the thin end of the wedge in terms of surveillance for people receiving care and support - and for staff. After all a camera won’t stop abuse from happening, it merely records it. Yes, you might then have evidence to be able to take action, but surely our efforts would be best directed towards ensuring that good practice in care and support is offered on a consistent basis.
I attended the excellent roundtable event on covert surveillance convened by the Care Quality Commission (CQC) on 19 May where a range of opinions on the subject were aired and it did cause me to reflect on my views …in fact to change my mind.
Obviously there are many questions that have to be resolved: Would it really serve as a deterrent? Would it be for all people receiving care and all the time? How would any permission be secured? How would the issue of consent be handled? How would recordings be kept and for how long? What are the legal implications or the rights of staff? How would proportionality be assured?
These are crucial questions and they hint at the complexity of the issue and matters of context and control. I still firmly believe that staff should be selected for their values, trained to develop meaningful person-centred relationships, there should be enough staff, they should be regularly supervised and supported to reflect on their practice such that they feel competent and confident, valued and motivated, so that it wouldn’t matter if a camera was recording everything they do! Like so many other aspects in adult social care ensuring quality care is about leadership and governance - plain and simple!
Nevertheless, I fully respect the view that there should be an option in exceptional circumstances and as the last resort to use covert surveillance in order to gather evidence when there are suspicions of abuse. It would be helpful if CQC were to develop a Code of Practice as professional guidance on the circumstances which would legitimate such action and how it could be undertaken. I am sure that we will continue to debate this controversial issue for a long time to come.
Des Kelly OBE
National Care Forum