Stephen Hawking, and the difference between ‘Capacity’ and ‘Competence’

Physicist_Stephen_Hawking_in_Zero_Gravity_NASA

The Mental Capacity Act defines capacity as,

the ability to make a decision’.

Whilst competence is defined as

the ability to do something successfully or efficiently’.

Competence is a far more expansive creature.

It is the ability to execute a decision, after it has been made .

If we run the two together, at most, the definition of capacity, would be,

‘ the ability to make a decision, successfully’.

Not to be indecisive, like Hamlet

But indecisiveness is excluded from incapacity under the Act.

The Act, was not titled, The Mental ‘Competency’ Act.

Despite this  the MCA capacity test requires a person to understand the reasonably foreseeable consequences if he were to actually execute his decision once made.

This requires far more, than the an ‘ability to make a decision’ as  ‘capacity’ is defined by  the Act. As it requires the competence to perform the decision.

This is a person’s competency not his capacity .

Such a distinction may not affect the assessments of delirious patients, or, the alzheimer confused, to consent to medical treatment. .

But, even here, the capacity test allows draconian and dangerous removal of any patient’s autonomy.

And prevents any questioning, of medical diagnoses, and/or treatment.

Were Ashya King, an incapable adult, he, nor, his parents, could, have availed themselves of laser treatment, and, he,  might now, be severely disabled.

http://www.dailymail.co.uk/news/article-3148042/Cancer-patient-Ashya-King-six-parents-arrested-taking-abroad-pioneering-treatment-UK-given-clear.html

The  MCA Code of Practice worrying  provides a  denial of  medical or mental diagnosis to be possible evidence of   incapacity to consent to treatment.

Jack Nicholson, in One Flew Over The Cuckoo’s Nest, would, therefore, be deemed incapable, of consenting to his treatment, because of his denial of his non existent mental disorder.one-flew-over-the-cuckoos-nest-movie-poster

The MCA Code gives little guidance on assessing capacity when considering proactive decisions.

Stephen Hawking ’s capacity to decide to go into space, or out into the community, without his wheelchair..

Or, an autistic adult’s decision to go out into the community alone.

Are decisions both have the capacity to make but not the competency to perform.

If, they were to insist, they did have such capacity, this would be evidence, this would be evidence, they failed to appreciate, the consequences of their decisions, and, were therefore under the functional assessment,incapable.

Although Professor Hawing’s incapacity, could, not be caused by an’ impairment of the mind’, as unlike an autistic, he has a voice box.

As the Act, likes to have its cake, and eat it, it states, reckless decisions, per se, are not evidence of incapacity.

The MCA capacity test is not about capacity, but competence, safeguarding, and control.

And discriminates against the disabled by using, a disabled’s person’s inability to execute a decision, against him by conflating, incapacity with incompetence.

Parliament appears to have modelled, this capacity test, on the test used, to assess a child’s competency to give evidence.

As section 53(1) of the Youth Justice and Criminal Evidence Act 1999 (YJCEA 1999) povides:

A person, is not competent to give evidence in criminal proceedings, if it appears to the court, that he is not a person, who is able to understand questions put to him as a witness and give answers to them which can be understood [section 53(3)].

Having lectured, this for twenty years, I can attest, it is a minefield of semantics.

Case law, arguing, it is satisfied, if a child can distinguish, between ‘fact and fantasy’ ie they know teletubies are not real.

Santa Claus?

And, a child must appreciate, the importance of telling the truth, and the consequences in court. as opposed to a social occasion.

Truth is truth?

Suffice it to say, the competence of a child, is a vague, subjective exercise, for a judge to assess, on questioning each particular child.

So one can but wonder, why, Parliament, chose, a similar blunt, subjective test/ tool, to potentially remove, anyone’s autonomy for life in most cases.

Could it serve the real purpose of the MCA ? ie removal of consent to care and treatment for profit

Profitable Retardation of the Autistic ? Learning ‘Difficulty’ conflated to ‘Disability’.

Einstein

As Liverpool Health NHS Foundation Trust opens new learning disabled hospital

Plans approved for new learning disabilities hospital in Merseyside

We must ask why learning disability is now a physical illness and those with these difficculty are put in hospitals.

Could be the £13,000 A WEEK per patient paid by NHS

Autism, despite its  vague, non pathological definition.

And  vague criteria  diagnoses- lack of imagination and social communication.

Is the UK’s most costly medical condition.

http://www.lse.ac.uk/newsAndMedia/news/archives/2014/06/Autism.aspx

Why ?

Because, ‘autism’ is so vague  it is the ultimate cash cow.

Despite treatment having little effect.

Analysis finds weak evidence for most autism treatments

And with the billions ploughed into the industry  outcomes for the autistic are  now dire- medication damage, early death and institutionalisation for life.

The autism industry has built a lucrative empire by autism  awareness, detection, and diagnosis.

I always worried about the more intelligent, and/or less obedient 3 year old, who did not knock on the ‘special box’ three times, when told to, to get the toy out.

Or went to find, where a toy actually was, rather than, where the other child, who had not seen it being hidden, would have, thought it was.

Who were diagnosed autistic on such tests.

Screen-shot-2015-08-11-at-11_42_33And wondered if this really did indicate a lack of empathy?.

We all have autistic genes.

http://www.medicalnewstoday.com/releases/308185.php

Autism is now being detected in babies,

http://www.nhs.uk/news/2013/11November/Pages/Can-autism-really-be-detected-in-babies.aspx

And, those just ‘At risk ,‘ presumably with autism in their family, are singled out.

At risk of what ?

Something with no pathology, no definition that manifests itself on a spectrum that we are all on.

The intensive hunt for the autistic mirrors that now for Alzheimers.

Our ‘autism friends’, health visitors, nursery schools, GPs, CMHS, Social Services etc.

The diagnosee is a lucrative captive customer, for the autism industry’s ever increasing cabal.

An industry which is PR controlled, with its own experts, managers, qualifications, researchers, guidelines.

That controls the research, the training, the guidelines, the tests, and, even, the definition of autism.

This cabal per se, is lucrative and, as charitable, tax free, and gains more income from students, training, government, and fundraising.

All singing from the same, unquestioned hymn sheet.

The autistic and parents have little input nor do the outcomes for the autistic.

And all are controlled by draconian  Care and Court of Protection MCA orders, that can enforce any treatment/medication/residence/education the cabal want.

Only those few protected, as part of the cabal, or  who escape diagnosis survive.

For the ‘autistic’, the discrimination starts early.

At 4/5, the autistic child is subject, to the same IQ tests, as, a‘normal’ child, for their EHC statement.

No allowance is given for their communication and  attention difference.

http://autism.about.com/od/schoolandsummer/fl/Why-IQ-Tests-May-Not-Tell-You-Much-About-Your-Child-with-Autism.htm

Which will result in their IQ scores being lower than their actual intelligence..

And, no matter how high their IQ score,  their autism difference  will mean they will have ‘learning difficulties’.

Which is then mislabelled a ‘learning disability’.

No one, distinguishes, the crucial difference.

Disability is the permanent intellectual impairment of having a lower than average intelligence and affects an individual’s capability.

Difficulty is not an intellectual impairment just an acceptance that autism results in a child learning differently.

And will need  more one to one assistance, time to process information, visual aids, and flexible steps for progression.

On this conflation and misunderstanding, inappropriate education is  put in place.

A class room assistant, may teach them, all frogs are green, but the curious intelligent autistic notices they are not.

And, some basics, irrelevant to autistic processing and cannot be learnt justify presumed retardation.

And, as these basics cannot be acquired because of how autistics learn they are not allowed to  progress.

And not encouraged to either, as ever increasing SEN, now EHC funding, would  be removed from their school.

‘Learning disability’, is now termed, ‘intellectual disability’,  the old ‘mental retardation’.

Now deemed an  ‘inapproriate’ term,  as insufficiently PC.

Yet,  substantively/conceptually now forms the basis of an autistics persona, and education.

Yet, there is little evidence for any link between learning disability and autism,

see study in 2009 suggesting little evidence, despite up to 70% of ASD, being now accessed with as learning disabled.http://bjp.rcpsych.org/content/195/6/531

This special needs ‘education’ goes hand in hand with behaviour charts.

Such behaviour becoming progressively worse, as the boredom of thwarted curiosity and intelligence, kicks in.

And ADHD, aggression, irritability results and medication is prescribed.

More children than ever in 2016 were put on off label antipsychotics for ADHD

https://www.madinamerica.com/2016/07/more-children-receiving-off-label-antipsychotics-for-adhd/

So the autistic at as young  as 5 can be made pharma cows for life.

See here the pharma role in the creation of ADHD

And now ADHD has been widened to attentive ADHD

http://www.medicalnewstoday.com/articles/315359.php

Ritlevin does not work after three years, so stronger more expense antipsychotics are used.

These drugs then actually create a learning disability, pathologically by changing the pathways in the brain, so a once normal brain, with a mere learning difference due to autism becomes learning disabled.

As the effect of the drug reduces  thinking, observation, and motivation.

So, the intelligent, could not improve, even if appropriate education were in place.

Meanwhile, the special needs residential school ,charges £3,500 per week , for its own army of Speech Therapists, Educational Psychologist, Behavioural therapists and specialist teachers.

And make huge profits either for venture capital or recycled to executives if Charitable.

The ‘experts’ mainly manage one to one contact and containment by low wage, itinerant class room teaching assistants.

Why, has no one, ever wondered why, National Autistic Residential Schools, rarely produce 16-18 year old autistics, with a single GCSE?

After,  the equivalent of 5 Eton students fees,of ‘specialist’ input?

Because the autistic are now not taught to National Curriculum in specialist schools, but to specially created P Scale assessment.

At 16, under ECHs schools are no longer funded, instead ‘education packages’ for life skills to train the autistic for their 24/7 surveillance captivity, in ‘independent of family/ community living’ are funded, and this money can be claimed, by  usually residential provider until the autistic is 25.

The autistics’, lack of adaptive skills, tying a shoe lace, changing a battery, organising cupboards, using machines, following instructions, continues the myth of retardation. https://iancommunity.org/ssc/autism-adaptive-skills.

CAMHS treatment and assessment Units require an IQ of 50, or less, yet, there main occupants are non verbal autistics.

The ‘treatment’ consists of antipsychotic medication (illegal, as not short term severe behaviour) which acts as a major neuro depressant/tranquiliser.

Until, at 18, the final insult.

A mental capacity assessor, will deem, on an autistic’s sad lifetime achievements, of at most P scales, and, few adaptive skills.

The MCA assessment will be on adeptive skills not cognitive ability .

The, particularly non verbal autistic, will now be labelled ’ severely intellectually disabled’, regardless of previous IQ .

This label aids, an illegal blanket capacity assessment, that the autistic are so intellectuality impaired, they were never, and will never be, capable of making any decisions.

And , allows the state commissioned, private/charity sector provision, to earn £4,000 per week, for their lifetime encagement, in their ‘best interests’.

Now, that’s  rip off, abuse and discrimination……

15747770_947933215306183_5282025104727343976_n 

Science shows teachers/educationalists.

wronghttp://www.cracked.com/article_20321_5-things-it-turns-out-you-were-right-to-hate-about-school.html

 

 

 

How many deaths in St Andrews, Northampton? Who is accountable?

Whichhemaccountability-in-the-nhs-report-jun11

Who protects the vulnerable voiceless, like Bill, and Kristian, paying £6,000 (£4,500 tax free) per week, for their enforced ‘treatment’?

How many of them  have died in St Andrews?

A freedom of information request, revealed, the CQC, apparently, indicating, they were not prepared, to investigate the deaths at St Andrews,

“CQC was aware of the service’s own reviews, following the deaths and, following a meeting with the provider in 2011, we wrote asking for information about their clinical governance and assurance processes with regard to how natural-cause deaths are identified and investigated.”

http://www.theguardian.com/society/2013/jul/07/call-inquiry-deaths-psychiatric-hospital

But how can they be ‘natural deaths’?

A ‘natural death’ is defined as

‘death due to a disease running its full course with no other intervening factors’.

But nobody,  dying in St Andrews, appeared, to be suffering from any disease, as far as could be gleaned, from the hospital’s ‘routine’, if not refused, health check.

And if they were, why was their disease not treated, for the providers £4,500 per week payment ?

I was unable to find Care Quality Commission Reports for St Andrews for 2010/11.

But four years later, a CQC report stated it still

requires improvement’, https://www.google.co.uk/#q=st+andrews+health+care+care+quality+commission

Yet, St Andrews own website, appears to boast it is ‘outstanding’.

http://www.standrewshealthcare.co.uk/our-services

And, why is St Andrews, still the only alternative, particularly for young autistic/ learning disabled/ behavioural problems ?

And, as beds in public ATUs, are all to be phased out, on the much publicised excuse, of the abuse in Winterbourne View, (which was a private institution), together with huge political clout, St Andrews, along with Cygnet and a few others, all private, will be the only places mental patients can be sent.

And, its newly opened, 120 bed adolescent unit, was found, by the CQC, to be so understaffed, patients were forced to restrain each other.

http://www.communitycare.co.uk/2013/12/17/inadequate-staffing-supervision-young-peoples-mental-health-unit-finds-cqc/

How can this be ‘treatment’ and, how can it justify  £6,000 per week, per patient, when tax free element factored in.

So, we have a provider, being paid a fortune, for what, the scant, government controlled oversight of the CQC has, in its light touch inspections, revealed ‘inadequate’.

No accountability for services, and use of huge sums of public money, and no measure of outcomes for the service users.

The perfect business model.

As 3% of St Andrew’s patients, were residents of Northamptonshire.

The Local Healthwatch Northamptonshire, had a statutory right/duty, to go into  this publically funded, privately run local health  service, to assess the care provided, from the perspective of patients, and service users.

They visited St Andrews, and reported in 2014.

http://www.healthwatchnorthamptonshire.co.uk/sites/default/files/st_andrews_summary_dec_2014_ms.pdf

‘that the mix of staff means there are a high proportion of relatively inexperienced and unqualified staff meaning that patients are not always receiving the clinical expertise and knowledge’.

‘ staffing levels, ( 2 registered nurses per ward), are putting patient safety at risk.

Patients who talked about low staffing levels said this has a knock on effect on the quality of care including the ability to increase their level of relative freedom, for example being able to go out in the grounds.’

The Healthwatch, had particular concerns, about the physical healthcare of patients, finding 38% of physical complaints were upheld.

But then, surprisingly, in view of these findings,  Healthwatch concludes,

‘its expectation is that, as commissioners of the service, NHS England, is robustly holding SAH to account for the quality of all aspects of service provision, including physical healthcare’.

But it clearly isn’t holding SAH to account.

But, they do recommend, that SAH reviews, the 7, unexpected deaths during 2013/14, to establish whether there were any actions, that could have been taken, to prevent them.

One, would surely have thought, reviews, would automatically result from  a patient’s death, as a basic safety issue in respect to future treatment, and not need, an external body to recommend them.

Remember, these patients are only mentally ill, not physically, so why are they dying in such numbers ?

This surely says a lot about the lack of their care, and actual treatment ?

Keeping mentally disordered patients alive, surely should be the most basic requirement of care costing £6,000 per week.

And, if patients die, then the service provider should be held liable, particularly, if the patients care costs so much, and they are not physically ill.

Why is the NHS paying that amount. How could it be justified ?

It is unknown, why the report in para 6, states 7 deaths in 13/14.

6. We recommend that SAH reviews the 7 unexpected deaths during 2013/14 to establish whether there were any actions that could have been taken by SAH to prevent the unexpected deaths. We further recommend that SAH commissions an independent review into the 7 unexpected deaths’.  

When the only deaths revealed publically, that I could find, were the 5, in 2010/11.

Have additional deaths, occurred under the radar, after the 5 in 2010/11?

http://www.northamptonchron.co.uk/news/health/health-news/appeal-for-st-andrew-hospital-deaths-report-to-be-public-1-6008003

The Healthwatch, wrote to NHS England, requesting  a published independent review. http://www.healthwatch.co.uk/sites/healthwatch.co.uk/files/letter_nhs_england_to_healthwatch_england_august_2014.pdf

But, how could this review, be independent, if commissioned, by NHS England, who themselves  commissioned 90% of St Andrews service?

This means they are investigating into their own chosen services.

If failings were to be revealed, NHS England as the commissioner ,would be liable for them.

The Healthwatch, further recommends a lay summary of the review be published.

As they want,

‘to be assured that SAH has a culture of continuous review and learning from unexpected deaths’.

How about  being  accountable, for them ?

They recommend, that SAH invite the charity Rethink, to talk to the senior management team and the Board about Rethink’s 2013 report “Lethal Discrimination”, which calls for action to tackle ‘premature mortality’ in secure mental health settings.

The latest guidance for investigation by coroners, into deaths of those subject to a DOL under MCA

see link http://www.no5.com/news-and-publications/publications/351-inquests-and-deprivation-of-liberty/

Gil Baldwin, Chief Executive Officer, St Andrew’s Healthcare, commented,

‘our charitable status means that any money we make is used to grow and improve our services for the benefit of our patients’.

But says nothing, of the executives’ huge salaries, as revealed in St Andrews Financial Report to the Charity Commission for 2013/14.

http://www.standrewshealthcare.co.uk/sites/default/files/documents/St%20%20Andrew’s%20Accounts%20for%202013%20to%202014%20(reduced%20size%20for%20web).pdf

So how many  more deaths per se let alone ‘unexpected’ deaths, in healthy people in a mental, not physical hospital,have there been in St Andrews since those in 2014 ?

And where were they revealed ?

And, why was there so much publicity, about the deaths in SLOVEN public provision and none about the deaths in private St Andrews provision

And worse still, this publicity, used to move all mental patients to St Andrews, or, other private provision, as a matter of NHS policy ?

Surely, patient safety, should be paramount not private profit.

 

 

 

 

The For Profit Revolution- Brave New 1984

quote-George-Orwell-if-you-want-a-vision-of-the-431Two years ago, a Mail piece on the inhumanity of nurses in Staffordshire, prompted my following comment;

‘Careerism, academicism, demarcationism, managerialism, professionalism and finally dehumanisation– all maintained through Codes of Conduct’.

We are going through the most significant industrial revolution in history, without even knowing, let alone consenting.

Managerialism, outsourcing, commercial awareness,  and de-skilling, have converted  vocations,- carer, teacher, nurse, social worker, and, professions,- solicitor, doctor, academic, into disparate, cost effective , disposable ‘resources’ to  maximise profit, for  corporate  resource owners.

Deregulation is another word for self regulation.

And in public services  there is effectively no competition.

So, no accountability and no competition.

A recipe, for maximum extortionate profit and poor service.

Laudable verbage is bandied.

– collaboration, commercial awareness, professionalism, practitioner, dignity, codes of conduct, confidentiality, and, most of all leadership.

These  Leaders are often not elected but are everywhere.

And lead beyond authority to places we ought to be even though we do not know we should be.

This Nostradamus Newspeak perniciously shapes our society, and morals.

Replacing  substance, with control, and process.

Collaboration ensures individual compliance.

Commercial awareness allows rip off.

Professionalism, a perfunctory, impersonal, prescribed service TO AVOID COMMUNICATION and actual service.

Practitioner,  interchangeability/removal of expertise/role.

Dignity’s autonomy, beneficence, non-maleficence and justice, is  reduced to, a certain standard of personal behaviour- allowing a person to dress, not shouting and address in correct terms- name title.

Codes of conduct control the individual’s behaviour, work, and communications, mask and justify bullying.

Confidentiality allows ultimate secrecy  and maintains a cell structure. Where misinformation and lies flourish. Manipulation is rife and no one has facts/truth,

Leadership allows the absolute power to dictate without question.

These ethoses underpin, our institutional,public and corporate structures.

Individualism is now heresy.

Autonomy  dead.

All  work’s substance and performance, controlled, and  reduced to zero hour cogs,  owned, by a few large, untouchable corporate outsourcers.

Atos, G4S, Capita, SENCO, are paid 4 billion a year, to act, as a recruitment agency . http://weownit.org.uk/privatisation-doesn%E2%80%99t-work/whats-problem-outsourcing-companies is now

Whilst, the actual worker, is an unemployed, poorly paid, prescribed slave. https://finolamoss.wordpress.com/2014/10/04/prescribed-care-and-communication/

All a recipe for inadequate service.

As the corporate owner monopolises the market, and, is commissioned by the government, so unaccountable.

And, the actual service is provided by itinerant, prescribed, individuals ,with no autonomy, or incentive.

But even this extortioning capitalism isn’t enough,

Now supermarkets have more automated tills, than manual.

Researchers are training robots to ‘care’ for people in enforced state care.

Robots are the ultimate resource.

Human can be dropped from Human Resources.

As an ever more controllable, disposable work force, is put in place.

Huxley wrote a letter to Orwell,  expressing his believe, that no government, would bother, with the psychological hassle of ‘stamping on the face of humanity’, and would prefer, the genetic engineering, and pleasure, of his Brave New World.

http://www.dailymail.co.uk/news/article-2111440/Aldous-Huxley-letter-George-Orwell-1984-sheds-light-different-ideas.html

Our governments, be they labour or conservative appear to be conspiring to do both.

bravenewworld