The compulsory removal of elderly people in England and Wales under Section 47 of the National Assistance Act and its 1951 Amendment: a survey of its implementation in England and Wales in 1988 and 1989

Vulnerable adults and the abolition of powers to remove a person in need of care

The coalition Government is urging parliament to repeal the power of local authorities in England to remove a vulnerable adult who retains decision-making capacity from their home if they are in need of care and attention. The move is justified on the grounds that the power is little used, might contravene the person's human rights and does not reflect the government's person-centred and community-focused reforms of adult social care and support. This article reviews the power to remove a person to a suitable place under the National Assistance Act 1948 and argues that reforming, not repealing, the law is what is required if vulnerable adults are to be protected from abuse and neglect.

Professional judgements of risk and capacity in situations of self-neglect among older people

Over the past 50 years, self-neglect among older people has been conceptualised in both social policy and the academy as a social problem which is defined in relation to medical illness and requires professional intervention. Few authors, however, have analysed the concept of self-neglect in relation to critical sociological theory. This is problematic because professional judgements, which provide the impetus for intervention, are inherently influenced by the social and cultural context. The purpose of this article is to use critical theory as a framework for interpreting the findings from a qualitative study which explored judgements in relation to older people in situations of self-neglect made by professionals. Two types of data were collected. There were 125 hours of observations at meetings and home assessments conducted by professionals associated with the Community Options Programme in Sydney, Australia, and 18 professionals who worked with self-neglecting older people in the community gave in-depth qualitative interviews. The findings show that professional judgements of self-neglect focus on risk and capacity, and that these perceptions influence when and how interventions occur. The assumptions upon which professional judgements are based are then further analysed in relation to critical theory.

Compulsory removal from home under the National Assistance Act 1948

District nurse Mary Thomas has had concerns about one of her older patients for some time. The lady, Miss Oates, is in her 80s and she lives alone in a bungalow with 30 cats. Her physical frailty is such that she is unable to care properly for herself or her cats. She has refused all offers of help from the social services authorities and only allows the district nurse in to dress an ulcer on her leg. The bungalow is filthy and stinks of urine. There is no heating or electricity. There is cat excrement and uneaten pet food everywhere. Today Sister Thomas has found her patient lying at the foot of her bed after falling the night before. She refuses to be helped into bed and seems determined to stay on the floor. Despite the urging of the district nurse and GP the patient has consistently refused to leave her bungalow. Both sister Thomas and the GP accept that the patient has no signs of a mental disorder or of mental incapacity, nevertheless they both consider that care and attention in a care home, even for a short period to allow her bungalow to be cleaned, would be of great benefit and wonder if the law could be used to compel Miss Oates to move to a care home.

Compulsory removal of competent adults from their homes

The National Assistance Act 1948 was enacted in order to provide the legal framework for the care and support of society's ill and socially deprived. In certain limited circumstances, Section 47 of this Act permits the compulsory admission of competent adults to hospital or to other types of residential care. The fine balance between protection from harm and respect for personal freedom is not served well by this Act which has its origins in Poor Law legislation. It is no longer in accordance with current practice and therefore needs to be reviewed. This could be achieved by setting up regulatory systems to protect the rights of individuals considered to be in need of compulsory admission. However, it seems likely that the only way to protect the individual's civil liberties effectively is by changing the existing law.