Residential care: In a decrepit state

The corporate brokering will seal the fate of the faltering care giant, Southern Cross

Around 30,000 of our frailest citizens have suddenly acquired an anxiety-inducing interest in complex negotiations between executives, landlords and financiers. The corporate brokering will seal the fate of the faltering care giant, Southern Cross – and also determine how many residents of its hundreds of homes will be shunted out. Moving house is rarely easy, and the strain of uprooting is incomparably greater for people who can barely move themselves. Some mix of state action and commercial compromise may yet avert a lethal mass arthritic exodus, but as the crisis unfolds there is an abject lack of guarantees. This sorry tale is, at root, about a failure of responsibility.
The specific ideal of honouring our elders is familiar from Confucius to the commandments, and a more general injunction to protect the weak is also shared by faiths around the world. Alas, such ethical edicts need spelling out precisely because human nature so often falls short. The horrific treatment of people with learning difficulties at a Bristol hospital, brought to light this week by BBC's Panorama, is sadly the latest in a long catalogue of institutional abuses that stretches from the old mental asylums to children's homes. It is not, however, such cruelties which condemn ever-more people to see out their days in residential homes, but rather extended families' reluctance to devote themselves to their elderly as they may once have done. In a world where households rely on both partners working, this reluctance is understandable enough – and all the more so since medical advances stretch conditions of geriatric infirmity which would once have lasted a few months to many years. The real problem is that our collective desire to find someone else to do the caring is not matched by a shared willingness to foot the bill.
The terms of the Dilnot commission, which is due to report in July, make plain cost controls will remain centre stage. Its unarguable but politically poisonous message to baby boomers may well be that those who do not want to care for parents themselves will have to accept big consequences in terms of what they will inherit. The only alternative is a further withering away of quality and coverage. In stark contrast with the health service proper, where commercialisation remains the controversy of the hour, privatisation of elderly care got going in earnest two decades ago and is now all but complete. Few illusions linger about the comprehensiveness of the service, and a Financial Times probe this week suggested poorer care was more widespread in for-profit than charitable institutions. But farming care out has, perhaps, allowed cash-strapped public authorities to imagine the demographic tide of decrepitude as someone else's problem. As Southern Cross teeters, this final delusion is falling away.
Should Southern Cross collapse, councils will have obligations to re-house some but not all of the residents. What they will not have is the power to commandeer assets to meet these duties, assets they mostly sold years ago. When the utilities were privatised, emergency provisions were written into the law to allow the government to seize the reins in the event of corporate failure to make sure, for example, that the lights stayed on. The care of the frail was not deemed worthy of similar protection.
Of course residential institutions are supposed to meet all sorts of standards. But as with restaurant hygiene rules, everything depends upon inspections, which the Bristol debacle have found wanting. While Southern Cross has been free to dabble in sale-and-leaseback property bets that have now gone so wrong, the Care Quality Commission seems oddly constrained: one of its inspectors this week revealed his fears about a "dangerous" situation only on condition of anonymity. That body should start by taking responsibility for speaking frankly about the state care is in. All of us will then have to take responsibilty for fixing it.

In praise of… Stewart Lee

His performances unfurl like a stroll on a summer's day: scenery and good companionship take precedence over destination

When praising a comedian it is generally a good idea to quote one of his or her jokes. The trouble with Stewart Lee is that he doesn't really do gags – at least not in the traditional sense of set-up, fire, reload. His performances unfurl like a long stroll on a summer's day: scenery and good companionship take precedence over destination, and any laughter seems almost serendipitous. For all of his self-deprecation and apparent hesitancy, Lee is evidently a practised charmer. So too with the apparent shambling of his act: it is just that, a put-on. In a recent episode of his latest BBC series, Stewart Lee's Comedy Vehicle, Lee discusses the evolution of modern comedy (something he is an expert on, as revealed in last year's memoirs How I Escaped My Certain Fate): "What the comedy is now – it's not like the 80s – what it is now, it's a load of people and they all hate their electrical appliances." This jibe about modern comedy's turn from shouty politics to smug consumerism slowly turns into a riff about how Mr Morphy Richards strives to make toasters that work, then advice on how to return broken toasters. Yet Lee can also do precise structure, as demonstrated by his sharply observed music journalism and his comedy musical Jerry Springer: The Opera. But let us return to the original question: what is a typical Lee gag? In desperation, this paper turned to the comedian's publicist. She could think of only one conventional one-liner ever made by Lee – and he'd bought it from another comedian for a quid. Typical.

Syria: Truth will out

President should let foreign press in to hear the Syrian people speak for themselves

Every revolution has its face. In Iran, it was Neda Soltani, who was shot in the chest during a demonstration. In Tunisia, it was a fruit seller called Mohammed Bouazizi who set himself on fire. In Egypt, it was Khaled Said, who was beaten to death after posting online a video showing police officers sharing the spoils of a drug haul. And in Syria it has now become Hamza al-Khatib. A YouTube video showing the appalling injuries this 13-year-old boy received in mysterious circumstances (the judge and the coroner both claimed his corpse bore no marks of torture) has gone viral. Hamza has now become the face of the Syrian revolution.

We do not know the circumstances of his horrific death. But we do know more about the systematic killings and torture by Syrian security forces as they attempt to suppress demonstrations in the city of Deraa where the revolt started. Human Rights Watch has done an invaluable service in attempting to document such crimes as the attack on the al-Omari mosque, ambushes of unarmed demonstrators or the blockades in which they attempted to starve communities into submission. But this report should only be the start. At least 418 people have been killed in the Deraa governorate alone. HRW found two witnesses who survived detention at a local football field, where detainees were picked at random from a crowd of 2,000 and summarily executed. And they also uncovered evidence of protesters killing members of the security forces.

The US secretary of state, Hillary Clinton, sharpened her tone in her reaction to Hamza's death. She is right to dismiss the political moves of President Bashar al-Assad as empty gestures. First he lifted the state of emergency, and has now declared a general amnesty for political prisoners, moves which appear bold until the small print appears. Neither has stopped nor inhibited the brutal Baathist crackdown. Bashar is proving to be his father's true son. As that crackdown continues into its third month, pressure is growing at the UN to hold Assad and key members of the security apparatus accountable for crimes against humanity. Syrian dissidents meeting in Turkey had no desire to form a government-in-exile or a transitional council, as Damascus had feared. They are pushing instead for a UN security council resolution, similar to the one passed on Libya, which would allow an investigation by the international criminal court.

For a president who put so much effort into burnishing his image as a reformer in western eyes, a solution lies at hand: let the foreign press in. Let the Syrian people speak for themselves about the conflict in their midst. What could a popular leader possibly have to fear?