Football and the ladder of power

Andrea Sutcliffe, Chief Inspector of Adult Social Care at the Care Quality Commission.

Over the last week, football has dominated the headlines and rightly so. First came the long-awaited inquest decision that the Liverpool fans at Hillsborough were‎ unlawfully killed in 1989 and the fans were not to blame. Then Leicester City Football Club against all the odds were crowned Premier League Champions after an amazing season that deserved a fairytale ending.

‎The outpouring of affection and support showed that while the victory for justice belonged to Liverpool and the footballing triumph to Leicester, they did it for every ordinary fan in the land. Praise, heartbreaking and heart-warming stories flooded the air waves, newspaper pages and social media. To get a sense of it all watch this rendition of You’ll Never Walk Alone from the Liverpool Philharmonic Choir; read Adrian Tempany’s survivor’s story in The Observer; and we have the enticing prospect of Gary Lineker presenting Match of the Day in his underwear in celebration of Leicester’s success!

Blogs drawing lessons from these events are already appearing, for example, my former colleague Steve Palmer reflecting on Claudio‎ Ranieri’s version of the Mum Test is lovely.

Ladder of power

My reflections have been inspired by two meetings I had last week about services for people with learning disabilities — the first organised with providers by the Association for Real Change to discuss the CQC inspection regime and the second with a group from CHANGE, people with learning disabilities working together for equal human rights. At both the desire to see meaningful change in the way services are commissioned and provided was clear, and why this is not happening as quickly as it should was an important topic of debate.

Providers acknowledged the positive impact of our new inspection approach but expressed frustration with commissioning decisions. Sean and other colleagues at CHANGE pinpointed ‎the root of the problem as they described the ‘ladder of power’, which puts professionals at the top and leaves people with learning disabilities at the bottom of the ladder at the mercy of others who either think they know best, don’t understand or, worse, don’t care. Their message was simple — the ladder of power ignores people with learning disabilities, doesn’t employ them and makes them feel intimidated and frustrated — and they want this to stop.

We not ‘them’

To make that happen we all need to stop thinking about people with learning disabilities as ‘others — not like us and apparently not worthy of the same expectations, hopes and dreams we all have a right to embrace. Nothing could be further from the truth! Instead, we need to live and work by the principle that everyone has the same rights and deserves to be valued, respected and treated with dignity.

Seeing people as different lay at the heart of the Hillsborough scandal — Liverpool fans were demonised by the police and the press, which allowed the truth to be hidden for 27 years. How much sooner would the public outcry have forced justice if the fans who died and survived had been consistently portrayed for what they were — someone’s son, sister, dad or friend overtaken by tragedy? Let’s not make the same mistake for people with learning disabilities.

CQC has a role to play in setting expectations of truly effective and responsive person-centred care and then holding providers to account if this does not happen. There’s more we can do and I am looking forward to developing some of the ideas we talked about last week. But we cannot do this alone and everyone in the health and social care sector has a part to play.


I am sure that the pleasure so many have taken in Leicester’s success reflects the frustration we feel when our club is at the bottom of the pile, disregarded and patronised by richer rivals. Let’s translate that feeling of solidarity from the world of football into the world of health and care and make sure that people with learning disabilities are treated like the citizens of the world they are.

Originally published at

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