There’s a lot to admit…

primary_care_training_knife_crime

I know our usual conversation is about health and social care but, bear with me, today can we talk about knife crime? We might learn something.

There were 42,957 offences in the 12 months ending in September 2018, a 31% increase on the previous year and the highest number since 2011, the earliest point for which comparable data is available.

Data for NHS hospitals in England, over a similar period, showed an 8% increase in admissions for assault by a sharp object,

This is a problem, right?

It’s not just here; Australia, knives reportedly the most used weapon and Canada, stabbing, the most frequent homicide method.

How do you solve it? It’s obvious… but you won’t like it.

In the short term; drag every copper we’ve got out from behind desks and steering wheels, onto the streets, go back to beat policing, search likely knife carriers and change the law so that the unlawful carrying of a blade puts you in prison for ten years.

No arguments.

In the longer run; an epidemiological response based on the work of Gary Slutkin, and the idea that human behaviour is formed by modelling and imitation.

Work in schools, communities, families, the workplace, on the streets.

Copy Scotland, where courts offered perpetrators help in terms of employment, relocation, housing and training to get out of the cycle of criminality.

There is little argument that the majority of knife crime takes place in neighbourhoods suffering social disadvantage and disinvestment.

Identify the risk factors and work with the young people to change their behaviour.

Now, we know, none of this is going to happen because first, we’d have to admit policies have been wrong.

We can’t recruit our way out of this mess. Training a police officer takes 18 weeks and then there is a period of probation and what not and the former Home Secretary, who cut police numbers, is the Prime Minister and well… you know what all that entails.

Draconian responses are difficult because of their racial overtones and liberal society has moved into another place.

We’re not going to admit an epidemiological response is going to work because to do so is to admit that cutting budgets for local government, family services, Sure Start, youth schemes, probation and courts is part of the problem and reinvesting takes time to trickle through.

You see, solving this problem entails admitting we were wrong.

For a politician to admit they have been wrong is as career limiting as the vicar admitting they’ve been downloading porn.

What can we do? Slutkin tells us; look at the data.

The most reliable predictor of a stabbing is another stabbing. The most likely predictor of gang activity is a run of stabbings.

An epidemic. There are three ways to stop an epidemic; interrupt transmission, prevent the spread and change the norms of the group.

So, find the leaders, find the people hanging out with the leaders, public eduction, diversion activity.

Hire violence interrupters who are trusted and have credibility, trained in persuasion.

Community workers and signs in supermarket windows that say… ‘Ten days since the last stabbing’. Involve the community.

All of this depends on policy makers admitting they’ve been wrong.

We’d have to say; we had austerity policies to get the economy back on track but experience tells us we were too cautious about relaxing them.

We’d have say; we’ve learned that investment in communities and public services is important and we will reinstate it where we can.

We’d have to say; we must move on as fast as we can. Learn the lessons, turn the millstones of our mistakes into the stepping stones for a better future.

Knife crime is a case study in how the knock-on effect of the poor management of the nation’s affairs can go wrong.

So too, is the predicament of adult social care.

There is no blood on the street when an 80 year old dies. We say; ‘they had a good innings’.

We never ask, did our policies make them lonely, malnourished, cold, depressed, their needs casually treated and did they die sooner than they might have?

There is a lot to put right but first, a lot to admit.

Contact Roy – please use this e-address – roy.lilley@nhsmanagers.net
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Reproduced at TrainingPrimaryCare.com by kind permission of Roy Lilley.