EVERY month, about 12 cases of alleged adult abuse are reported in Herefordshire. Nearly all the victims are elderly people or those with learning disabilities.

The allegations being made range from physical and mental abuse to neglect and from theft to rape.

Sadly, there are fears the numbers do not reflect the true picture of what goes on in the care of the old and the vulnerable in the county - they have been described as "just the tip of the iceberg".

That is not to suggest that all persons needing care in the county are at risk. In the majority of cases, their welfare is second-to-none and their quality of life good, taking into account their own particular circumstances.

But it is clear that too many people among the old, the frail, the mentally ill and those with learning difficulties suffer abuse.

Recently, the Government reported that every day as many as 500,000 older people are being abused in England - and admits the numbers could be much higher.

It now wants to give the problem a higher profile - children have the NSPCC to protect their interests, even animals have the RSPCA to help safeguard them, so why not guardians for grown-up people, many whom are unable to cope on their own.

Herefordshire is a little ahead of its time setting up the Herefordshire Vulnerable Adult Protection Committee (HVAPC), involving Herefordshire Council, West Mercia Police, the Probation Service, the Commission for Social Care Inspectorate, Hereford Hospitals Trust and Herefordshire Primary Care Trust and other agencies to tackle the problem.

It has adopted the Government policy that there can be no secrets and no hiding places when it comes to abuse of vulnerable people.

Three years ago, HVAPC appointed Lynne Hodgman as adult protection co-ordinator.

Mrs Hodgman spends much time on awareness training in a range of care homes and centres in Herefordshire and has so far trained 1,500 care personnel to be alert to adult abuse.

She says abuse is not often as seriously physical and obvious as the 78-year-old woman elsewhere in the country who was removed from a sheltered home by her son-in-law to look after his three children.

She was found dead in his home and a pathologist found more than 100 injuries on her body, including cigarette burns under her arms and razor cuts on her stomach.

Abuse, says Mrs Hodgson, comes in many guises not usually perpetrated by "bad" people but often because people follow cultural care practices of the past which are now out of date in the 21st century.

She cites as abuse cases of old people sitting on commodes while eating their breakfast, remaining in soiled or soaked incontinence pads for too long, kept unwashed, hair not cared for, nails left uncut and allowed to grow long and inwards, unwanted sexual acts against people who did not understand, theft or misusing people's property or money and rough handling or restraining.

Recently, Mrs Hodgman and Catherine Holberry, who is lead nurse for older people at Hereford County Hospital, reported on their work at a meeting of the hospital trust. Catherine Holberry had dedicated the week to adult abuse and set up an exhibition in the hospital, as well as producing 500 yellow ribbons to mark the occasion.

She said her task was to promote the very best practice in hospital staff in caring for vulnerable patients but also to help them recognise symptoms of abuse and to report it.

Both women agreed there was keen co-operation among all those involved in HVAPC to ensure there were safe systems in place to prevent all abuse but when this failed, to have robust procedures ready to deal with it.

Mrs Hodgman says there is still much to do. Victims of abuse are often too scared to report what is happening to them and it was difficult to establish how much was going on in their own homes.

The whole community needs to be alerted to the situation and people prepared to become whistleblowers if they know or suspect that abuse is taking place.

Anyone wanting to refer a case of abuse or ask advice should call 01432 261627 (for Hereford), 01432 383251 (for Ross, Ledbury or Bromyard)and 01432 383349 (for Leominster). For out-of-hours calls in all cases, phone 01905 768020.