Safeguarding Adults with Learning Disabilities

(Limited Text - Ministerial Extracts only)

Tuesday 17th October 2017 Westminster Hall

[The Parliamentary Under-Secretary of State for Health (Jackie Doyle-Price)]

It is a pleasure to serve under your chairmanship, Mr Wilson. I join everyone else in paying tribute to the dignified and passionate way in which the hon. Member for Newcastle upon Tyne North (Catherine McKinnell) outlined her case. It is truly heartbreaking. Lee’s mother is watching today. She put her trust in the institutions of the state to care for her son, and we failed her. It should never have happened, and for that I am truly, truly sorry. I give the hon. Lady and Bev my commitment that I will take lessons from this. I hope the hon. Lady will act as my conscience in ensuring that I do so. The issues highlighted across the Chamber today need to be acted upon, to ensure that we do our best by all our constituents.

I was struck by the way that the hon. Lady talked more generally about people with learning disabilities. It is, frankly, the reason we all get involved in politics—we get involved in politics when we see the state failing and to make sure we do the best for everyone in society and for the people we can see being failed. I do not think that any group is failed more than people with learning disabilities. They have potential and the ability to live independently, but all too often they have been parked. My hon. Friends the Members for Henley (John Howell) and for North Swindon (Justin Tomlinson) outlined examples of where, with some support, people with learning disabilities can lead very productive lives, but it requires support and investment. Sadly, that is not always forthcoming, and without it, they are very vulnerable, as this tragic case all too clearly illustrates. We owe it to them and to ourselves, in order to make the best of society, to do all we can to help people with learning disabilities to live independent lives.

We need to do more to tackle the whole issue of prejudice. The hon. Member for Newcastle upon Tyne North said she has been very persistent in trying to secure this debate, but perhaps it is fitting that the debate is happening in the middle of National Hate Crime Awareness Week. That is the perfect backdrop against which to address her case. It is fair to say that we are still early in the day when it comes to hate crime prosecution. There is slowness in reporting all hate crime, and suddenly people have become more aware.

People with learning disabilities are generally victims of quite widely held prejudice. It is not just the fact that they are targeted because of their disability; the agencies that should support them do not necessarily give them the support they need because of their disability. We have seen across the board, in so many examples of abuse, that particular social groups who are not the best at representing themselves do not always get a fair deal at the hands of the organisations that support them. We should look at that under the umbrella of hate crime, but it is slightly different; it is about prejudice more generally that we can all help to tackle. It is a very real inequality that we are tackling.

Central to our job as Members of Parliament is supporting people who have been victims of maladministration and who are not getting enough support from the state. In many cases, that is people with learning disabilities. I have always found that some of the most rewarding work I do as a Member of Parliament is in supporting people with learning disabilities. It is also the most inspiring, and it is great to see the enthusiasm that my hon. Friend the Member for North Swindon referred to.

Unfortunately the Minister for Disabled People, Health and Work, my hon. Friend the Member for Portsmouth North (Penny Mordaunt), is no longer in her place, but the fact that she was here is testimony to her support for this work. We are very keen that people with learning disabilities receive more attention. I give the hon. Member for Newcastle upon Tyne North that commitment, and we will continue to engage with her as this work develops.

I agree with the hon. Lady that people with learning disabilities are among the most vulnerable in our society, and it is the responsibility of all of us to protect them from risk. I will not pretend that we have got this perfect—there is a hell of a lot more to do. There has been significant progress in identifying and managing risk, but it is not consistent, and there are too many occasions when it just does not happen.

The hon. Lady articulated clear views on a specific case of hate crime. She will appreciate that that falls outside my bailiwick, but I will make a few observations, in so far as I can without treading on other Departments’ toes. As she said, the judge concluded that hate was not a factor in the motivation behind the crime. That is a matter for the courts, and it is for them to interpret, but I come back to the issue of prejudice. That case throws up a number of issues that we all need to be more vigilant about. We know that people with learning disabilities are very vulnerable to bad people, and bad people will find vulnerable people to prey on. I am aware that young women with learning disabilities are often preyed upon sexually, which is a real hidden issue that we need to think about. There is also the whole issue of modern slavery. People with learning disabilities are often subject to that. In this case, Lee was obviously being exploited financially by the people who murdered him.

[Barbara Keeley]

I did not manage to raise the very important point that my hon. Friend the Member for Newcastle upon Tyne North (Catherine McKinnell) raised about the fact that Lee Irving was labelled as difficult to help and classed as an adult who could choose a lifestyle, with such tragic results. That has echoes of other forms of abuse because, as my hon. Friend so clearly pointed out to us, his intellectual skills and reasoning were at 0.2% of those of adults of his age. Why were agencies saying that he could choose that awful lifestyle, which ended up having such a tragic result?

[Jackie Doyle-Price]

I totally agree with the hon. Lady. As she says, we have seen that in other cases of abuse. We can look at Rotherham and how the agencies behaved there. It is almost as if there is a view that, “He’s a bad ’un; he doesn’t deserve protection.” That is absolutely not the case. We need to be thinking about the person in a very person-centred way. It was very clear that Lee had a learning disability and did not have the capacity to act as an adult, yet he was treated as one. That is one of the real lessons of this case.

With specific regard to the requests of the family, the whole area of transition is certainly of concern to me. We see this issue in relation not just to learning disabilities, but to mental health. In both cases, families are often completely unable to influence support or care for their loved one; they are utterly powerless because they are in the control of institutions. We need to be learning the very clear lessons there.

We need to raise awareness of hate crime against people with disabilities. Too often, we look at hate crime through the prisms of race and gender. To be honest, we look at hate crime through those prisms because it is the victim of a hate crime who will raise it as such and, frankly, people with disabilities are in less of a position to do so. That said, things are getting better. As I said, it is early days for the offence and prosecution of hate crime, but I am told that in the past year the police have recorded an additional 5,558 disability hate crimes; the number is up by 53%. That suggests that people are more inclined to report it and that the police are more inclined to identify hate crime due to disability, but we continue to monitor the situation and see what else needs to be done to protect the vulnerable.

[Catherine McKinnell]

I appreciate the response that the Minister has given, but the increase in reporting of hate crime is very concerning. There are potentially two issues here. One is that people are more motivated or able to report hate crime, but it may be that there is a significant increase in hate crime as well. It is incumbent on the Government to find a way of monitoring that, so that we can understand whether this is a growing problem or whether there is just more success in terms of the reporting of the crime. We should not confuse the two.

[Jackie Doyle-Price]

That is a fair point. Data is everything, and as time progresses, we will build up more meaningful data, but certainly if crimes are being reported, they are more likely to be prosecuted. Even if the behaviour has been hidden, or if it is on the rise, at least prosecution can happen, but we need to tackle the behaviour first and foremost, to be frank. Prevention is always better than cure.

Under the hate crime action plan launched in July 2016, we committed to providing funding to community-led projects aimed at tackling hate crime. In the first year of the scheme, we funded nine projects across England and Wales covering all types of hate crime. We funded a project in Carlisle involving Mencap. It was to develop an education resource to raise awareness of disability hate crime and how to report it. The great thing about that was that it was created by people with learning disabilities for people with learning disabilities, so it was enabling and empowering the victims. I am advised that three of the projects for the second year of the programme will focus on tackling disability hate crime, but clearly there is more to do.

On 21 August 2017, the Crown Prosecution Service published revised public statements and legal guidance for all strands of hate crime, as well as a support guide for disabled victims and witnesses. One of the most telling things about the speech by the hon. Member for Newcastle upon Tyne North was that it was in the interaction with the criminal justice system that perhaps the most decisive intervention to support Lee could have occurred. Again, we can do more. The Solicitor General is well aware of this matter and, I am sure, is already having discussions with the legal agencies about how we can spread good practice and perhaps look at guidance.

Safeguarding was obviously the real failing in this case. Clearly, we need a system that protects those at risk and acts on issues effectively; that did not happen in this case. As we have heard, once someone becomes an adult, it is very important that it has regard to their feelings and wishes, but the whole issue of mental capacity needs to be determined. In the Care Act 2014, there is a clear legal framework for safeguarding, which gives clear instruction on the responsibilities of local authorities and the rights of adults, but it is also important to involve their families and loved ones as and when necessary. Again, that is a very troubling aspect of this case.

We need to do better. We need to make clear what is expected of the various agencies under the Care Act. We are pursuing Making Safeguarding Personal, which is a sector-led improvement programme that aims to reinforce the placing of the individual at the centre of safeguarding. We are also working with the Association of Directors of Adult Social Services to improve that.

To come back to the issue of the criminal justice system, that was a missed opportunity to give Lee support. During the past two years, we have been working very hard to expand liaison and diversion services. It has been a good news story: more than 71,000 vulnerable adults have been taken out of the criminal justice system and instead put on an integrated health and justice pathway, helping them into health services and away from custody where appropriate. I can assure the hon. Lady that that is still a key part of how we will approach this issue. In fact, I met the team doing that work just last week.

To address the specific recommendations made by the family, the transition from children’s to adults’ services is clearly key. That is where things go wrong; we need to ensure that it is joined up. I always say that if we have a weak link in a chain, we can usually get over that, but if we have a succession of them, that is when things go terribly wrong. As the hon. Lady outlined, there were probably half a dozen in this case.

We are determined that young people with learning disabilities will be properly prepared for adulthood. We are looking at four specific areas: employment, good health, independent living and community inclusion. From the way the hon. Lady articulated Lee’s circumstances, I do not think he could have been judged to be meeting all four of those criteria by any stretch of the imagination, so we must ensure that the support network is in place to help to steer individuals through that, for as long as it takes. It can take a number of years, but the end goal is a good one if we are prepared to make that investment. If people are not ready, they must have support to prevent them from being exploited by those who would exploit people who are vulnerable.

Many people think that the Mental Capacity Act 2005 is very complex legislation, and clearly in this case not everyone knew their obligations under it. There was not a clear understanding of how far the family should have been involved when Lee’s mental capacity was clearly not that of an adult. We want to do a lot more work on educating people in this space. In 2015 we established, with the Ministry of Justice, the National Mental Capacity Forum, specifically to develop those messages and good practice across the sector.

We also have to look at deprivation of liberty safeguards. The Law Commission has recently published its report on mental capacity and deprivation of liberty, and I welcome the observations of the hon. Member for Newcastle upon Tyne North in the light of this case. Like all Law Commission reports, it is a very well-thought-out piece of work. It has had lots of investigation and engagement with stakeholders. We need to make sure that the law is proportionate in respecting people’s liberties, but can also be used to protect the vulnerable. That is clearly the test that we will apply.

We have heard that Lee struggled to navigate the system and that agencies did not work well to support him. Another important tool that will perhaps avoid cases like Lee’s in future is having a named social worker who owns the individual and their needs, and makes sure that those have been satisfied. I think that would make a big difference. We have the named social worker pilot scheme so that more people can have that personalised care and support. They can hold every agency responsible under care plans and be really person-centred, recognising that this is an individual with his own personality, needs and circumstances. That is a very important piece of work. It is our response to the 2015 consultation, “No voice unheard, no right ignored”, which sought views on strengthening the rights of people with learning disabilities, autism and mental health conditions, to enable them to live more independently.

The hon. Lady raised the case of Southern Health and Connor Sparrowhawk. I think we agree that sunlight is the best disinfectant, so all NHS trusts are now required to publish estimates of how many deaths they could have avoided had they been better. That includes the deaths of people with a learning disability. From June next year, trusts must also publish evidence of learning improvements that happen as a result of those data. We expect that the leaders of trusts should show some real accountability and leadership in how they deal with their duties under that requirement.

I want to give the hon. Lady plenty of time to speak at the end, because this is clearly a very important subject for her, but I will quickly add that one of the most important things we need to get right in supporting those with learning disabilities is to invest in good quality supported housing. That is central to encouraging independent living and to having the infrastructure in place to protect them from any potential exploitation.

The hon. Lady also raised the issue of costs and challenges. It is to be celebrated that people with learning disabilities are living longer—for a long time they were dying prematurely. That is a massive improvement in justice, but it does bring with it cash challenges, and obviously we are facing cash challenges across the sector. I wish that was easy to fix. It is not, but it is at the top of my in-tray, as I am sure both she and the hon. Member for Worsley and Eccles South (Barbara Keeley) will understand, and we are very keen to address it. On the specific issue of sleep-ins, which I know Mencap is very worried about, we are actively involved in discussions about how we can support the sector to deal with that.

To conclude, what happened to Lee was not the result of a single cause. There were a number of failings, as the hon. Member for Newcastle upon Tyne North articulately set out. I think there are real challenges: how the criminal justice system understands people with a learning disability, how all the agencies can work more effectively together and how we can provide support for people with a learning disability, so that we not only support, but protect them. We are taking action at a national level to address those. The permanent secretary at the Department of Health is about to convene a cross-departmental roundtable to look at how we can deal with this across Government.

I can give the hon. Lady my assurance that people with learning disabilities are a key priority of mine, and I look forward to making sure that we do not have to have a debate like this in future.