Children and Vulnerable Adults: Abuse

Baroness Hollins Excerpts

Thursday 26th June 2014 Lords Chamber

[Baroness Hollins (CB)]

My Lords, I congratulate the noble Baroness, Lady Walmsley, on initiating this very important debate. I will focus on some of the measures needed to prevent and address the abuse of children and adults with learning disabilities. I do this as a family carer of a vulnerable adult and from my perspective as a psychiatrist working in learning disabilities for more than 30 years. The House will also wish to know that I am a member of the recently established papal commission for the protection of minors.

Why is it important to focus on people with learning disabilities, or “intellectual disabilities” as they are known around the world? There are 1.5 million of them in the United Kingdom. They are one of the most vulnerable groups in our society yet they are also one of the most marginalised, underserved and least able to protect themselves. The appalling abuse at Winterbourne View that was uncovered in 2011 focused policymakers’ attention on the abuse of adults with learning disabilities, adults who are more at risk of all forms of abuse. Similarly, compared with their non-disabled peers, children with learning disabilities are three times more likely to experience neglect, bullying and abuse. There are long-term consequences of abuse for well-being, psychological well-being and mental health, with a strong link to depression and harm. The National Association for People Abused in Childhood provides support for adult survivors of childhood abuse and it reports that the demand for its services, including a telephone support line, is currently at an all-time high.

The Serious Crime Bill makes it explicit that under the Children and Young Persons Act emotional cruelty likely to cause psychological harm to a child is an offence. I suggest that that should also include witnessing domestic abuse. Given the increased risk of abuse and neglect, it is vital that we consider whether these measures taken by the Government will adequately protect children and adults with learning disabilities. The Care Act, which received Royal Assent in May, provides a clear legal framework for how the health and care system should work together with the safeguarding adult boards. The Act requires local authorities to make inquiries when they think that an adult with care and support needs may be at risk, and to take action if needed. To tackle problems quickly and prevent them happening again, it is vital that organisations share information with the SABs. The Act makes it clear that if an SAB requests relevant information from an organisation or an individual, they must provide it. Clearly, for local authorities to perform their duties, they need to identify that someone is at risk.

Since 2010, there has been a mandatory requirement to submit abuse of vulnerable adults returns to the NHS Health and Social Care Information Centre. In February, the centre’s report on safeguarding adults referrals revealed that of the nearly 42,000 men who received safeguarding referrals in 2012-13 nearly 11,000 had a learning disability, as did nearly 10,000 of the 65,000 women who were reported. Worryingly, these figures may be the tip of the iceberg as we know that the abuse of both adults and children with learning disabilities is under reported. We know that the families of those at Winterbourne View who raised concerns were not listened to and that a member of staff who acted as a whistleblower went unheard. It is shocking that it took a TV documentary for that abuse to come to light. What steps are the Government taking to ensure early identification and prompt reporting?

Those working with adults and children with learning disabilities must receive training on signs of abuse and neglect. When people with learning disabilities speak up, we need to ensure that those listening, whether professionals in health, education, social care or the police, have the skills to communicate in a way that that person understands. We know that these people are often unable to speak out for themselves so we need to ensure that families and carers are listened to when they have concerns.

I am encouraged that the Department of Health has commissioned a whistleblowing helpline, to be provided by Mencap, for staff and organisations working within health and social care and I commend the noble Baroness, Lady Walmsley, for her amendment to the Serious Crime Bill that will make it a duty for people who work in regulated activities with children or vulnerable adults and who suspect abuse to report it to the local authority. I too support mandatory reporting.

Reporting a suspicion that turns out to be inaccurate must not become a disciplinary matter for health and social care professionals—the needs of the child or vulnerable adult are paramount, however distressing false suspicion may be for others involved. Where suspicions are found to be correct, taking immediate action to protect the victim and others from further abuse and neglect is imperative but we must also ensure that appropriate treatment is available for the perpetrators of abuse.

What about prevention? People with learning disabilities have the same human rights as everyone else—the same rights to freedom from abuse and neglect, the same rights to be treated with dignity and respect. However, they also need to be empowered with education. They need to know their rights, what abuse and neglect are and what to do if this is happening to them. This is difficult. Some people may find it easier to understand pictures rather than words. Books Beyond Words uses pictures to tell stories about difficult topics, including abuse, to engage and empower people with learning disabilities and to facilitate their discussion with those who are supporting them. I declare an interest as chair of the charitable organisation that develops these pictures and this method of communicating.

The Government must take measures to prevent abuse or neglect of children and adults with learning disabilities happening in the first place. We need interventions to be offered before there is a need to resort to criminal prosecution. Parents and carers sometimes feel isolated, overwhelmed and unable to cope with their responsibilities and they need specialist support to be available when they need it.

As the scandal at Winterbourne View highlighted so starkly, we need to ensure as well that those meant to be providing care to children and adults with learning disabilities as paid care workers are fit to do so. Many of these care workers are underqualified and poorly paid. We need to ensure that care workers receive a better wage for the important work they do. Can the Government ensure that the use of zero-hours contracts among employers of care workers comes to an end? Let us consider those children and adults living with the effects of abuse. They may carry the pain and trauma with them for the rest of their lives. Their GPs need to know where to refer them. For disabled people the availability of trauma-based therapies is even more limited than for other people. This is discriminatory. I end by asking that the abuse of vulnerable children and adults should be at the forefront of our minds—it is everyone’s business.