Queen’s Speech

Baroness Hollins Excerpts

Monday 17th May 2021 Lords Chamber

[Baroness Hollins (CB) [V]]

My Lords, I declare my interest as chair of the Department of Health and Social Care’s oversight panel, which is reviewing the care and treatment of people with learning disabilities and of autistic people who are being detained in long-term segregation. As the noble Baroness, Lady Stroud, has just discussed, the gracious Speech set out an ambitious and laudable levelling-up agenda to tackle the long-standing geographical disparities facing the country. I will speak about another kind of disparity: that faced by people with learning disabilities, which is as apparent in considerations of community and welfare as it is in health.

Debate about people with learning disabilities often ends with the comment that services need to be better. The Mental Health Act White Paper published earlier this year recommended a duty on commissioners to ensure an adequate supply of community services for people with a learning disability and autistic people. This duty aims to address the failure of both local authority and NHS commissioners to commission skilled local community services, thus leading instead to involuntary detention in hospital at times of crisis. The proposed statutory principles in the White Paper are choice and autonomy, least restriction, therapeutic benefit and the person as an individual. Perhaps a fifth principle should be added: care in the community.

The Mental Health Act White Paper hopes to drive significant change for people with a mental disorder. When it is published, the Bill must address the financial disincentives which serve to encourage lengthy hospital admissions and an explicit requirement for a duty to make reasonable adjustments in community and welfare services. Article 19 of the Convention on the Rights of Persons with Disabilities is a good place to start, given that the UK is a signatory to the convention and ratified it in 2009. Article 19 demands that we recognise

“the equal right of all persons with disabilities to live in the community, with choices equal to others, and shall take effective and appropriate measures to facilitate full enjoyment by persons with disabilities of this right and their full inclusion and participation in the community”.

The gracious Speech was notably silent about the widely anticipated social care Bill. Following the disruption of Brexit and the human tragedy of the high number of Covid-related deaths of people dependent on our care system, will Her Majesty’s Government now commit to fully overhauling the social care system—including for disabled adults of working age, not just older people living in care homes?

We need a trained workforce to meet the needs of people with learning disabilities. Commissioners, many of whom are buying the wrong services, must receive specialist training on the needs of the populations they serve. In the course of chairing the oversight panel for the independently chaired care and treatment reviews programme, I have heard panel members angrily decrying the fake lives and fake homes provided for some people with learning disabilities and some autistic people, who, after lengthy countertherapeutic hospital admissions, are too often discharged to alternative institutions such as converted wards away from real life and outside their communities. One important reason for this is the lack of suitable housing providers and suitable safe homes for people.

As we hear today of the importance of community and welfare, let us not forget those who are so often forgotten and ask: what does levelling up look like for people, for example, with learning disabilities from a black and minority ethnic background, whose average life expectancy is just 35 years; or for the over 2,000 people with a learning disability or autism still held in assessment and treatment units almost 10 years on from the Winterbourne View scandal; or for thousands more living their lives in institutional segregated services, denied a chance to live an ordinary life and now facing even more barriers to the most basic of institutions: the democratic vote?

I urge Her Majesty’s Government to take seriously the needs of people with learning disabilities and autistic people and to avoid measures such as Covid passports or photo IDs, which are likely to constitute serious barriers to their full community participation.