Disabled People: User-led Organisations

Lord Ramsbotham Excerpts

Wednesday 8th June 2011 Grand Committee

[Lord Ramsbotham]

I, too, thank the noble Baroness, Lady Wheeler, for obtaining this debate. I shall be brief. I declare an interest as a former adviser and now vice-president to the former Sainsbury Centre for Mental Health—now the Centre for Mental Health—because I wish to comment particularly on the mentally disabled. I want to concentrate on an area in which the treatment of the mentally disabled is not good, has not been good, but—it has been announced—is going to be better. My concern is that what appears to be happening in the user-led agency is likely to deny a way of putting that right. I refer to the well of psychiatric morbidity in Her Majesty’s prisons, where it is reckoned that at least 70 per cent suffer from some form of identifiable personality disorder—and some a great deal worse.

For the past four years, the centre has been concentrating on two aspects of work—the treatment of those who are mentally disordered in prisons, and the problems faced by those with mental disorders in obtaining employment. The employment issue is linked with prisons, but the centre has more generally been looking closely at the employment of people with mental health problems in the community. It has become abundantly clear that the key area for achieving independent living for the mentally disabled is employment, and that the best way of achieving that is through individualised support based on their sort of sustainable lifestyle and what they can actually do. That requires careful identification and then placement. The Centre for Mental Health is currently supporting nine centres of excellence, which are using an individual placement and support model across the country. That model is based carefully on this business of finding out what each individual needs. What also applies to it is having people trained as individual placement and support workers who have been attached to user-led and other organisations because they can advise those organisations on how best to look after people who come and work with them.

One problem in prisons at the moment is that no structured mental health treatment is available for this vast number. I was much heartened by the Government's paper, Breaking the Cycle, in which the Justice Secretary said that they were at last going to tackle this problem. Indeed, I have had discussions with the Department of Health as to how this might be done. However, having heard what the centre had come across, particularly about the user-led organisations, one idea that struck me was: what better thing to do than to localise this by employing local user-led organisations to go into prisons and help people who, after all, will come out of prison and whose employment will be out of prison. I was therefore very concerned when I heard that there were threats to the user-led organisations, which looked like being one of the key tools in resolving a problem.

I was encouraged to speak because one of the great messages that I got from the Sainsbury centre was that my noble friend Lady Campbell was challenging the Government on the cuts that were being imposed and asking them to spell out the impact that they might have on user-led organisations. Always being happy to support my noble friend, I felt that I would add this other area, which I would be most grateful if the Minister could look into—not least to alert the Ministry of Justice that there is a potential problem here, which could be solved before causing more problems than it deserves.

Health and Safety: Common Sense Common Safety

Lord Ramsbotham Excerpts

Thursday 25th November 2010 Lords Chamber

[Lord Ramsbotham]

My Lords, I congratulate the noble Lord, Lord Young, on initiating this debate and I welcome his report. I have to admit that my contribution will be devoted to one issue that is deeply affected by three of his recommendations, which propose: a shift from a system of risk assessment to a system of risk-benefit assessment; a review of the Health and Safety at Work etc. Act to separate play and leisure from the workplace context; and the abolition of the Adventure Activities Licensing Authority and the replacement of such licensing with a code of practice. I note with interest that the Adventure Activities Licensing Authority is not one of the organisations threatened with abolition or merger in the Public Bodies Bill.

As I have said before in this House, the only raw material that every nation has in common is its people and woe betide a nation if it does not do everything possible to identify, nurture and develop the talents of its people—all its people—because, otherwise, it will have only itself to blame if it fails. For the past 15 years, I have been working with those at the bottom of the national pack—namely, offenders and those at risk of offending. You often find that they have been neglected in a whole variety of ways, including by parents and schools, but when notice is taken of them and opportunities are put their way, they seize them and demonstrate abilities that can be harnessed and developed to the benefit not only of themselves but of the communities in which they live. At the heart of that process is challenging people to do things that they did not think they could do, because the resulting self-esteem is the key to further progress. Many of the challenges involve risk.

Here, I declare an interest as a member of the advisory board of Youth at Risk, which is an organisation involved in providing those challenges. For several years, Youth at Risk has been working in the hardest of inner-city areas and in young offender institutions. For the past three years, it has been running community transformation programmes for 10 local councils across the United Kingdom that are designed to work with young people at risk of poor outcomes. During this time, the organisation has worked with more than 1,700 young people and 2,200 adults, of whom 100 per cent reported that they were able to develop more stable relationships, 63 per cent said that their self-esteem had been improved and 75 per cent reported that they were more able to support others. Typically, those young people included 80 per cent with behavioural, social and/or emotional problems; 60 per cent who were involved in gangs; and 30 per cent who were involved in gun and knife crime.

The evaluation found that the programme successfully engages with vulnerable young people, who engage because they are inspired by the opportunity to change their lives. The statistics prove that they are more determined to achieve as a result. At the same time, the programme has been rolled out in schools and now works with young people who have challenging behaviour that is destructive to their and others’ learning. The programme looks after those whose self-esteem, belief and aspirations need development as well as very able pupils who are at risk of becoming young offenders. All that has been summed up in a poem by two young participants of which I would like to quote one verse:

“Ready to work together so that we might stand tall,

We've learned all about pride before a fall.

As I said there’s no us and them, there’s no square,

LIFE IS A RISK THAT WE ARE WILLING TO DARE.

Like the challenge course, life is no breeze;

We’re about bringing mountains to their knees”.

Despite all that evidence, the sad fact is that Youth at Risk is having to withdraw its programme from one of the councils because the health and safety restrictions being imposed in effect remove the ability to undertake any form of challenging programme that contains the slightest risk. However, the results of overcoming fear and surmounting challenges are clear for all to see. If ever there was an example of the truth of an unenforceable rule that I found displayed on an Army notice board, “A breach of common sense is a breach of the rules”, this is it.

Like other noble Lords who have had the privilege of visiting our Armed Forces in operations in Iraq or Afghanistan, I came back exhilarated and humbled by that experience. The Armed Forces demonstrate very clearly how today's young people respond to challenge and risk. What do those responsible for taking risk out of their lives think about the impact on the future of our country of risk-averse generations? As the Prime Minister says in his report,

“We simply cannot go on like this”.

Of course, health and safety is important but the collective madness that is daily exercised in its name is not only a breach of common sense but is endangering our present and our future.

I hope that the recommendations in the report will be actioned as swiftly as possible before yet more community transformation programmes have to be cancelled. Organisations such as Youth at Risk are performing a job of national importance. Woe betide us if we do not do everything that we can to support them and to prevent what they are doing for our present and our future being itself put at risk by all the unnecessary restrictions, which are so clearly described by the noble Lord, Lord Young, in his admirable report.