Winterbourne View Hospital and the Transforming Care Programme

Darren Henry Excerpts

Thursday 10th June 2021 Westminster Hall

[Darren Henry (Broxtowe) (Con)]

It is a pleasure to serve under your chairmanship, Ms McVey. I thank the hon. Member for Worsley and Eccles South (Barbara Keeley) for securing this debate. I am pleased to be here to speak on such a crucial topic. First, I want to reflect on the past 10 years since the Winterbourne View scandal, and secondly, look forward and ensure that such horrific events cannot happen again.

What the BBC “Panorama” programme exposed was absolutely shocking, disgusting and heartbreaking. It revealed patients with a learning disability and/or autism being repeatedly pinned down, slapped and taunted by staff. That community was let down. Following that, the Government promised to transform care for people with a learning disability and/or autism by 2014 by supporting those in assessment and treatment units to move out of those settings and get the right support in the community. The Government still have a long way to go before they achieve what was promised. It is vital that we continue to learn from Winterbourne View. The Government have shown that they are willing to make the necessary changes by publishing the White Paper on reforming the Mental Health Act. I commend the reforms that it has set out.

I want to send my personal thanks to the Department of Health and Social Care as well as the Lord Chancellor for driving forward reform of the Mental Health Act. The Act has long been outdated, and I hope that implementing many of the recommended changes will fire the starting gun on changing the way our country views and treats mental health conditions.

There is a clear desire, set out in the White Paper, to change the culture surrounding mental health by enacting a person-centred approach to care. That is a new approach to the way in which our mental health service is run, and will begin to achieve the desired goal of bringing the Mental Health Act in line with 21st-century principles in medical care.

Having spoken to stakeholders, including Mind, the National Autistic Society, Rethink Mental Illness and the Mental Health Foundation, I want to share the conclusions that I have drawn and the lessons that must be learnt following the atrocities of Winterbourne View. Broadly speaking, they are, first, ensuring that the shift from in-patient care to care in the community is backed by a Government commitment to provide community support services. Secondly, all in-patient facilities must take into consideration the requirements of all their residents, and ensure that when individuals are ready to be released, the right care in the community is in place for them. Thirdly, to prevent situations from reaching a stage where individuals have to be placed in an in-patient facility, we must emphasise early intervention.

I applaud the long overdue decision in the White Paper to remove autism and learning disabilities from the definition of mental disorder in the Mental Health Act. For too long, autism and learning disabilities have been grounds for detention under the Act. I also welcome the commitment to build new mental health hospitals, with two schemes already approved and more to come. And we will tackle the maintenance work needed in the mental health facilities where patients are treated.

Before new projects commence, however, it is essential that we ensure that all new facilities that are built take into account the needs of those with autism and learning difficulties. Removing autism and learning disabilities from the terminology of the Mental Health Act will not mean that individuals with autism and learning disorders will not suffer from poor mental health, so they will require access to those facilities in time. Therefore, we cannot continue establishing new mental health facilities that are not constructed with all those who will access them in mind. The needs of those with autism and learning difficulties may be different from those of others who access in-patient services, and those needs must be catered for. I would welcome a new approach to the creation of in-patient facilities that means that the needs of those with autism and learning disabilities are given greater consideration.

The White Paper states that care and treatment reviews will have statutory force to help to address inappropriately long stays in in-patient units. This is a welcome development that will ensure that people with autism and learning disabilities do not become trapped in in-patient care. In total, 2,040 people who have a learning disability and autism remain detained in in-patient settings and 59% of those people who have been detained in hospital have had a length of stay of over two years. That is simply not good enough. However, there are other barriers in place, ensuring that individuals are not being released from in-patient care at the appropriate time. There is a lack of programmes and facilities for people to be released into.

Without the appropriate resources in place, individuals are becoming trapped in facilities that may no longer have the correct environment. I spoke about this today with one of my constituents in Broxtowe, Justin Donne, who is chairman of the board of trustees at Autistic Nottingham. He had this to share:

“What has become clear in our communities is that the suffering of autistic people being locked up is needless, as our advocacy, social and personal assistance services have successfully kept most of our service users out of that condition. Moreover, we get occasional requests from outside our geographical remit”—

that is Nottinghamshire—

“regretting that they do not have the appropriate facilities in their location. This proves that we obviously need to significantly invest more funding in organisations such as ours”—

that is Autistic Nottingham—

“who provide real, tangible help that benefits both the individual and the community, and saves money and hospital resources by investing in essential preventative services.”

The National Autistic Society’s vital community work is a testament to just how successful community support can be in helping individuals outside an in-patient facility. More must be done to address these issues and I look forward to hearing the Government’s comments on this area in particular. I would welcome a commitment to evaluate and improve the services that are currently in place across the UK to support individuals with autism and learning disabilities when leaving in-patient facilities.

The Government have committed £31 million of mental health recovery funding for a range of projects, including admission avoidance and quality of in-patient care. I would welcome a breakdown from the Minister of what specific projects will be funded.

The focus of the White Paper is on a new person-centred approach to care. Putting the individual at the centre of their own treatment enables them to make their own decisions surrounding care and results in a more tailored approach. To those with autism or learning disabilities, it is even more vital that the care is centred on their specific needs. The introduction of a statutory advanced choice document will go a long way to ensuring that that is acted upon and to enable people to express their view on the care and treatment that works best for them as in-patients, and that is before the need arises for them to go to hospital. As the White Paper states, putting these plans on a statutory footing for the first time will require them to be developed in good time in partnership with patients.

My concern about shifting the emphasis of care away from in-patient facilities to community support relates to whether properly established and funded support is in place in the community. The NHS long-term plan established a commitment for increased community support for early mental health intervention, which is echoed in the White Paper. I would welcome a detailed outline of what this expansion of community support will look like at all levels, how and when it can be expected and how it will be implemented across the UK to ensure that all areas of the UK have the same levels of support. As I have stated, we need to focus on prevention. If that is not possible due to the complex needs of the individual, how can we ensure that individuals with learning disabilities and autism in hospitals are safe and respected, that their dignity is maintained and that their human rights are not violated?

I spoke recently with another constituent of mine, Ashley Swinscoe, who does vital work in my local community supporting those with autism and/or learning disabilities within our local community. He discussed early intervention and proposed that schools needed to offer support to individuals until they were 21 years old. He said that through this stage, consistent support should be offered from childhood to adulthood. This consistency would help the individuals manage the stress caused by the changes in life. That would also reduce the risk of behavioural and mental health declines.

If individuals are not ready for supported living and require residential care, providers must also offer supported living in the future. Residential care is not long term, and providers should promise to progress individuals to become more independent, with fewer restrictions, and to move to supported living. That is a suggestion from Ashley Swinscoe from my constituency.