Care Services: Abuse of Learning Disabled

Lord Touhig Excerpts

Thursday 13th December 2012 Lords Chamber

[Lord Touhig]

My Lords, I thank the noble Lord, Lord Rix, for securing this debate and for bringing to it his very great experience and background in giving support and care to people with disabilities.

In his Statement on the final report on Winterbourne View, the Minister for Care and Support, Mr Norman Lamb, said that,

“hospitals are not where people should live”.

He was so right. He went on:

“There are far too many people with learning disabilities or autism in hospital, and they are staying there for too long—sometimes for years … We should no more tolerate people being placed in inappropriate care settings than we would people receiving the wrong cancer treatment”.—[Official Report, Commons, 10/12/12; col. 49.]

However, the truth is that we have been prepared to tolerate this sort of care—and for far too long. We have simply tinkered at the edges of the issue of caring for people with learning disabilities.

As the noble Lord, Lord Rix, said, more than 30 years ago the big idea was care in the community. Everyone got worked up calling for the closure of institutionalised hospitals and care homes. At the county hospital near where I then lived in Pontypool was a ward called St Hilda’s Ward. The hospital had been the local Victorian workhouse and this ward was given over to the care of around a dozen ladies with learning difficulties. It had become their home and they had become very much part of the community, shopping in local shops and attending every event from carol services to school fêtes. Care in the community was supposed to end this sort of caring arrangement, giving people an independent life in their local community, but I believe for many it has made things worse. In order to give people a degree of independence, they were put into small houses and encouraged to live in what were supposed to be family units, but for many the care was non-existent.

A dear friend of mine was persuaded that her daughter with Down’s syndrome would be better off living independently in the community. She was placed in a house with two elderly men, both of whom had dementia. The so-called care amounted to a person—often a different person—calling each morning to see that they had breakfast, coming again in the middle of the day to see that they had a midday meal, and calling late in the afternoon to see that they had tea or supper. The rest of the time they were left alone, with next to no contact with neighbours or anyone but close family. My friend’s family rightly removed this lovely young person from this so-called care in the community placement. It simply did not work and care in the community did not amount to a tin of beans.

Contrast that with three young women, all with Down’s syndrome, whom I met during the Blaenau Gwent by-election. They lived together in a small house and their carer lived with them. It was truly a family environment. They had a rich and varied social life, and the carer was part of their family. That is real care in the community, but I believe it to be the exception rather than the rule. If any noble Lords walk down Victoria Street tonight, barely a few hundred yards from this Chamber they will see people sleeping in doorways. Many clearly have mental health problems and learning difficulties, but their homes are cardboard boxes. This is the life of many who should be cared for in the community.

The Minister, Mr Lamb, said that all hospital placements will be reviewed by June 2013 and everyone who is there inappropriately will move to community-based support as quickly as possible. Could the Minister say precisely what is meant by a move to community-based support? If it is like the so-called care in the community that we have now, I wonder how many will end up like the poor souls sleeping on Victoria Street.

I would now like to spend a few minutes speaking about another matter of concern—disability hate crime. More than a third of the patients at Winterbourne View had a diagnosis of autism and the National Autistic Society, of which I, along with the noble Baroness, Lady Browning, have the honour of being a vice-president, has been campaigning to end poor care and abuse at large, institutional-style services such as Winterbourne View since “Panorama” first aired its programme. The 11 individuals who were charged following the Winterbourne View scandal were charged with disability hate crimes. Disability hate crime is a major concern, regardless of whether someone is in hospital, a care home or the community. It is clear that nobody should suffer abuse because of their disability. In race-related hate crime, the Attorney-General has the power to intervene to increase sentencing where he believes that it has been too lenient. I strongly believe that this power should be extended where there has been a disability-related hate crime.

A lack of training and support for staff can contribute to poor and, in the most extreme cases, abusive practices such as those seen at Winterbourne View. It is vital, therefore, that staff have access to training in the specific needs of patients, especially those with autism. The Department of Health made specific commitments related to training in the adult autism strategy. However, I know that the National Autistic Society is concerned that such commitments have not been fulfilled. In July, the National Audit Office published a memorandum explaining that, despite progress in many areas, key recommendations related to training had not been implemented. Its report demonstrates that the Government have failed to, for example, work with the National Health Service and local authorities to identify priority groups for training and to ensure that autism awareness training is available to everyone working in health or social care.

I urge the Government—and I am sure I am not alone in this—to ensure that the training commitments made in the adult autism strategy are fulfilled. The review of the strategy will take place next year. This is the chance for the Government to carry out their promise to ensure adequate training. I certainly hope that they will embrace that.