26 Nov 2014

Winterbourne View report: why has there not been more progress?

Today’s report on the care of people with learning disabilities in England is full of horrible words and phrases like “stakeholder”, “mandatory commissioning frameworks”, and “provider and workforce development”.  Aaaaggghhh –   just saw another one:  “system boundaries”.

Which is a pity because the report makes some very good points about why it has taken so long to do anything about care of people with learning disabilities and/or autism.

It’s not just that it is now nearly four years since the Winterbourne scandal and the horrible abuse of people with learning disabilities which was secretly filmed.

It’s not that the Government ignored it.  They didn’t.   They commissioned reports themselves.  In fact, look on the Department of Health’s website and you will see “Final report into the events at Winterbourne…”.

That was in December 2012 and there was an interim one in June that year.

In August 2012 an independent report said there needed to be a fundamental changes are needed in how care of vulnerable adults is commissioned and monitored.

Now this latest one by Sir Stephen Bubb, of the Association of Chief Executives of Voluntary Organsiations (ACEVO), has arrived.  It was commissioned by NHS England because not enough had happened.

For instance, a Concordat was signed by the Government and a number of other organisations pledging action. Specifically, that all current hospital placements would be reviewed and anybody inappropriate placed in hospital should be moved into the community as soon as possible.

The deadline was no later than June 2014.  NHS England’s figures show that between September 2013 and September 2014, 923 people were transferred out of inpatient care.

Marvellous?  Not.  Because the same data for the same period shows 1,306 people were admitted.

Why has there not been more progress?

The report says it’s not as if people haven’t tried before.  For decades, it says, people have described what good care looks like.  But , it hasn’t happened, the authors say, because it has been too hard to do the right thing and too easy to do the wrong thing and the people most eager to change the system – those with learning disabilities and/or autism and their families, have had too little power or support to do so.

Clinicians are asked to admit fewer people who present challenging behaviour to inpatient settings, and to discharge others, on the basis that they can be appropriately supported in the community   Many clinicians, the report says, would like to do that, and some manage it but often they do it in spite of the system not because of it.

And so it goes on.  Health and social care providers are asked to expand community capacity.  Frontline staff are asked to do things differently.  And some, the report repeats, manage to do this but, and again the report repeats, in spite of the system not because of it.

Sir Stephen’s conclusions are technically simple:  a big expansion of community provision, and more empowerment for the people it’s meant for, that is those with learning disabilities and/or autism and their families.

What is clear, though, is those very people often feel completely disempowered.  Their families have to fight and fight for the right services.  Still too many people are being sent to hospitals hundreds of miles away from home, they are kept there for too long because there is nowhere to move them, and they regress.

It, of course, is not as simple as saying all people with learning disabilities should be moved back into the community.  Some have severe problems that mean they could harm themselves or others.   So there need to be secure places of safety.

But it is a tragedy if they languish there for the wont of a place in the community when they are better.

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6 reader comments

  1. chris says:

    Just watched part of the interview with Norman lamb. I would add that just talking to advocacy groups will not be good enough to solve this issue. Not all people with learning disabilities and those with Autism or represented by them. also the way advocacy groups are funded (normally by local councils) mean they will not challenge what is happening on the ground . Cornwall is very good example of this. I have been bullied by one advocacy group in the county for simply standing up for people’s rights. Respect Gary very much but Norman lamb needs to actually talking directly to people with learning disabilities and those with autism.(l have actually request Cornwall Council to paid for an advocate out of my personal budget so at least I can decide for myself who represents me (there are good advocacy providers but not many in the south west)

  2. Charles Henley says:

    Winterbourne View Report
    This latest contribution to the Winterbourne View scandalous saga will resolve nothing – it will transfer these unfortunate people into ‘the community’ where their problems will remain but cease to attract attention. It is only the numbers that are currently involved that justifies media attention.
    Once dispersed these people will join the many thousands of other families already leading deprived and traumatised lifestyles arising from the decimation of vital support services. The clock is being turned back half a century as Care in the Community sinks without trace.
    A Winterbourne View outcome has been predictable for decades. Care in the Community policies have been influenced by the wrong people and implemented by the wrong authorities. Structured and specialist services vital to enable these special people to survive in the community have been decimated. Nothing will change until fundamentally flawed doctrinaires have been exposed as unrealistic and unachievable – but nobody with influence really wants to know.
    At best it can only be said of those responsible for the current policy debacle that they were well intentioned. At worst it could well be seen as one of the cruellest confidence scams played on the most vulnerable people and their carers in social history.

  3. raj sodha says:

    It appears that whilst they all mean well but individually, there is nobody out there actually cares! There are always lessons to be learnt after the event!

    It has always been like this and will always be like this!

  4. Robert says:

    I’ve a grandson with leaning disabilities and in Wales all the providers to help him find work have gone, all he’s been doing for the last year is workfare he works for his benefits . The job center actually told him they no longer find work for people like him so he has to find the jobs himself, they are only doing people who are having benefits stopped . People like him, interesting way of using language .

    He goes to work every day he worked 44 hours a week for his benefits and he is working dam hard the employer then employed two people and said maybe one day we will employ you, cheap dam labour really.

    No wonder people have no interest in politics or politicians .

  5. Christian Stanley says:

    LET HIM GO HOME STOP HIS SUFFERING THE NHS IS MEANT TO GET PEOPLE BETTER.

  6. Stavroulla Ng says:

    If you want to know why we need #LBBill & think its all covered in the Care Act; this is your answer http://wp.me/p4r3Nb-l6. Please follow and support it. We need change now.
    Thank you

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