Robert Buckland: Mental Health Hospitals At Risk Of Treating People Like ‘Cash Cows’

Former justice secretary says people with a learning disability or autism are being subject to abuse and mistreatment.
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Over 2,000 people with a learning disability or autism wake up in an inpatient unit each day, with many being subjected to abuse and mistreatment on a frequent basis.

Abuse includes individuals being kept in isolation, save for a food tray being pushed through a slot in their door. We know of people whose family members have discovered broken bones and bruises - and, far from historic, these cases are recent and by no means unusual.

In February 2023 alone there were 5,455 reported uses of restrictive interventions, including physical, chemical and mechanical restraint. I cannot accept that the best and most humane way to deal with a vulnerable person is to isolate and physically, often painfully, restrain them.

We have all been horrified by revelations of shocking treatment of neurodiverse people in the mental health hospitals, and when the names Whorlton Hall and Winterbourne View are mentioned they send a collective shudder across the neurodiverse community.

We may, perhaps optimistically, believe that society has moved on from segregating neurodiverse people, but this is tragically not the case.

Our current laws still permit detention in mental health hospitals on the grounds of learning disability and autism. I agree with Mencap and other leading learning disability charities in their view that this is cruel and reductive, and welcome the Government’s intention to put right this wrong via the draft Mental Health Bill.

But a change in law is not enough. The current crisis in the social care system means someone with a learning disability will struggle to get discharged, with the average length of stay in mental health units being over 5 years. There is currently insufficient community care infrastructure to fulfil the needs of all those vulnerable people in our society.

The number of cases where community care or support - that is there to empower neurodiverse people and enable them to lead happy lives - fails, should obviously, be zero.

The reality is very far from that, and the consequences of each failure for a neurodiverse person are unconscionable in a civilised country in the 21st century. It is not a matter of someone missing a few hours of care here and there, but one that sees vulnerable people detained and spiralling into crisis, often under the Mental Health Act, in hostile and distressing inpatient units.

In mental health hospitals, people are at risk of becoming the ‘cash cows’ of profiteering private providers who charge the NHS thousands of pounds a week to care for patients.

For these unsuitable providers, there is no incentive to discharge patients and too often this is the only solution available to local authorities who are not in a position to administer care themselves.

These providers mislead the system into believing that the level of care is suitable for neurodiverse people. This is not an acceptable, or indeed sustainable way for taxpayers’ money to be spent, let alone for human beings to be treated.

It’s encouraging that the Government and NHS have committed to reducing the number of inpatients with learning disabilities/ and or autism by half by March 2024.

However, Mencap estimates that, at the current rate of progress, this target will not be met until 2028. The new Integrated Care Systems (ICS) have a key role to play in tackling this issue of such importance to people in the neurodiverse community, and I cannot think of a better place to properly commit to the integration of health and social care than this group of vulnerable people.

While the situation is distressing for many of the people stuck in inpatient units, I do not want to create the impression that no progress has been made at all. Some ICSs have made great strides in meeting the 2024 target and I have faith that, while there is still work to be done, many will rise to the challenge.

That will not happen, however, without a redoubling of effort at all levels of Government. The political will to fight for people with autism and learning disability will also have to be there to make this all-important target a reality for people who are, now essentially locked away because of their disability.

I will be hosting a reception in Parliament to convene all of those people and groups who are, like me, passionate about getting this crisis the attention it deserves.

As Chairman of the All Party Parliamentary Groups on Learning Disability and Autism, and as a former Cabinet Minister, I will do all I can to put an end to the trauma and anguish I have seen first-hand caused by a loved one being shut away in these units.

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