Charles Henley First posted on Facebook 4th April
Under Lock and Key’ 4th April 2017
It is now over a month since the Channel 4 presentation of ‘Under Lock and Key’ revealed that carers and their families have been the victims of failed care in the community policy objectives for the past 30 years.
When St. Andrews was given permission to build an extension that would increase its capacity to 110 beds in 2015, it was with the understanding that it was to accommodate the needs ‘of young people across the country’.
I was intensively involved in the 1960s – 80s when ‘medical models’, institutional care and treatment, had been judged to have failed abysmally and care in the community considered to be the right alternative. It was, and enabled 50,000 inmates to be liberated from institutions. Thousands of these people had high degrees of challenging behaviour, and there was no way that they could have survived in the community without the structured and specialist service and dedicated staff provided by day centres and competent residential staff.
When the King’s Fund Centre, aided by Mencap and other charities, campaigned in the 1980s to close Centres and rely on ‘the community’ to take care of all needs, this was clearly utter madness and a clear invitation to the authorities to bring back institutions. I contacted Brian Rix, Secretary-general, Mencap, and David Towell, Fellow in Health Policy and Development at the Kings Fund Centre (extract below), warning of the inherent risks, and have continued to do so ever since.
Channel 4’s documentary left little doubt that institutionalisation had become acceptable again, and the folly of the King’s Fund Centre and Mencap’s‘s misguided intervention might at last become apparent to even the most ardent supporters of ‘extreme inclusion’ fanatics. My personal campaign for 30 years has been aimed at restoring day services to the quality reached in the 1980s – and stopping the return to institutionalisation. I have failed, but they have succeeded in getting rid of all the vital support services that enabled 50,000 to be freed from incarceration and are now so desperately needed by so many other carers. I question whether the King’s Fund Centre supporters are truly proud of their achievement?
The clock has been turned back half a century, and the future looks bleaker now than it was when I came into this area of work in the mid-1960s, amazingly, this has caused scarcely a ripple of interest or protest. Yet, incredibly, the King’s Fund Centre/ Mencap’s’s influence on service provision, built on ‘visions’ has extended across the decades and, with the aid of their supporters, is still influencing a bias against appropriate day services without any logical reason. Nothing will change until the King’s Fund Centre and Mencap recognise and admit ‘they got it wrong’, but as David has evaded all my appeals to him to justify his group’s determination to close all vital supportive services, this hardly seems likely to happen.
The possibility of return to the support levels of the 1980s are now out of the question both about time and cost. As the NHS and LGA have not got a clear strategic policy but are also relying on ‘visions’ for inspiration, the only hope for the future suggests the need for radical action. One viable option is to take advantage of the current indecisiveness about future relationships between NHS/LGA and Social Care.
In my experience, learning disability matters have always been bottom of the heap as far as the NHS and LGA are concerned and always will be – there is need for a divorce. The current aim of carers and professionals and practitioners should be to campaign for an open and objective debate on the merits of a single service agency led by an experienced leader with its own Minister.
Mencap should be leading such a campaign but it has already backed out of promoting this option twice in the past year. Regrettably, its track record conveys the impression it has become a spent force being given the run-around by the NHS and LGA. If carers have the inclination to put pressure on other charitable organisations, MPs, the media, anyone with influence, with an essential degree of unity this could still be achieved.
It gives me no satisfaction, but I append an extract from my first direct warning sent to the Kings Fund Centre, 17th June, 1986, following a lengthy detailed warning already sent to Mencap 22nd March 19” 1986.
This was not in the ‘rocket science’ category, but obvious to an ordinary person who had just a superficial knowledge of people with learning disabilities and a general knowledge of what life is like in the real world.
“I refer particularly to King’s Fund Report No. 50 ‘An Ordinary Working Life’. My original reaction to this publication was that it was so obviously flawed in its premises, research evidence, and assumptions and conclusions, that no practitioner with a basic knowledge of the client group and fundamental knowledge of ordinary working life could possibly take it seriously.
On reflection, I should have appreciated that policymakers however, are invariably not practitioners, and only too few have had relevant experience in contact with the real world that exists outside of their limited professional environments. Consequently, as time has elapsed my complacency has turned first to concern, and from concern to considerable alarm as it becomes very evident that even the most bizarre proposals in this Report are given credibility which is beyond belief.
I believe, that unless a breath of sanity can be restored to the current debate on the issues of community integration and normalisation, the clock will be irrevocably turned about half a century for severely and profoundly handicapped people and their families and for our society as a whole. In this event it will without doubt be a damning indictment of King’s Fund Report No. 50 as one of the most damaging and irresponsible social policy documents to be published this century.”