Outdated institutions should be banned from detaining autistic people and people with learning disabilities
The government has failed to invest in high quality community services which would support people to leave hospital and it has done nothing to stop the flow of people into inpatient units from the community.
Today, the Health and Social Care Select Committee has published its report into the treatment of autistic people and people with learning disabilities in inpatient units.
This is the latest in a long line of reports and reviews which have called for an end to the use of inappropriate and outdated institutions to detain autistic people and people with learning disabilities, dating back to the Winterbourne View scandal in 2011.
Over the past decade, we have had a string of promises and targets from the government but every time they have failed to match their ambitions with actions. A decade on from David Cameron’s promise to end the use of these units, there are still more than 2,000 autistic people and people with learning disabilities detained in them.
While it is possible to point to a range of complex factors behind this failure, it can largely be traced to two problems. The government has failed to invest in high quality community services which would support people to leave hospital and it has done nothing to stop the flow of people into inpatient units from the community.
People with learning disabilities need support to manage their conditions and adaptations so that they can continue to live independently
While inpatient placements are far more expensive than community support – often running to hundreds of thousands of pounds a year – this cost is borne by the NHS, rather than local authorities. Since 2011, £9 billion has been taken out of local authority social care budgets, often meaning that the less expensive community support which autistic people and people with learning disabilities need is unaffordable to cash-strapped local authorities.
Fixing this will require immediate funding, which is why the Committee has called for the government to assess how much it would cost to support all current inpatients in the community. But beyond this, it means reforming our social care system so that it provides the support people need.
On social care reform, Boris Johnson seems stuck on the one issue of stopping people having to sell their homes to pay for care. While this would be welcome, it would only address part of the problem. When reforms are introduced, they must ensure that comprehensive person-centred support is available to everyone who needs it, enabling them to live independently in their own home.
At the same time, we still have a mental health system which allows people to be detained in hospitals solely because they are autistic or have a learning disability. These are not health problems which can be treated or cured. Instead, autistic people and people with learning disabilities need support to manage their conditions and adaptations so that they can continue to live independently.
It is past time that our mental health system recognised this and stopped trying to force neurodivergence into a clinical box. The government has promised to remove autism from the scope of the Mental Health Act, but this change may not be introduced for years.
Today’s report suggests government could and should go further, by banning the admission of autistic people and people with learning disabilities to inpatient units unless there is an urgent health need which is not related to their autism or learning disability. This would mean they could get help for mental health conditions, without being inappropriately forced into a clinical environment.
The recommendations made by the Select Committee today should come as no surprise to the government. They are what experts, campaigners, and those with direct experience of these units have been calling for since at least 2011.
For the sake of the 2,000 people still trapped in inappropriate units, I hope that this time the government listens to the advice they are being given and finally takes the actions which are needed to end this scandal.
Barbara Keeley is the Labour MP for Worsley and Eccles South and member of the Health and Social Care Committee.
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