The publication in quick succession of three reports, combined with last week’s BBC Panorama programme showing patients at Whorlton Hall hospital being abused by staff, have shed much-needed light on the mistreatment of learning-disabled people. Eight years after a reporter went undercover at a similar hospital, Winterbourne View, the scenes appearing to show vulnerable adults being bullied and threatened were all the more appalling for being familiar.
The emergence over the weekend of a whistleblower, former Care Quality Commission inspector Barry Stanley-Wilkinson, made the systemic nature of this failure even clearer. Mr Stanley-Wilkinson says he wrote a critical report of Whorlton Hall that was never published. The CQC says that report did not allege abuse. But it has apologised for failing to spot problems at Whorlton Hall, which it recently rated “good”.
The hospital, which was recently taken over by the US healthcare company Cygnet, now stands empty. Ten staff have been arrested and the criminal justice process must run its course. But any grim satisfaction in rooting out bad apples should be short-lived. What has been revealed over the past 10 days, in reports by children’s commissioner Anne Longfield, the CQC and academic researchers as well as by the BBC, goes beyond the actions of a callous few.
The underlying problem has three main aspects. The first is discrimination against learning-disabled and autistic people. Last week’s review of mortality rates, commissioned by the NHS, showed that women and men with learning disabilities die 27 and 23 years earlier than the general population, with researchers pointing to “bias in treatment” as an explanation.
Such bias of course intersects with other prejudices – as the variation in death rates between women and men suggests. Panorama provided further evidence of this, with shocking footage of male carers ganging up on a female patient known to be afraid of men, a form of misogynist bullying they described as “pressing the man button”.
The second aspect is the standard and status of work in the care sector. This question is far bigger than Whorlton Hall. The fact is that care – whether of autistic or disabled people, dementia sufferers or looked-after children – is undervalued. This does not excuse unkind or illegal behaviour. It does mean that many of the people employed in this area are underqualified, poorly motivated and unsuited to what must be recognised as demanding work.
The third aspect is structural and concerns commissioning and regulation. The squeeze on local authority budgets combined with the government’s failure to propose, let alone deliver, a policy on social care, has created unhealthy conditions. The commissioners who purchase care packages must be accountable. So must the CQC. But politicians too must take responsibility for the failure to follow through on commitments made following previous scandals. Health secretary Matt Hancock’s refusal to be interviewed about Whorlton Hall was a serious mistake.
Since 2011, the number of adults living in specialist hospitals has fallen from 3,400 to 2,300. But steep rises in the use of physical restraint, combined with warnings from Anne Longfield and others about “values and culture”, are alarming. If the government has rejected proposals for an independent commissioner for learning-disabled people, ministers must explain why – and what they plan to do instead.