A Trade in People

Within the Centre for Disability Research (CeDR) at Lancaster University we’ve been supporting the 7 Days of Action campaign (see their website  https://www.sevendaysofaction.net/ ).

This campaign, led by activist families has three aims:

1. to get people with autism and learning difficulties out of in-patient settings and back into their communities;
2. to keep them in their communities once they are home;
3. and to stop them from having to leave their communities in the first place. At any one time across England, approaching 3,000 people with autism and/or learning difficulties are inpatients in various types of ‘specialist’ services, ostensibly to help understand and treat mental health problems or behaviours putting the person themselves or others at risk of harm.

For five years, triggered by a BBC Panorama undercover expose of practices at one of these services, Winterbourne View, government policy has been to drastically reduce the number of these services and to develop better support for people in the communities where they live. In practice, relatively few of these services have closed. Media exposes of shocking practices in these places keep coming, such as the Channel 4 Dispatches exposure of practices at St Andrews Hospital (see the 7 Days of Action response to this here https://www.sevendaysofaction.net/Dispatches-under-lock-and-key ).

This week, 7 Days of Action is focusing on the increasing role of independent sector companies in driving these inpatient services for people with autism and/or learning difficulties, combining rigorous analyses of what’s happening with people’s experiences of dealing with services provided by these companies. A report, A Trade in People: The inpatient healthcare economy for people with learning disabilities and/or Autism Spectrum Disorder published by the Centre for Disability Research at Lancaster University and led by Mark Brown of the 7 Days of Action campaign  summarises some of these analyses and experiences.

It is clear that an increasing proportion of these inpatient services are being run by the independent sector rather than the NHS (it’s now up to about half of all these services). Over a quarter of a billion pounds of public money every year is being paid to independent sector companies to run these services. People can be stuck in these services for years and years.

As well as running these inpatient services, registered with the Care Quality Commission as hospitals, some of these companies are also running services for people with autism and/or learning difficulties that are registered as care homes, with some services originally registered as hospitals being re-registered as care homes (http://chrishatton.blogspot.co.uk/2016/10/plastical.html ). It’s not always clear what the difference is between some of these care homes and the hospitals run by these companies, particularly in the potential for abusive practices (see https://www.theguardian.com/society/2017/jun/07/care-home-directors-convicted-over-devon-learning-disability-regime ). Some of these companies also run residential special schools for children and young people with autism and/or learning difficulties, about which we know very little.

We think it’s vital that, as with NHS services, independent sector companies providing inpatient services are subject to proper scrutiny and accountability. That is why, at CeDR, we are proud to support the 7 Days of Action campaign.

Chris Hatton

@Chrishattoncedr