Three years ago, the Winterbourne View scandal provoked national outrage at the appalling treatment of patients with learning disabilities. The government promised to move as many patients as possible from such assessment and treatment units by June of this year. That meant finding 2,600 places in community settings. It has been, as care minister Norman Lamb admitted on Wednesday, an abject failure. For the past year, more people have been admitted to units like Winterbourne View than have been discharged. Today, in a report that is a familiar description of silo thinking, perverse incentives and the scarcity of transitional funding, Sir Stephen Bubb called again for action. His recommendations for a commissioning system based on individual rights are sensible. But few of them are new either – an indication of how hard it is to create change when the NHS, central government and local councils all need to be engaged. It takes a serious deadline and political commitment to make things happen in mental health and social care.
Yet big sums of money – £4,000 a week per patient – are spent, usually in the private sector, on what can amount to little more than the warehousing of vulnerable people in specialist units, often hundreds of miles from their families. Sir Stephen’s most innovative suggestion is to find £30m, perhaps from some of the cash raised in bank fines, and use it to kickstart a partnership with private investors to provide the kind of supported residential care, with specialist back up, that is needed. But critics warn that this too risks being too institutional to create genuinely individual care packages.
Turning the report into practical measures that satisfy learning disabled people and their families, as well as service providers, will take drive and commitment. But it could be just the small-scale exercise in joined-up provision that would be a trailblazer for integrated health and social care. This is a moment for central government to coordinate local activity: identify areas with accommodation shortages, negotiate a plan and knock heads together to make it happen.
