The government’s response to its consultation on the ‘No voice unheard, no right ignored’ Green Paper offers little new thinking and no overarching framework to carry things forward, so it seems unlikely that there will be much change in services – and the consultation may turn out to be another missed opportunity to make improvements in the lives of people with learning disabilities.
The government’s long-awaited response to the Green Paper consultation ‘No voice unheard, no right ignored’ was slipped out on Tuesday with little fanfare by the Department of Health. The low-key nature of its release seems fitting as the response from the learning disability community so far has been one of disappointment, and for good reason.
The key aims are as you would expect, and could have come from any document produced in the past 15 years – people with learning disabilities will be supported to live independently as part of the community, their views will be listened to etc – but there seems little substance in the government’s response that is liable to make this happen. Certainly there is nothing like an overarching framework that would give direction to the future of learning disability services, which is something that has been missing for a number of years.
Some of the measures outlined are also just reiterations of what is going on already. For instance, there are plans to update guidance for commissioners – but guidance has been available for years. As have examples of good practice.
Meanwhile, some of the more significant hoped-for changes, such as taking people with learning disabilities and/or autism out of the scope of the Mental Health Act unless they have a diagnosed mental illness, have been kicked into the long grass with the promise of ‘further discussion’, although no timescale has been put on when this will happen. As Rob Greig, chief executive of the National Development Team for Inclusion, noted in his blog, this happened last time it was discussed – in 2003. “How much more discussion is needed?” he asked.
Without the additional legal rights the Green Paper talked about, there are fears about whether anything will improve.
There is also little in the document that will compel those in positions of power to make the necessary changes. Recent history – think the Winterbourne View Concordat – has shown that plans can, and do, wither on the vine if the mechanisms are not in place to hold people to account if progress is not made.
But why do we need all these new consultations and reviews? We had a perfectly good learning disability strategy in place at the start of this decade – Valuing People Now (VPN).
When the then coalition government wound it down in early 2011 – more than a year before the end of its planned life – VPN had not achieved its goals, but was on the road to doing so. Removing the strategy imperative imposed by central government, has meant that the learning disability agenda has since drifted and there are signs that some commissioners are starting to slip back into old habits in terms of commissioning – viewing people more as recipients of existing services, rather than seeing their job as securing the services that would enable them to live lives of their own choosing.
For instance, the number of larger shared-occupancy houses is starting to rise, with no evidence that this provides better outcomes for the people with learning disabilities who live there, or is more cost-effective. Likewise, commissioners are still buying places in assessment and treatment units – often out-of-area – and we know they are neither cost-effective nor provide good outcomes.
Of course, it is a hugely complicated picture; commissioners have to grapple with ever-shrinking budgets – with more cuts to come – and in some cases alternative services are not available. But this should not remain the status quo.
Dr Rhidian Hughes from the Voluntary Organisations Disability Group also noted that the plans need proper funding, especially given the cuts to social care in recent years. It is difficult to argue with that, although with the ongoing austerity agenda it is hard to see where the necessary funds will come from.
The government’s response appears to be another missed opportunity to make things better for people with learning disabilities. The overarching and coordinated policy that could address the lack of direction in the learning disability sector that has been present since the end of VPN is not there and, while there are some good ideas in the response, they won’t make the difference hoped for without that overarching policy.
Many in the sector argue there is no need for consultations and responses like this – the principles of VPN were right when they were produced, and were supported by people with learning disability and those who worked in the sector. They are still generally right and are still supported by the learning disability community. The government would do well to revisit them.