The Human Equilibrium
Yesterday, I spoke at a conference in York. The conference was titled: “Social Work is Human Rights”. One of the speakers was the excellent Gavin Harding from NHS England Transforming Care team. Gavin, who has a learning disability and has spent time held in an ATU, is also the Mayor of Selby (http://www.independent.co.uk/news/uk/home-news/gavin-harding-uks-first-mayor-with-a-learning-disability-appointed-in-selby-10268437.html). He gave a rousing talk and ended with the great parting shot: “You lot don’t get placed in ATUs. Why should people with learning disabilities?”
Gavin’s talk made me hastily change how I was going to present mine. I usually tell the Get Steven Home story as a chronological narrative. I still did that, to a fashion, but bearing in mind the title of the conference, I wanted to stress more than ever the “humanness” of Steven. How a normal human being with autism could get caught up in a horrendous and dangerous situation for a year of his life. Why should he end up in an ATU, when you lot don’t?
On the train I home, I was feeling pretty good and then foolishly clicked on the following link:
A 28 bed (!!!) unit for people with autism has been put into special measures after failing another CQC inspection. Lots of questions started floating around my head:
- How did those 28 people end up there?
- How will they get out and start to leave fulfilling lives like Gavin and Steven?
- How do the owners get away with it?
This morning, I found the actual CQC inspection report. I’m not normally lily livered but I could only get about 2/3rds of the way through it. It is distressing reading (http://www.cqc.org.uk/location/1-121484499). A few lowlights:
Five patients were prescribed high doses of antipsychotic medication without this being identified and there were no monitoring guidelines for high dose antipsychotic treatment. There were no monitoring guidelines for rapid tranquillisation.
How can this be? Giving people medication that they haven’t been prescribed! Isn’t that a crime? Please don’t give me the argument that they probably lack the capacity to decide about their medication. Without prescription from a clinician, what makes this any different from them being given heroin?
We reviewed the legal files for five patients during this inspection. Of these, four contained evidence of periods of detention without this being legally authorised, whereby the patient was not subject to detention under the Mental Health Act or subject to a Deprivation of Liberty Safeguards (DoLS) authorisation. The patients had not been aware of this, had not been allowed to leave and had continued to be given treatment.
How can this be? Illegal detentions. Don’t blame the MHA, MCA or DoLs for this. The residents won’t get anywhere those pieces of legislation because the management of the unit don’t want them near the legislation. It is a conscious decision not to apply the law. Where does this law breaking go from here? Bear in mind, this was a CQC report and they are only adopting special measures, can one call in the police to investigate at least two possible breaches of law? Doesn’t seem much point in taking out a safeguarding referral – the professional safe guarders will be from the same organisation that commissioned the service and sent the 28 people to their doom.
On all the wards, the kitchen areas were locked and so patients had to ask staff for access to the kitchen. This meant that patients had no access to drinks except when staff let them into the kitchen. Some patients told us they tended to purchase and keep snacks and drinks in their bedrooms but this was dependent on finances and access to leave.
The above may not be illegal in itself, although it probably falls into the deprivation of liberty category. What it does show though is the crux of all this. The owners of Bigfoot Hospital (WTF) are a company called Equilibrium (why do these companies have such darkly ironic names? The 28 residents can’t possibly have any equilibrium in their lives, although there is probably plenty of equilibrium in the owner’s bank accounts). The big feet at Equilibrium can’t possibly see their residents as human. And if you don’t see somebody as human, then their human rights aren’t going to figure on the radar.
They’re not alone though. The UK has a weird relationship with human rights. There is a deep unease and suspicion about the Human Rights Act. Me and several other people with positive human rights stories were plastered all over the London underground last year and on billboards throughout the country. However, for most people that I speak to outside of the disability world, human rights begins and ends with Abu Qatadar and Theresa May’s cat story. This Daily Mail type distrust allows companies like Equilibrium break the law. They can treat their residents with contempt because they hold the law that protects people with contempt.
For people who have followed the Justice for LB campaign, the actions and responses of Equilibrium must ring a few bells. It’s the same attitude that allows Southern Health, despite report after report, inquest after inquest, governor’s resignation after governor’s resignation, to treat their public with sneering, arrogant contempt. The Chair and CEO can respond to fears expressed by My Life, My Choice that they can’t use Southern Health services because they might die, with talk of learning lessons, action plans, people and family engagement. It’s all bollocks. It’s further contempt. Because out comes another report this week of another death in their service and the company statement is exactly the same as all the other statements they have made in the last four years:
It’s not enough to be human to have human rights.
You have to fight a system that refuses to see you as human.
That’s why you lot never go to ATUs.
From → Social Care