It has been a week of shocks. On Tuesday the CQC published an interim report on the use of segregation in inpatient hospitals and the government published the latest update on LeDeR. Chris Hatton has written an excellent, comprehensive review of these here. That same morning Sara Ryan absolutely nailed the situation on the Today programme . You can hear her at 47 minutes. It’s also worth having a listen to the CQC at 1:22 and Jeremy (Bethany’s Dad) at 2:51.

It seems that these reports were published in haste in advance of last night’s Panorama, which showed undercover footage shot in Whorlton Hall, a Cygnet hospital. The footage was as harrowing and distressing as expected. The bravery of Alex, a patient who was frequently targeted, in wanting the footage shared must be recognised. I woke up this morning angry. This anger can be heard in in both Sara and Jeremy’s voices in the link above. It could be heard in Sir Stephen Bubb’s interview on Parorama when he discussed the lack of action that followed his report into Winterbourne View. So much anger at people being let down again and again.

I have so many thoughts about the programme that at this stage I am just going to bullet point some of them. A fairly random scattering of why’s and what-should-be-dones. A mix of general and personal.

  • The words on the wall. The screenshot above shows staff discussing the result of a patient phoning the police, whilst sat in front of a wall full of meaningless care-world buzz words. Later a manager used the room to tell staff to restrain however they liked but to just make sure they wrote down that they had followed approved techniques.
  • The CQC tweeted this morning suggesting they didn’t find out about the abuse because patients didn’t tell their inspectors. The inspection process thus revealing itself (again) to be not fit for purpose.
  • Thoughts about how these cultures develop. Panorama touched on it. These are closed societies. Whorlton Hall was actually more open than many ATUs in allowing families on the wards. I wasn’t allowed on my son’s ward at all during the 16 months he spent there. Without oversight the culture is dependent on the individuals in the service. In Whorlton Hall there was clearly a core group of bullying workers who took pleasure in taunting the patients. Unchallenged this culture spread until it became the dominant culture from the top down.
  • The absence of commissioners in the conversation. These services are being bought even though everyone knows they’re damaging. Why is that being allowed to continue? Why aren’t commissioners challenging services, or the NHS, or government more?
  • Why the total lack of interest from the government? The LeDeR report was published in a way that MPs were not able to ask questions of it. Norman Lamb requested to ask an open question and this was denied. Matt Hancock meanwhile could only promise not to over-promise.
  • Sara Ryan meanwhile nailed it again, this time in the Guardian; “children and adults are experiencing state-sanctioned torture in settings across the UK”. 
  • The role of profit in all this. The sinking realisation that as long as people are commodities this will continue.
  • Why the lack of value placed on the lives of those with learning disabilities? What does that say about our society?
  • Distance. Admission to one of these units usually involves being moved away from your local area. Contact with family and friends, the people who would look out for you and speak up for you is severed. Watchful eyes are removed.

I could double the length of the list or pick any one of the points above and write pages on it, but nothing really takes away the horror or the sense of helplessness. My feeling is that 8 years after Whorlton Hall, which has been exposed 8 years after Winterbourne View, we’ll be viewing another example of abuse. The same script, just different actors. A paper published this month looked at reasons for the failure of activism today. It’s worth a read for the glimmer of hope it gives; the easy read is below.

Those of us who have had children admitted to ATUs will probably always wonder exactly what went on during their stay. I know in my son’s case being so far away was traumatic in itself. The institutional approach made it hard for the good support workers (and there were some), to build relationships. 45 minute observations meant frequent transitions and changes of staff. The restrictive, reactive approach meant that there was limited understanding of distress. As the tweet below shows whatever happened to my son I know that the admission has left him traumatised. Whether that was through being moved such a great distance from home or whether it was due to the environment itself, I don’t know. Maybe it was both. Either way it shouldn’t be happening.

I thought my anger had reached peak levels and then I stumbled across a tweet from the CEO of my son’s previous providers. Their actions led directly to my son’s ATU admission. Never one to miss a marketing opportunity, there he was, tweeting about Panorama. I put down the phone and went for a dog walk. I heard a cuckoo. That was a positive.

Things have to change. Without more reports and investigations. Everyone knows what is wrong with the system, we don’t need further reports or stories. Just get on and do what needs to done.