It didn’t take long for Jeremy Hunt’s warning against “the normalisation of cruelty” in healthcare to bear grim fruit, though not all from the directions he anticipated.
Forty-eight hours after Labour MP Ann Clwyd wept at PMQs (I have never seen that in 30 years) over the mistreatment of her dying husband on a Welsh NHS ward, a couple of Australian radio pranksters drove nurse Jacintha Saldanha to suicide in London.
I mention it only because it has a bearing on the Winterbourne View case, which made headline news again this week. As you know, Norman Lamb, the coalition’s new care minister, announced significant changes in policy and practice in light of the scandal. It saw six staff go to prison while the home’s then owners trousered an unknown share of the home’s £5m profits.
Shocking stuff, we can all agree. But it has happened before BBC Panorama blew its whistle and is likely to happen again when vulnerable people with learning difficulties and behavioural problems are warehoused far from home among strangers who may be well intentioned but are often under pressure and under trained.
‘So £3,500 a week customers can be pumped to the eyeballs with anti-psychotic drugs. “Zombie” was the label one parent used’
As with radio pranks it’s easy to laugh, then throw stones when cruel facts emerge. So we should hesitate to dump all of wider society’s failures on struggling care staff and regulators. MPs know that, but can’t always resist a stone.
This time both Lords and Commons tone was constructive for Mr Lamb’s first ever ministerial statement from the despatch box (long trousers at last!). MPs know he’s decent and like him, just as peers do Lord Freddie Howe who later repeated the statement.
Labour’s spokesmen, Liz Kendall and Lord Phil Hunt, followed broadly the same path, although Hunt’s greater age and experience allows him a more confident perspective. One way or another, NHS commissioning has been going on for 20 years, he mused. But has it led to “enhanced outcomes?”.
Both were worried about the number of long-stay patients (3,000 out of 3,400?) who might have to be moved from NHS-funded private hospitals into “community-based support” within the next 18 months – a tall order even in more benign times, as these are not.
The state has been shutting down grim old hospitals as long as I can remember, but Winterbourne View is a reminder that some re-emerged in private guise – Monday’s Family Mosaic report again highlighted the danger of slipping back.
So £3,500 a week customers can be pumped to the eyeballs with anti-psychotic drugs. “Zombie” was the label one parent whom Lamb asked to meet used about his own son.
Drug use is just one subject to be reviewed, along with guidance on physical restraint, new care plans and a beefed-up inspection regime for the Care Quality Commission in which families will be involved, their views better known to officialdom which tends to ignore complaints (shades of Jimmy Savile?) like the police and council.
Splendid. But is the CQC having too many duties laid on it which it cannot discharge efficiently, ministers were asked? And will the new commissioners – 212 bodies against 150 primary care trusts, Liz Kendall noted – have the skills, cash or will to protect the most vulnerable?
The NHS Commissioning Board and the Local Government Association will provide guidance, said Lamb. Should local health and wellbeing boards be required to sign off on plans, added Hunt?
All good questions even before we address the concept of corporate accountability which Lamb is keen to pursue against greedy, negligent boards. When I looked up owners Castlebeck, I found that business turnaround specialist Sean Sullivan had done wonders for its offshore owners, Lydian Capital Partners. But the FT reports that it may be sold to Partnership in Care, run by private equity firm Cinven. Giddy stuff. There’s money in learning disability, but how much do staff or patients get?