There is an ongoing horror story around the support of some of the most vulnerable people with learning disabilities that, despite diktats and edits from the highest level, refuses to go away.

Those of us who thought, just maybe, that the scandal of Winterbourne View might really mean that change could happen have been proved horribly wrong.  Instead we learn that less than one in 10 people with learning disabilities who were due to be moved out of hospitals by the government deadline of June 1st had been transferred.  Norman Lamb, the minister responsible described the transfer programme as an “abject failure”.

For those who thought the sort of abuse revealed on the BBC’s Panorama was an exception to the rule, have also been rocked by the news that Bill Mumford, Chief Executive of MacIntyre who was brought in to provide fresh leadership to the transfer programme, was dealing with an abuse enquiry himself.

Something is seriously awry…there needs to be a radical rethink to commissioning… The current system commodifies people

For all the talk, the programmes and the strategies it is clear that something is seriously awry. The question is where are the blocks? In the March count doctors were saying that 1,702 of the outstanding cases, including 534 placements in secure hospitals, individuals were not ready to move into the community because of the challenging nature of their behaviour or illness.

At ARC we have long argued that there needs to be a radical rethink to commissioning. Shared responsibility needs to be taken, to allow creativity of approach and ongoing flexibility that would allow excellent community based support. The current system commodifies people and places them right on the fault line between health and social care. Providers are often held at arms length and forced into a contract bidding exercise that dehumanises people. The artificial separation of agencies and organisations works against not towards good outcomes for people.

And even if we get to a point where people are supported in their community how do we make sure that people are safe? Bill Mumford himself asks the question, “what do you do when your worst nightmare has just become a reality”?  He lists the work that MacIntyre have undertaken to ensure people are safe and care is top quality, and yet even that does not seem to have been enough in this instance.  The recent CQC consultation (now closed) on its inspection regime strongly spoke about wanting to work with providers to improve their services.  But commissioners will fall outside this regime. The Statutory Guidance on market shaping, published on Friday 6th June, pulls no punches in the responsibilities of local authorities towards commissioning, partnership working, the need to work with communities and the primary importance of the voice of people who use services are paramount. Yet still there are further questions to be asked here. Surely it is only by us all owning a creative, positive and outcome based vision together that the current dismal situation will change.

June 2014