The care of autistic children is a disgrace. Covert systems lead to perverse outcomes..

The Times analysis of the situation is summed up well by Oliver Wright but he fails to appreciate that if we need to ration health care covertly, there are fewer votes to be lost in dereliction of duty to those who cannot represent themselves.  Treatment of the mentally ill is a toxic mix of political and NHS failure

n the aftermath of the Winterbourne View care home scandal Jeremy Hunt pledged to make improving the care of vulnerable patients a central mission of his time as health secretary.

But despite speeches, policy documents, steering groups and delivery groups two reports next week will lay bare the continued failure of the system to protect those least able to help themselves. One of those reports was commissioned by Mr Hunt’s successor and Tory leadership rival, Matt Hancock. He won’t be thanking him for it.

Part of the problem is political. For example, despite introducing minimum standards for how adults on mental health wards should be treated in 2014, no such standards exist for children. For that, responsibility rests with ministers.

They are also responsible for a system that provides no incentives to minimise the use of expensive in-patient mental health beds. Those beds are paid for by the NHS whereas community care is paid for by stretched local authorities.

The NHS itself should not be absolved of blame. One former Conservative health minister said they had been shocked by just how unresponsive NHS leaders were to reform. It is certainly true that the NHS has jealously guarded its freedom to set spending priorities.

Finally, despite being the authors of one of the reports the Care Quality Commission, which inspects mental health units, bears some responsibility. That it took a minister, under pressure from the media, to uncover the continued failure of these units is shocking.



Oliver Wright and Greg Hurst report in the Times 18th May 2019: Autistic children are routinely restrained and drugged in care

Autistic children as young ten are being detained and subjected to chemical and physical restraint hundreds of times a month, two reports will say next week.

Ministers are braced for fresh revelations about the inappropriate treatment of children with learning disabilities more than six years after Jeremy Hunt, when health secretary, pledged to end the “normalisation of cruelty” in parts of the care system.

One report from the children’s commissioner reveals that in a single month last year 75 children were restrained 820 times, an average of 11 per child.

In another report the Care Quality Commission is expected to reveal children and adults being subjected to long periods of prolonged seclusion and segregation in secure and rehabilitation mental health wards.

The CQC report was commissioned by Mr Hunt’s successor, Matt Hancock, after revelations of abuse in mental health institutions seven years after the Winterbourne View care home scandal in Gloucestershire which resulted in six workers jailed for abuse and neglect.….


This entry was posted in A Personal View, Commissioning, Perverse Incentives, Post Code Lottery, Rationing, Stories in the Media on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

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