Inhumane Treatment

Leading Article in THE TIMES, 18 May 2019

The true measure of any society can be found in how it treats its most vulnerable members. There are few more vulnerable than children suffering from serious mental health problems, learning disabilities and autism. That makes our report today into the way that some vulnerable children are being treated in parts of the health system particularly disturbing. Two new official reports to be published next week have uncovered evidence of autistic children as young as ten being regularly detained and subjected to chemical and physical restraint. A report by the children’s commissioner found that 75 children were restrained a combined 820 times in a single month last year. Another by the Care Quality Commission found children on secure wards being subjected to long periods of seclusion and segregation.

What makes these reports so shocking is that they come seven years after the Winterbourne View care home scandal, which was supposed to have brought about a complete change of culture in treatment in care centres. Six staff at Winterbourne View were jailed in 2012 after an undercover BBC Panorama reporter documented shocking acts of bullying and physical and mental abuse of patients. That case prompted Jeremy Hunt, the health secretary at the time, to take action against what he called “a kind of normalisation of violence where the unacceptable is legitimised and the callous becomes mundane”.

Yet the callous clearly remains mundane in some parts of the health system to this day. The latest report by the Care Quality Commission was ordered by Mr Hunt’s successor, Matt Hancock, partly in response to the shocking treatment of a 17-year-old girl whose case was reported by The Times last year. Bethany, who has autism and suffers from extreme anxiety, had been detained in a psychiatric hospital for almost two years. For much of this time she had been locked in a cell-like room with only a mattress and chair and had been fed through a hatch in a metal door. Her case came to light only after her father won a legal battle against the council that had tried to gag him from speaking out about his daughter’s treatment.

Bethany’s case and the evidence uncovered by the new reports highlight both a systemic failure by the health service to deliver on the promised culture change and a political failure to drive through the necessary reforms. Of course there are times when restraint may be justified or where seclusion and segregation are necessary for the safety of hospital staff. After the Winterbourne View scandal, the NHS did come up with new guidelines on when and how such interventions might be used. But those guidelines applied to adults. Separate guidelines for children were promised but five years later, there is no sign of them. Meanwhile, a green paper proposing changes to mental health legislation published in 2015 has been kicked into the long grass. As with so many other policy areas, this vital issue has fallen victim to a government distracted by Brexit.

This now clearly needs to change — and fast. These two new reports should be a source of profound shame to ministers and health officials as well as those responsible for meting out such inhumane treatment. There can be no excuse for children going unwashed for six months, or not having their care plan reviewed for a year, or what appears to be the routine use of medication. Indeed, it seems clear that many of these children should not have been in hospital at all but would have been better cared for at home.

In the foreword to her report, Anne Longfield, the children’s commissioner, writes that she “will never forget the stories I heard from mums and dads at a meeting I arranged for parents with children in these units and their tears of anger and frustration”. This scandal shames our society and their anger should be shared by us all.

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