Hospital abuse prompts review of learning disability services

The Healthcare Commission has launched a national audit of learning disability services after a new report found “institutionalised abuse” in one hospital in south London.

The health watchdog will look at 200 NHS and private services in England to establish whether problems identified in the Sutton and Merton primary care trust (PCT) are widespread.

An audit of the conditions at Orchard Hill hospital, published today, finds patients forced into rigid routines with little regard to their individual care needs. For example, at meal times staff wrapped some patients in tissue paper and fed them faster than they could eat.

The report also reveals “inappropriate” use of restraint. For example, one woman had a splint on her arm “for many years” to stop her putting her hand in her mouth.

The investigation was initiated by the Sutton and Merton PCT in January last year, amid concerns about 15 serious incidents of abuse since 2002. These included the rape of one woman being treated there, whose mental age was so low she could not give consent.

But it comes just six months after another commission report detailed neglect and the physical, emotional and financial abuse of people with learning disabilities at Cornwall Partnership NHS trust. It was this study that prompted the nationwide audit of services.

Healthcare Commission chief executive Anna Walker said today’s report “confirms that we are right to be concerned about the quality of care for people with learning disabilities throughout England”.

The commission does not blame staff at Orchard Hill, saying there were not enough of them and they were not properly trained. However, the report says that the problems might be “largely unintended but it is abuse nevertheless”.

It also criticises the poor facilities in the hospital, noting the inadequate access for disabled people and insufficient space for hoists in bedrooms and bathrooms. Patients were also restricted in their movements, having just three to four hours of activity a week.

The trust has accepted all the report’s recommendations and now plans to hand over responsibility for commissioning services for people with learning disabilities to the local authority. Orchard Hill hospital is due to close by 2009.

The nationwide audit of services will establish whether a similar transfer of powers should take place in other areas. Rob Greig, the government’s co-ordinator on this issue, told the Guardian he believed local authorities should take such a role.

Ms Walker said: “The trust has worked with us at every stage of the investigation and this should be commended. But clearly it does not excuse the neglect of the people with learning disabilities in its care.

“The trust was providing institutionalised care which sacrificed the needs of vulnerable individuals in favour of the needs of the service. It is simply not good enough.”

Shadow health minister Tim Loughton said today’s report raised concerns of a “systematic abuse of people with learning abilities”, and Liberal Democrat health spokeswoman Sandra Gidley said a national audit of such services was “long overdue”.

Mental health charity Mencap said it was “appalled” at the report’s revelations and argued it showed how people with learning disabilities “are given low priority by the NHS”.

Sutton and Merton PCT chief executive Caroline Taylor said: “We fully accept the report and are determined to make whatever changes are necessary urgently.

“In the 21st century people with a learning disability have a right to a life that is rich and full and we must make this our utmost priority.”