institutional abuse
Ending institutional abuse scandals
Was the chance to halt institutional abuse after the Winterbourne View scandal missed? Only stronger community services and radical action to shut down private institutions will stop history repeating itself, says Simon Duffy
Scandals are milestones on the long journey towards the liberation of people with learning disabilities. Sometimes they become important turning points, but often they lead to no meaningful change.
In the case of Winterbourne View, it looks as if we have missed our opportunity. A great deal of money, energy and ink has been spent, but it has been spent on the wrong things.
After the scandal broke, I was contacted by a researcher from a London-based think-tank. He was astonished by the violence and humiliation he had seen on the Panorama programme; I was astonished at his astonishment.
For those of us who have dedicated our lives to inclusion, deinstitutionalisation and community living, it is humbling to realise that the public, politicians and policy experts do not understand that institutional abuse is systemic, persistent and severe.
Winterbourne: the ‘least bad’
I met a group of families whose children had been at Winterbourne View. All agreed that this home was the ‘least bad’ service their children had experienced.
These families knew their children (now adults) would never be safe in this kind of institutional setting, many miles from home, locked into inhuman regimes of control and punishment, tranquillised and abused – physically, sexually and emotionally.
They also shared a common experience of being let down by services. They were not offered flexible support; instead, their child was placed in a care home or residential school. Understandably, the young person would get angry and act out, so they were moved again – further away from home into increasingly institutional settings.
Four points to end abuse
What was unusual about Winterbourne View was not the abuse but the fact that the abuse had been discovered.
When we discover something awful, we prefer to treat it as an exception, a one-off problem, something that can be solved by better leadership, new regulations or a grand government initiative.
However, you cannot solve a major systemic problem without understanding it. In the case of institutional abuse, this means breaking the cycle of institutionalisation at four critical points:
First, we must support families and communities as early as possible and enable them to design ongoing support solutions that help people live as citizens within their communities. Austerity has undermined this approach; today, local services are slashed as expensive institutional services continue to grow.
Second, we must close down institutional services. Foolishly, the NHS has focused on cutting its own local assessment and treatment units (inadequate as they are) while continuing to fund private sector hospitals that feed on local system failure. This is the wrong way round; we must bring the people and the money home, not reduce the ability of local services to respond to problems.
Third, we must ensure that funding for communities is controlled locally. Hard-pressed councils are tempted to let people become the responsibility of a better-funded but centralised NHS. Instead, we need an NHS that is accountable to local people and works with them to develop the community support needed to avoid institutionalisation.
“He was astonished by the violence and humiliation;
I was astonished at his astonishment”
Finally, we must begin to demonstrate more clearly that institutionalisation is not a failure in the quality of services – it is a failure in human rights.
In future, we must talk more explicitly about false imprisonment, segregation and the crimes committed against people who have been placed in the custody of the state. Only then will we make real progress.
Simon Duffy is director of the Centre for Welfare Reform and secretary to the international cooperative the Citizen Network
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Further reading
Alakeson V, Duffy S (2011) Health Efficiencies: The Possible Impact Of Personalisation In Healthcare. Sheffield: Centre for Welfare Reform
Brown F, Dalrymple J (2018) A New Way Home: a Personalised Approach to Leaving Institutions. Sheffield: Centre for Welfare Reform
Duffy S (2015) Getting There – Lessons From Devon & PlymouthÕs Work to Return People Home to their Communities from Institutional Placements. Sheffield: Centre for Welfare Reform
After the Winterbourne View scandal, a great deal of money, energy and effort was spent – but on the wrong things
