Community Care minister Stephen Ladyman has voiced alarm at the
“growing number” of people with learning difficulties being placed
in independent sector hospitals rather than in the community.
Speaking at a conference last week, he said the move “flew in the
face” of good practice and accused local authorities of failing to
commission adequate community-based services.
While Ladyman acknowledged that progress had been made in the
closure of NHS long-stay hospitals, he criticised councils for
flouting policies based on the Valuing People white paper.
He told the annual conference of learning difficulties charity
Association for Real Change, held in Southport, that local
authorities were choosing to “reinvent the long-stay hospital by
the back door,” instead of following new practices.
Guidelines for commissioners include ensuring that individuals are
provided with services “as far as possible” in the community rather
than residential settings, and that they are placed near their
homes and families.
Ladyman complained that many of the people who were in-patients in
private and voluntary sector hospitals were placed far away from
home “possibly without justification”.
The number of registered independent hospital beds stands at around
1,000, with about 900 patients, according to a Healthcare
Commission survey published in July.
Most of the patients are formally detained under the Mental Health
Act 1983 and may have “severely challenging” behaviour or mental
The Department of Health said a “significant percentage” of local
area budgets for learning difficulty services was being spent on
The DoH has issued a clarification to all NHS and social services
chief executives outlining “appropriate” commissioning of services.
Head of the government’s Valuing People team Rob Grieg said private
hospitals were “just responding to market opportunity”.
He added: “There is clear evidence to show that it is possible to
support people with really complex needs in the community, and
commissioners need to make more effort to implement this.”
The DoH is currently engaged in discussions with the Social Care
Institute for Excellence and the National Institute of Clinical
Excellence to look at the issue.