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It is hard to avoid a feeling of "here we go again" as you scan the catalogue of failings and neglect highlighted by the Healthcare Commission in its investigation into learning difficulties services in Sutton and Merton, south London.

Just over six months on from the Cornwall care abuse scandal, we have yet another indictment of the way we deal with vulnerable people. Maybe the examples of ill-treatment are not quite as shocking as those that took place in Cornwall, but the report's revelations of institutional abuse are no less disheartening than the earlier exposures. It was clear Cornwall was the tip of the iceberg but now we have confirmation that there are deep-seated problems elsewhere.

The closure of long-stay hospitals (not that Sutton and Merton have closed theirs yet) is the beginning, not the end, of the road towards enabling people with learning difficulties to achieve their potential. And if, as it appears, some staff are adopting institutional attitudes when working with people with learning difficulties living in the community then this must be tackled. This is where managers right up the chain of command need to ensure their staff have the training and resources to employ best practice - and be aware enough to blow the whistle on bad practice when it occurs.

One key question is why weren't these problems highlighted sooner. Why didn't local advocates notice something was wrong? How come the local partnership board or the Valuing People support team didn't pick up on it? The case certainly highlights how vital it is to ensure a good, accessible complaints system is in place so that at the very least people with learning difficulties themselves can raise the alarm if they are not being treated well.


The Healthcare Commission report makes 25 recommendations for Sutton and Merton but other providers of learning difficulties services should also study them to see what they can glean to ensure their own house is in order before a Healthcare Commission inspector comes to call on them.

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Inquiry reveals another institutional abuse scandal involving NHS trust

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 Janet Snell