Villages and vision

Well, poor old Mencap. You’d think from the brickbats thrown at
it by Rescare that the perverse idea people with learning
difficulties should live in the community was all its own idea
(News, page 2, 30 March-5 April). And, yes, it’s even been damned
as being ‘politically correct’ – usually a sure sign that opponents
are on rocky ground.

So, let’s put aside, almost 25 years since the White Paper,
Better Services for the Mentally Handicapped, all the evidence that
long-stay hospitals were – and remain (they still house 20,000
people with learning difficulties) – isolating, segregated, and
institutionalising places. Let us also put aside the whole thrust
of government policy, and local authority and voluntary provision
long before, but particularly since, the NHS and Community Care
Act. And most of all, let us forget the evidence of thousands of
people – often elderly and very vulnerable people, who spent
decades literally behind walls – who now live happily in the
community.

Let’s be like Rescare, the National Society for Mentally
Handicapped People in Residential Care. Let’s blame all the
shortcomings of community care, all the (not unnatural) fears of
parents of people with a learning difficulty not on resource
problems or a failure to pull all services together, but on the
misguided liberals from the King’s Fund team who produced the
Ordinary Life series, professional advisers, and successive
Secretaries of State, of whatever party. And let’s wave a wand and
solve all our problems bringing back village communities.

But for those of us who want to dissent from this reactionary
notion let us remember that this is Rescare’s second line of
defence. It came into being to save the long-stay hospitals. Now
that that battle has been lost, it has dug its trench with village
communities. Yet what is most curious is not so much Rescare’s
advocacy of the idea as the Department of Health’s decision to
carry out an evaluation of residential and village communities
(News, page 3, 6-12 April). What will this reveal that the DoH has
not been told already, not least by the National Development Team
and myriad others? How would village communities differ from the
old institutions? How could potentially inherently inward-looking
places have that outward-looking aspect which the DoH circular of
only three years ago recommended for provision?

That allowing every one with a learning difficulty to live in
their own home poses problems is without doubt. But no one, save
Rescare, pretends that the way to the future is to look backward.
That is why the DoH ought not to have jumped so readily on to this
dilapidated bandwagon but rather should have restated that a
commitment to an ordinary life that must be the underpinning
philosophy of provision.