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Learning Disability Services (Cornwall)

Let me begin by apologising, on behalf of the NHS, to the vulnerable people in east Cornwall who have suffered from individual and institutional abuse, and to their families, who have shared their distress. As I told the House in my written statement on 6 July, the Healthcare Commission and the Commission for Social Care Inspection recently published a report of their investigation into abuse at the Cornwall Partnership NHS Trust. I fully accept the conclusions and recommendations of their report, and have already agreed to the immediate application of special measures. The failings identified by the two commissions are horrifying. People with learning disabilities are entitled to be treated with the same dignity and respect as every other member of the community. Abuse of those particularly vulnerable people is absolutely unacceptable and I am determined both that matters should be put right in Cornwall and that lessons should be learned nationwide, where necessary. In 2001, our White Paper ““Valuing People”” set out the principles of rights, independence, choice and inclusion for people with learning disabilities. Had those principles been followed in practice in Cornwall, then of course the abuse would never have happened. Action has already been taken in Cornwall. An external team was appointed in October 2005 to start improving services. Disciplinary action was initiated against seven members of staff, five of whom have been dismissed. More than 200 community care assessments have now been completed for everyone using the trust’s services. However, more is still required. The special measures now being taken include an external independent review of the board’s membership and workings. They also require the external team to remain in place in the trust for a further 12 months to oversee the necessary transformation of the service. It is not only Cornwall Partnership NHS Trust that needs to take action. The North and East Cornwall primary care trust is shortly to be joined with the West of Cornwall and Central Cornwall PCTs to become the Cornwall and Isles of Scilly PCT. Along with Cornwall county council, those PCTs are responsible, as commissioners of the services involved, for ensuring the highest possible standards of care. They signally failed to do that. As we said in the White Paper ““Our health, our care, our say”” in January:"““We expect PCTs to be robust in their management of services that do not deliver the necessary quality. Where there are deficiencies in service quality, PCTs will be required to set out a clear improvement plan””," which"““may include tendering for the service where standards fall below those expected.””" Let me make it clear that unless, in the very near future, fundamental improvements are seen in those services in Cornwall, I expect the new PCT and the county council to look to other providers, in line with the White Paper principles, to ensure that they discharge their responsibility to those vulnerable people. We are also considering the implications for learning disability services across the country. The commissions say in their report:"““While we accept that there may be other pockets of poor practice found elsewhere in the country, this does not excuse poor practice at the trust and, in our view, the extent of unacceptably poor practice in Cornwall is unusual.””" None the less, I strongly welcome and endorse the Healthcare Commission’s decision to conduct a national audit of services for people with learning disabilities. My Department is working with the Healthcare Commission and the Commission for Social Care Inspection in developing that national audit, which will assist in addressing national recommendations; for example, it will check that services are properly registered under the Care Standards Act 2000, where required by law. The audit process will be tested on three sites in September this year and will then be implemented nationally from January 2007. Let me stress, however, that there is no need to wait for the conclusions of the national audit, necessary though it is. If any service user or their family, any professional or member of the public believes that abuse is going on in any setting elsewhere, they should come forward now. Any allegations will be fully and properly investigated. I shall be asking strategic health authority chief executives to take immediate action to ensure that NHS bodies that provide services in a housing association, voluntary or charitable sector are registered with CSCI and, if they are not, that they apply for registration immediately. As I said in my written statement, my Department is already taking other steps to provide additional safeguards for the protection of vulnerable adults. The Safeguarding Vulnerable Groups Bill is currently going through Parliament, and will assist in responding to the national recommendations for safeguarding vulnerable adults. In particular, it will ensure that unsuitable people are not employed by the NHS in future. We have also issued statutory guidance to directors of adult social services, stressing their responsibility for ensuring that local arrangements for safeguarding vulnerable adults are working effectively. We will have further discussions with the Healthcare Commission and CSCI to ensure that, if necessary, regulatory arrangements are strengthened so that that learning disability services are properly inspected everywhere in future. What happened in Cornwall was shameful and must not be allowed to happen again. But the situation in Cornwall should not be allowed to cast a shadow over the excellent services provided for many adults with learning disabilities by thousands of staff—in the NHS itself, in social care services and in the private and voluntary sectors. Many people and their families are immensely grateful to those staff for the care and support they provide. While thanking those staff for the services they provide, I underline to the House our determination to take the necessary steps, both locally in Cornwall and nationally, on the basis of the reports that have been presented.