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Adults with Learning Disabilities

The hon. Member for Rochford and Southend, East (James Duddridge) has given us a horrifying example of what can happen when people do not fulfil their duties and do not honour their obligations to the patients under their care. Such patients have the same human rights as everyone else. My hon. Friend the Member for Hendon (Mr. Dismore) mentioned that some people do not recognise that. It is absolutely and explicitly accepted by the House that every human being has the same human rights and should have the same opportunities to exercise those rights. I welcome the fact that we are having this debate and that this report has been produced to provide some focus on the needs of people with learning disabilities. I congratulate my hon. Friend and the Committee on their work. Let me start with a little discourse about the human rights approach, which is very helpful in this instance, but it is not the only way to look at learning disabilities. I will probably get into trouble for suggesting that the human rights approach cannot be adapted to be comprehensive in its assessment of the issue. As I was telling my hon. Friend before the debate started, human rights lawyer Sonya Sceats, who was one of his witnesses—she is also the long-term partner of my stepson—is convinced that the human rights approach is a way of addressing many issues. Although it is a very good approach, there are complex ethical and practical issues about the way in which we address the needs of people with learning disabilities that require us to go beyond the human rights approach. I was trying to think last night how I could express that. I was trying to unravel the earplugs from my iPod. I do not know whether other hon. Members have this problem, but however carefully I roll up my earplugs when I put them away, they are always tangled in a knot when I unwrap them, and it takes ages to get them undone. Imagine how much more difficult it would be if I had 20 sets of earplugs in a box and they were all tangled together. I would have to unravel them one by one and then find one with the right plug before I listened to my iPod. The complex ethical issues that we are discussing are a bit like that. If we unravel just one strand of complexity by looking at someone's human rights, we do not necessarily see the whole picture. With people who have learning disabilities, we have to look at not only the human rights issues, but the practical issues, the risks, the financial issues and the family issues. Sometimes, when we unravel those strands, they point us in different directions and lead us to different strategies and possibly to different answers to the same question. Perhaps I can give hon. Members an example of what I am talking about. One issue that the report identifies is relationships between people with learning disabilities. One of the most fundamental human rights is that people should be able to determine for themselves what relationships they become involved in, and people with learning disabilities have exactly the same right to have sexual relationships as anyone else. However, when we face such issues and the situations that arise when people with learning disabilities have relationships, we have to ask a whole range of questions. Are the people involved in the relationship able to give informed consent? Do they have the ability to make contraceptive choices? If a woman with a learning disability becomes pregnant, that raises incredibly complex issues about parenting. When a person with learning disabilities is in their parents' care, it can be incredibly difficult to get the parents to accept that their child is as entitled to a sexual relationship as anyone else. My daughter does not have a learning disability, but I find it pretty difficult to accept that she has boyfriends. Imagine how much more difficult that would be to accept if she was a vulnerable child or a child with a disability. Sometimes parents end up having recourse to the courts, and attempts are made to get sterilisation orders or orders to restrict people's ability to have relationships. When somebody is in the care of a local council, the situation can be even more complex. When some councils have realised that people with learning disabilities in their care are going to have relationships, they have done what they regard as the right thing, and it probably is the right thing: they have done risk-management assessments, bringing in psychologists to gauge the individual's ability to give informed consent and educationists to discuss contraception. However, in doing that, and in taking that caring attitude towards the person with learning disabilities, have those councils restricted that individual's human rights? Let us face it, some Members of Parliament make unfortunate sexual choices, and no one does a risk assessment on us before we get involved in relationships. Perhaps there are one or two examples where people should have done a risk assessment, but it does not happen. We are allowed to engage in relationships at our will, whether they are harmful or not, and no one ever questions our absolute right to do that. Are we therefore breaching people's human rights by doing a risk assessment and bringing in all the resources that I mentioned? I do not have the answer to those complex ethnical questions. However, I do know that people with a learning disability—complex or moderate—are as entitled to a fulfilled life as anybody else. We have to find a way of navigating through this moral maze. If we can unravel one of the strands by looking at the human rights issues and implications, that is good, but, as I said, many more strands need to be unravelled. Another example of the complexities that sometimes overcome us is the closure of long-stay hospitals. If there was ever an example of people with learning disabilities having their human rights infringed, it is the fact many people with learning disabilities were effectively locked away in long-stay hospitals over many years. The Government had a commitment to close all those hospitals, and we often criticised Ministers because it was taking so long to do so. To some extent, that was the fault of local health services, which were not addressing the issue quickly enough. However, it was often also down to the parents and friends of the person with the learning disability. They believed that that person was secure in the hospital environment, and they did not accept the possibility that he or she could have any sort of independent life. The move away from long-stay hospitals was a bit like the move into care in the community, and it had the same sort of reputation. People therefore asked whether those with learning disabilities would get the resources and the support that they needed in the community. Often, therefore, the barrier to helping people to create an independent life was the people who most loved and cared for them and who wanted the best for them, rather than the Government or the local health services. Who is to say that those people were wrong in that assessment?