Health Department’s plan for detained patients falls well short of what’s needed

Responding to the Department of Health and Social Care’s (DHSC) Building Better Support plan to address the number of patients inappropriately detained in secure hospitals, Chief Executive of the Equality and Human Rights Commission Marcial Boo said:

Every day a person is detained in hospital unnecessarily is a day too many. It is therefore unacceptable, more than a decade after action was first promised, that hundreds of people with autism and learning disabilities are still being kept as in-patients when they could be receiving community care.

In too many cases, patients are also subject to restraint and segregation, which can worsen their conditions and make it increasingly hard for them to go home. In extreme cases, there could be significant violations of human rights.

The DHSC’s plan to address these concerns has been delayed two years by Covid, and we are pleased it has finally been published.

However, it does not go far enough and appears to suggest that some patients will still be placed in hospitals rated as inadequate.

We welcome the draft Mental Health Bill, which aims to reduce the number of inappropriately detained patients in the long term. But action must be taken immediately to move people out of unnecessary detention and into the community.

The EHRC is exploring how best to use its legal powers to help patients and their families. This may include action in the courts.

The EHRC is writing to DHSC outlining our concerns, which include:

• The suggestion that in a few circumstances, people will be admitted to a hospital rated inadequate by the Care Quality Commission.
   
• The timescales for delivery are not urgent enough, particularly in light of the apparent breaches of human rights in in-patient settings reported over years.
   
• It is not clear how or when the plan will help people who are ready to be discharged today.
   
• The plan does not explain why earlier measures did not work, why targets have been missed, nor how the proposed actions will address previous failures.
   
• The spending commitments are unclear and there is no analysis of how each of the measures will reduce admissions.

In discussions with DHSC, the Care Quality Commission and NHS England, the EHRC has called for an enforceable right to independent living for disabled people.

We have developed a legal model to incorporate it into domestic law.