Health Minister Mike Nesbitt said there have been “serious failings” in the learning disability system
Placements for adults with learning disabilities, often outside Northern Ireland, are costing the Department of Health £100 million per year – a fifth of the total budget for the sector.
That is according to a new document that sets out a plan to reform learning disability services in Northern Ireland. Care for patients with learning disabilities – both in childhood and adulthood – has been the subject of intense scrutiny in recent times after the abuse of patients at a specialist hospital in Co Antrim was uncovered, and the difficulties faced by families caring for children was highlighted in the media.
Health Minister Mike Nesbitt said there have been “serious failings” in the present system including the “abuse of patients” at a specialist hospital in Co Antrim.
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Muckamore Abbey Hospital, an inpatient facility in Co Antrim that provides specialist care for patients with severe learning disabilities and mental health needs, forensic needs or challenging behaviour, has been the subject of a major, long-running criminal investigation and a public inquiry.
And the services for children in Northern Ireland also came under the media spotlight after a TV documentary titled ‘I Am Not Okay’ was broadcast by the BBC, highlighting the challenging and sometimes dangerous behaviour parents of children with complex needs are dealing with.
Following that documentary, Health Minister Mike Nesbitt announced in October that £13m a year would be made available to boost support for families of children with complex needs.
The new Department of Health document, meanwhile, states that around 8% of the Department of Health’s overall budget is spent on adult learning disability services at present, equating to around £500 million per year.
And of this total, a fifth (£100 million) is being spent on “high cost placements” worth around £100,000 each per year – including what the Department refer to as ‘extra contractual referrals’ or ECRs.
These referrals are typically used when a patient is transferred outside Northern Ireland for a treatment or service that isn’t available locally.
For adults with learning disabilities in Northern Ireland, this could mean they are separated from their families and taken to facilities in England for care – at a high cost to the Department’s budget.
The Department of Health say the £100 million being spent on high-cost placements for adults with learning disabilities now accounts for “over half of all high-cost placements across all programmes of care in HSC [Health and Social Care] in Northern Ireland”.
The document states that there is a “financial rationale” to reform services.
The new model, titled ‘We Matter’, is currently out for public consultation. Mike Nesbitt has said it aims to better support people with learning disabilities at “an earlier stage”, in order to cut down on the need for expensive care plans that might see patients sent away from Northern Ireland for treatment.
“My vision is that this model for adult learning disability services, underpinned by a fully costed implementation plan, will enable my Department and HSC Trusts to better commission the right level and blend of services to support people in the community at an earlier stage, reducing the need for acute inpatient care, high-cost bespoke arrangements and Extra Contractual Referrals (ECRs),” he said. “It is intended to standardise provision across the region, ensuring that service users and families can access the same pathways and services aligned to assessed needs.”
In his ministerial foreword, Mr Nesbitt states: “Over the past year, I have visited a range of Health and Social Care (HSC) services that support people with learning disabilities, and I have been consistently impressed by the dedication of staff, the determination of families, and the potential that shines through when services work well. I have seen what is possible when people are supported at the right time, by the right person, in the right place. These are the moments where we get it right — and they must become the norm, not the exception.”
He also referred to the abuse of patients at Muckamore Abbey Hospital, which has been the subject of a major, long-running criminal investigation and a public inquiry.
“We cannot ignore the serious failings that have occurred in our system,” the Minister wrote. “The abuse of patients at Muckamore Abbey Hospital represents a profound breach of trust and has caused lasting harm to individuals, families and public confidence. A public inquiry has concluded, and its findings will be critical in shaping how we move forward — not only in ensuring accountability, but in making sure such failings can never happen again.
“This document is a platform for change. It sets out a proposed Learning Disability Service Model for adults in Northern Ireland — a new vision for how HSC services can better support people with a learning disability to live the lives they choose.”
Members of the public can read the document at the Department’s website, and submit their views up to 5pm on the consultation closing date of November 25.
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