The truth is a mess

car“The truth is a mess”  Featherstone 1991

Having been asked to deliver a talk on safeguarding vulnerable adults I thought I would share the essence of it in advance.

Is the community all it’s cracked up to be for vulnerable adults? It is fashionable to paint the community as a utopian panacea for people with complex needs.

But what drives the fashion? A modern society’s aspiration, certainly partly yes. But is that aspiration being cynically manipulated to reduce the cost of providing people with the specialist provision they need to maximise their potential.

The political rhetoric on the subject of closing specialist inpatient learning disability care is deafening, there appears little room left for dissent.

Little room to point out that this politic coincided with troubling (expensive) demographics and a fiscal down turn.

Making the proposed solution – that ‘community’ is the ultimate aspiration and then to move vulnerable adults there is strategically astute if not clinically sound.

But what is the reality for those then denied intensive therapeutic intervention delivered by specialists? Does the real society embrace difference like we would like to imagine, or is it more unforgiving, does it bully and abuse?

Are decent levels of support provided amid a context of unprecedented local authority cuts? Most professionals are aware of the scarcity of decent community support, yet fashion and the political roar allows it to roll on; unsuccessfully.

Unsuccessfully? Using NHS England’s own stats there has been a 7% rise in inpatient numbers since January 2014 – so what’s the problem?

The problem is that this statistic hides the more disturbing fact that inpatient numbers have risen in the face of rising discharges – how is this possible?

The revolving door of readmissions from community breakdowns of those prematurely discharged into the community.

The reality for many vulnerable adults is one of angst, denial of specialist services, perceived personal failure and sometimes impact on the community and police services.

The equivalent of taking a Ford, stripping it and rebadging it as a Rolls Royce.


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One Response to The truth is a mess

  1. Ursula says:

    Well Said! Quite depressing how politics and a self generating narrow minded rush for change can spiral to effect so much more than ever initially realised, especially for the vulnerable amongst us. And how powerless it feels we are to stop that change.


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