Britain’s cruel care system shames us all
Published by The Times (19th April, 2019)
The details are shocking. A troubled girl just 14 years old, sent for the first time into a place of supposed sanctuary for her psychiatric problems. She was subjected to the terror of physical restraint by four adults on her second day, then many more times over subsequent weeks. She was forcibly injected with drugs. She was bullied. And then she killed herself, despite warnings about her safety.
Amy El-Keria died within three months of arriving in the “care” of the Priory Group, Britain’s leading private mental health provider. She was inside a specialist child unit in East Sussex, the subject of a shocking undercover ITV investigation last night. I spoke recently to one mother whose autistic daughter left the same centre covered in scars from self-harm. In a sickening scene from the Exposure documentary, this teenage girl is ignored by staff as she bangs her head against a wall.
The Priory won fame by treating celebrities for drink and drug problems. But the group, bought by an international healthcare giant three years ago for £1.3 billion, earns most of its money from taxpayers. The latest accounts reveal payments of £720 million from local authorities and the NHS. It was fined £300,000 for allowing Amy’s death: a pathetic sum for a company that made operating profits of £62.2 million in 2017 and just handed one director of its parent company almost £8 million in severance pay. Meanwhile, many frontline staff earn little more than the minimum wage.
This corporate giant was held to account only by the persistence of a grieving family, forced like others to fight providers seeking to shroud tragic events in secrecy. Yet Priory, despite its grim record, is far from alone in profiteering from misery. Private outfits have moved on the mental health sector like sharks smelling blood, relying on a flow of patients to fund expansion. Some are run by big global players, others backed by hedge funds or private equity firms. One dire performer is a charity, which handed its former boss almost £1 million over two years.
It is especially harrowing to see these rapacious outfits muscle in on the cruel trade of locking up people with autism and learning disabilities, despite ministerial pledges to stop sending such people to secure units that can destroy their lives. This can be highly lucrative, with fees of up to £730,000 a year for people shut in psychiatric units despite often not having a mental illness. I have spoken to scores of parents weeping as they tell me horror stories of seeking help, trusting experts and then seeing beloved children put in solitary cells, fed through hatches like animals, injected with powerful drugs, bloated through inactivity and brutally restrained.
This flawed, floundering system seems little better than Bedlam. Some families are legally silenced. Yet the cash pours into the pockets of private companies even as community services are slashed. I have long supported the use of private providers within the NHS, uncontentious elsewhere in Europe, so it is disturbing to see these abusive practices and untrained staff. One Priory official in the Exposure film is caught complaining about making too little profit. Yet this problem goes far deeper than simplistic protests about privatisation.
Certainly there are grave concerns over inadequate regulation and there is an urgent need to change our health laws. We need to prevent organisations that might have vested interests having influence beyond an advisory role on decisions to detain citizens who lack mental capacity. We have also seen again the failure of the Care Quality Commission, a watchdog that keeps failing to bark until prodded into action by journalists, patients, families or whistleblowers.
Yet the NHS is guilty also of similar, and sometimes fatal, failings towards people with autism, learning disabilities and mental health problems. Indeed, the aforementioned mother of the autistic teenager said that the worst of the five units holding her daughter was run by the NHS, where the girl was held in seclusion with only a plastic mattress and food dumped on the floor. Another father told me that his autistic son was held in an NHS hospital for five years in a room 10ft by 7ft that lacked even a toilet or washbasin.
Many of these people display challenging behaviour. But these cases give glimpses into a secretive system. It is a scandal that private companies can earn so much money from the state yet fail so often to stop suicide and self-harm. Six months ago, Priory was criticised by a coroner for falsifying logs to cover up a failure to check a teenage boy who had killed himself. Autistic girls often mimic those around them to fit in, so many learn self-harm and eating disorders in these grim places. It is not just a question of cash either. Decent community support is not only kinder and more effective but can be cheaper too.
What does it say about us that these grim practices still occur in 2019? Why is there such shameful political inaction? Why does the state sanction abuse, bullying and failure? The answer is simple, yet scary for a father like me of a daughter with learning disabilities. For it is not an issue of private versus public. It is a far more frightening issue about a nation that seems not to care about people who are different and patients who are distressed — even when they are being tormented, traumatised and die in the care of those who are supposed to protect them.