No Profits from Mentally Li

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The last week in June was Mental Handicap Week' Between 7 and 10 of every 1,000 children born in Britain today are likely to suffer from some form of mental-handicap and many more are destined to become! mentallyhandicapped as a result of infection, accidental injury or assault in later years. Yet few people who do not come into direct contact with the mentallyhandicapped, either through their work or in their own families, are aware of the disabilities and capabilities of those affected, or of the problems faced by relatives who have to try and cope with a situation they hardly understand themselves.

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The scope of mentalhandicap reaches from those who are completely dependent, often with accompanying multiple physical handicaps such as spasticity, blindness, gross disfigurement, to those who would usually be considered merely "backward"

In between these extremes is a whole range of people with various differing talents and abilities and degrees of responsibility.

"Each requires a variety of facilities and different degrees of support, to enable them • them to advance and realise their full potential.

Under threat Facilities and support are sadly lacking and the little that is available is now under threat following the publication of the "Jay Committee" reccomendations.

More than . four years after its inception, the Committee of Enquiry into provisions and care for the mentally-handicapped finally published its report in March.

The Committee was set up in 1975 by the then Minister of Health, Barbara Castle, to investigate residential care provisions, following suggestions in the Briggs Report on Nursing.

This had advocated the estate profession " t deal with mental-handicap.

The Committee's proposals centre upon the removal of mental-handicap as a responsibility of the NHS putting it instead under the auspices of the Local Authority Social Services Departments.

This goes alongside eventual phasing out of the large subnormality hospitals with a shift in emphasis towards "community care"

Explaining these proposals, Peggy Jay, Chairman of the Committee and the mother in law of Callaghan's daughter, wrote:

"Although the basis of our beliefs is simply that mentally handicapped people should have the right to be treated as individuals, to live life to the full and to have the same access to services of all kinds as everyone else, some of the detail may appear idealistic to some.

In particular, our insistence on small-group living which goes beyond what is now generally regarded as ideal, many seem unobtainable at a time of economic restraint. But our idealism, if that is what it is, is deliberate.

We agreed we should aim for the most appropriate solution even though we realised that its achievement might take some time..

This generalisation of mentally-handicapped person's rights is so vague as to be almost impossible to disagree with.

But the proposals of her Committee will do absolutely nothing to uphold or to further these rights. Having already conceded that they are subject to economic requirements, she continued:

"We also looked carefully at the idea of …a separate caring profession for mental handicap care staff.

We belive . . that this would not be a good idea for either the staff or for the mentally handicapped themselves.

One of the elements of our model of care is normality and we see a separate caring profession as being opposed to this principle..

Mentally-handicapped

people are not 'normal' and treating them the same as everyone else will not make them the same as everyone else.

They need special considerations and have special requirements which are in addition to those of 'normal' people and their basic right is that these should be met. The argument for 'normality' can be used as an excuse for denying them their requirements.

It is not sufficient simply to call them 'handicapped' rather than 'subnormal' or "client' rather than 'patient' and it does not make sense to dispense with much needed facilities for the sake of 'normality'.

If someone needs a wheelchair it is inexcusable to refuse it because most people walk, or to offer them crutches because that's all that can be afforded.

The Jay Report is another example of the polarisation which has taken place in attitudes towards mental handicap care.

This has resulted in debate largely being reduced to a question of hospital care 'versus"community" care.

Unfortunately, the mentally-handicapped are in danger of becoming pawns in the game between the two sides.

Upper hand

The supporters of community care have undoubtedly had the upper hand so far, and this has been reinforced by the Jay Committee.

There are two main reasons for this: firstiy, they have been able to point to the good results achieved by numerous special test community projects and secondly to the sensationalist press headlines following various • hospital exposes. What more proof, they ask, could be required?

This, however, paints a rather biased picture.

Experimental community units have tended to be provided with model facilities and a good staffpatient ratio.

Also, patients have otten been picked according to their ability to fit into the scope of particular projects.

Many hostels, for example, will not accept people who are incontinent or non-ambulant.

Results have then been compared with underfinanced, under-staffed and over-crowded hospitals which are trying to cope with inadequate and obsolete equipment and many of the more demanSmall community residences can often be much more closed and restrictive .than the large hospitals.

Indeed, the hospitals usually lie in extensive grounds which, if utilised to the full, could provide more freedom of movement and occupational facilities than could the confines of a small hostel in the suburbs or the High Street, and also an environment free of much of the stress which accompanies living outside.

Living in the community does not mean being a part of the : community or accepted as such and the hospitals, provide a valuable option which can exist alongside community facilities.

The need for a more personal and homely atmosphere should not be an argument for phasing the hospitals out, but should instead be the impetus for reorganising them and planning them accordingly.

It should not be a case of either/or, but which is the more suitable for a particular person and their individual capabilities and requirements.

What is • not generally realised is the fact that the vast majority of mentallyhandicapped people do live in 'the community and not in hospitals.

They live at home with their familities and on the whole receive precious little assistance.

Minority report

David Williams, the Assistant General Secretary of COHSE sat on the Jay Committee and refused to sign the majority report.

He produced his own minority report in which he called for a "properly integrated and unified service" which would still be within the framework of the NHS and encompass the facilities presently administered by the local authorities.

He also points out that a good many local authorities are not even meeting the requirements placed on them by the 1959 Mental Health Act and declares that it would be folly to entrust them with responsibility for the entire mental-handicap service. In his report he states:

"Mental-handicap is have done everything in their power to uphold the reactionary policies of Callaghan and his cronies in The Labour leadersmp by selling out the struggles and demands of the workers they are supposed to represent.

PHOTO: Andrew Wiard. Report COHSE leader Spanswick They have paved the Tories' road to power by their abject acceptance of wholesale hospital closures the imposition of rigid cash limits on public expenditure, and four. . years of strict wage control.

The very existence of the NHS is now jeopardy, and the responsibility can be clearly laid at the feet of the likes of Williams.

Capitalism does not cater for social need; it caters for profitable demand; unfortunately mentalhandicap is not profitable Increased technology has drastically reduced the employment open to the mentally-handicapped and cash limits and lessening of overcrowding in the hospitals has drastically reduced residential places.

Provisions presently inadequate and even these face further reduction.

Whatever type of service results from the Jay recco. mendations, it will have to fight for its existence.

However, fundamentally caring society and to build the requirement is for that we must rid ourselves of the bureaucratic parasites which presently control the labour movement and prop up the capitalist system and fight for a programme which will open up the dealings of the private monopolies which bleed dry the NHS and expose the fraud they call democracy.

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