NDTi ambassador, David Brindle reflects on how hard-won gains in personalisation and community support are once again being challenged.
It makes our new strategy, based around inclusion, voice and system change, more important than ever.
Twenty years ago, I was genuinely excited by the possibilities of rethinking services around people’s voice, choice and control. There was a head of steam in government behind the idea of self-directed support and early adopters’ stories were starting to capture the public imagination.
The Valuing People Support Team, NDTi’s progenitor, had shown how personalisation could offer an immeasurably better way of life for people with learning disabilities and autistic people. Almost 3,000 people across scores of local authorities were operating personal budgets under the pioneering In Control programme. Some who had struggled for years with mental health challenges were getting out of their homes to attend classes, draw and paint, cycle and go fishing.
There was even, and we whispered this, a growing body of evidence that giving people cash instead of traditional services could be cheaper for the taxpayer. Fancy that!
Then came the global financial crash, a change of government and a decade of austerity (accentuated by Brexit) from which we have still not recovered. Under pressure to cut their costs, local authority and NHS commissioners reverted unthinkingly to traditional service models, curbed personal budgets and, it sometimes felt, pulled down the shutters on dialogue and innovation.
“People today too often do not have real choices in their lives and are not listened to or taken seriously, while systems are making it harder to get support.”
As a result, as NDTi’s new strategy points out, people today too often do not have real choices in their lives and are not listened to or taken seriously, while systems are making it harder to get support. And some key policy and legal signals are pointing in a still more worrying direction.
Take the Supreme Court’s overturning in June of the judgment known as Cheshire West. For more than a decade this ruling had served as a vital safeguard against untoward deprivation of liberty of people in care settings; its eclipse now poses a major threat to enlightened practice. An optimistic take is that new guidance will enable resources to be focused on people most in need, but that may require an heroic leap of faith.
Or take the climate of debate around mental health care, consequent upon a number of admittedly shocking and tragic cases that have been used to call into question, again, the 60-year policy presumption in favour of community treatment – most notably, the clear care failings in the case of Valdo Calocane, who killed three people in Nottingham in 2023.
As a journalist, I find that much of the media coverage of these cases has deeply worrying echoes of the moral panic surrounding the safety of ‘care in the community’ in the 1990s. Then, it took brave professionals, advocates, people with lived experience and, yes, key politicians to unite against huge pressure for a return to an institutional care model. We may need to do so once more.
But can we rely on the politicians this time around? The call in June by Kemi Badenoch, Conservative leader, for scrapping of the Public Sector Equality Duty suggests that our political parties are engaging in an unseemly Dutch auction of equality protections. It remains to be seen just how low they will be prepared to go in pursuit of votes.
There’s never been a more important time for people of good will to make a stand for the principles, and practice, of inclusion, voice and progressive system change. In nailing its colours to the mast so resolutely with its new strategy, NDTi is showing a welcome lead. Who will follow?