Understanding the past

4 After Lennox Castle

This final section of the unit will bring you up to date with what provision is like today for people with learning disabilities, now that institutions such as Lennox Castle are no longer part of the picture. Why and how Lennox Castle and other similar institutions came to be closed will be the focus of discussion. Of course, change in this particular area of provision was not something new. You would have noticed that Howard Mitchell, Allan Williamson and Colin Sproul all mentioned changes that were being introduced while they worked at Lennox Castle. Some of the early changes made no difference to where people lived, although they did alter the conditions under which they lived. You will remember from the timeline in Activity 4 and Appendix 3 that, for example, from the 1960s residents were no longer expected or paid to carry out domestic work. The drug chlorpromazine (Largactil) was introduced in 1952 and this, as Colin Sproul recalled, changed the ways in which patients were managed, although you might have wondered whether there was more than one way of regarding the impact of this as far as the residents were concerned.

The changes we will be focusing on here had a much greater impact on the hospital; in fact, they led to its closure by 2002. In Activity 12 you will see how provision changed and the alternatives there are now to institutional care (in the Glasgow area at least), you will have an opportunity to consider what the pressures were that led to the one final major change for Lennox Castle Hospital.

Activity 12 From care to citizenship

Download and read the following paper,? From care to citizenship?, by Jan Walmsley, from the link provided below. As you do so, make notes in response to the following questions:

1. What were the key factors which led to a change in provision for people with learning disabilities from the 1950s?
2. What have been the main results of these changes for people with learning disabilities?
3. Jan Walmsley compares and contrasts the two White Papers of 1971 and 2001 ? what does she see as being the main differences between them?
4. Who does she see as being neglected in these changes?

Comment

1. The key factors leading to a change in provision, picked out in the chapter, are:
   • the NCCL (National Council for Civil Liberties, now Liberty) campaign in the 1950s ? this actually began in 1947
   • the proposal in the 1971 White Paper for a shift towards care in the community
   • the emergence of different types of provider, specifically in the private sector
   • concern about the costs of funding residential care through the social security budget
   • the NHS and Community Care Act 1990, which brought in individual assessment by care managers for people needing support
   • the Disability Rights Movement, originating in the 1970s, which led to the user movement run by people with learning disabilities in the 1980s.
2. The main results of these changes for people with learning disabilities have been:
   • eventual closure of the large long-stay hospitals
   • a range of types of provision in the community, including, as well as many people still continuing to live at home with their parents, group homes, supported living and residential care
   • a wide range of types of support once local authorities were given responsibility for managing costs
   • an emphasis on consumer choice and the voice of users
   • introduction of Direct Payments.
3. Jan Walmsley suggests that the main differences between the 1971 and 2001 White Papers are:
   • In 1971, the focus was on what might be ‘done for? people with learning disabilities, whereas the arguments in the 2001 White Paper were being made by people with learning disabilities themselves as a result of the Task Group which travelled the country visiting self-advocacy groups and collecting evidence.
   • In 1971, accounts of abuse and neglect in the long-stay hospitals had put policies for people with learning disabilities in the public eye. Walmsley argues that, by 2001, this was no longer the case.
   • The language of the two White Papers differed. In 1971, there was a focus on encouraging more sympathetic attitudes towards people with learning disabilities, whereas in 2001 there is mention of choice, carers and aims for a better life generally.
   • The 1971 White Paper set some definite targets for local authorities to achieve with regard to more varied forms of provision for people with learning disabilities; by 2001, provision was much more complex, although the target of closing NHS long-stay hospitals was achieved in 2004.
4. The people Walmsley sees as being neglected in these changes include: people living at home with their families; people from black and minority ethnic backgrounds; and people who are severely disabled or who are considered to have ‘challenging behaviour?.

The paper by Walmsley provides a policy background to the changes that led to the closure of Lennox Castle Hospital. Provision for people with learning disabilities who do not live with their families has changed considerably. So what is life like for people today? What are the alternatives for people living in the community, both those who have and have not lived at Lennox Castle? You will find out in the next activity.

After Lennox Castle

For the next set of activities, you?ll be looking at what has replaced Lennox Castle. By focusing on the story of one young woman?s move into her own flat and, by hearing from Margaret Scally once again, you?ll be seeing how accommodation and support for people with learning disabilities has changed. You?ll consider how people make and manage their transition into independence and review some of the challenges they face. Finally, you?ll be debating whether residential care for people with learning disabilities still has a place in the range of alternatives available in the twenty-first century.

In these activities you?ll be able to consider how people make and manage their transition into independence, and review some of the challenges they face. Residential care still has some support, as you?ll also see, with alternatives to Lennox Castle now appearing in different forms.

Lesley Learmonth?s successful move into her own flat illustrates just how far things have changed since the time when choice for people with learning disabilities was more or less restricted to living with their parents or living in a large institution. You?ll have seen how she was supported in this move, and you?ll have heard Donna Thompson and Allan Williamson discussing how their organisations support and campaign for changes in the lives of people with learning disabilities.

Margaret Scally?s life has also changed considerably. Thinking of her, of Lesley and of the people who continue to live in residential care settings, you should be able to consider to what extent they have moved, in Jan Walmsley?s words, ‘from care to citizenship?.

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