The Better services for the mentally handicapped white paper outlined a desire to move away from caring for people with ‘mental handicap’ in institutional settings and to increase the provision of local and community care.
The white paper noted that there was a shortage of appropriate residential accommodation for ‘mentally handicapped’ people, as well as shortages of social workers and training centres. This meant that many parts of the country had minimal facilities for non-hospital care, with hospitals under pressure to admit more patients to overcrowded and unsuitable facilities. The document explained that many hospitals had been built when there was significant stigma attached to being ‘mentally handicapped’ and were isolated from the surrounding community. They were large, overcrowded, often designed for custodial care and with little privacy or recreation available.
The white paper set out the government’s plans for improving services, including increased capital investment in new facilities. It recognised that in some circumstances a hospital setting would be appropriate, but emphasised that it was the local authority’s responsibility to find a suitable home for a person on discharge and that people should not be retained in hospital if they no longer needed medical or nursing treatment. Where residential care was required, the paper recommended that local authorities should consider more ‘homely’ settings such as group-living in flats, or children’s homes and homes for elders. Local authorities’ homes needed to provide personal services, such as assistance with feeding or washing.
The paper deliberately used the terminology of ‘home’ rather than hostel to convey a sense of permanence for residents. It also acknowledged the importance of long-lasting personal relationships for people with learning disabilities and encouraged social workers to work with families and individuals to foster close links with the individual.