Services for Adults with Learning Difficulties: Hillingdon

Motion made, and Question proposed, That this House do now adjourn.—(Jeff Smith.)

14:40:00

I rise to discuss services for adults with learning difficulties and disabilities in Hillingdon. Approximately 1.3 million people in England have a learning disability. If we include those with learning difficulties, that figure is even higher. Yet too often our services, education system, NHS, workplaces and society as a whole are not inclusive of their needs, and they are often seen as an afterthought. I was motivated to bring forward this Adjournment debate having recently had the privilege of meeting many adults with learning disabilities and difficulties and their families in the borough of Hillingdon. They expressed to me that, again, they feel like an afterthought, as they were appalled by the council’s recent decision to close another vital service for adults; many other services have been closed, moved or cut in recent years. Before turning to the specific important services that have been lost or are under threat, it is important to note that, of course, many good organisations are working hard in challenging circumstances to provide support. In the NHS, the Hillingdon community team for people with learning disabilities provides specialist support for adults with learning disabilities in the community and across primary and secondary care. Those services, however, are largely around diagnosis and access to medical support—just one aspect of an adult’s needs. DASH, a voluntary sector group, offers a range of sporting and recreational activities for people with a disability, all focused on encouraging people to socialise, but it too has struggled with decreasing funding in recent years. Hillingdon Autistic Care and Support provides an autism hub, advice and social activities for adults in the London borough of Hillingdon, but the slashing of its budget in 2023 led to the closure of the popular tea rooms—a café open to the public that offered training and work support to adults with autism. Unfortunately, that was a sign of even more damaging cuts to come. Following those proposals, an e-petition signed by 3,330 people called on the council not to withdraw the funding for the tea rooms. Despite that, the council pressed ahead, claiming that 20 people benefiting from training and support was not good value for money—a disappointing sign of things to come, with a council knowing the price of everything, but the value of nothing. More broadly in the area of education, the Park View centre, part of the Orchard Hill college group near Uxbridge, has a range of on-site vocational opportunities. The college does excellent work in challenging facilities that were not purpose-built. I recently had the privilege of meeting a number of their learners and staff, and they showed me at first hand how much they have to offer our community and workplaces. As well as insisting I attend their next disco, their overwhelming message was that they love their job coach Holly, but unfortunately, there was only one Holly in the whole of the college. They wanted more work coaches, placements, internships and job coach support. Yes, learning is vital, but they wanted it to lead somewhere in adult life. They wanted real workplace experience and, ideally, a full-time or part-time role. The Government’s commitment to invest more than £1 billion into workplace support for those with disabilities is a welcome step forward. I hope that the Department of Health and Social Care and the Department for Work and Pensions will work together to ensure that this investment is also targeted to help adults with learning difficulties get the support they desperately need. Data suggests that the employment gap for people with a learning disability is still far too wide. Of the people accessing long-term social care, only 5% of those with a learning disability are in paid work, which is a shame on our society. Charities have previously called on the Government to set a new ambitious target for reducing the disability employment gap with strategic actions behind it. A previous Secretary of State for Work and Pensions said in March 2023 that he would set a new disability employment goal, but progress has been slow, and I hope the two Departments can work together to progress that. Such a gap is why supporting work placements, centres for training and volunteering is vital. Following the closure of the Hillingdon tea rooms, another such facility is now under threat. There is a strong community-led campaign to save the Rural Activities Garden Centre, which provides employment opportunities, skills, lifelong relationships and a connection to our community for adults with learning difficulties across west London. Conservative-led Hillingdon council took the decision just last week to slash that vital service. I have been shocked and saddened to see how the voices of adults with learning difficulties and their families have been silenced in this discussion, not even being allowed to speak or question the decision at the civic centre. We are now in this Chamber, and we can ensure that their voices and stories are heard; a number of them are in the Gallery with their families. George is 28. He was separated from his parents at birth due to their inability to care for him at that time. He has spent years unable to eat without a feeding tube and has battled self-harm throughout his life. After decades of struggle for specialist support, four years ago George found something precious: a community at the Rural Activities Garden Centre, where he feels valued and understood. Since the announcement, and as a result of the fear that that vital support system may be stripped away, George’s challenges have again become overwhelming. Oliver has been attending the RAGC for 10 years and has complex health needs. He is partially sighted and has severe learning difficulties and chronic kidney disease. More recently, he has suffered from post-traumatic stress disorder. Oliver’s battle with mental health impacted on his ability to do day-to-day tasks and the usual activities that brought him joy, but one comfort remained: the RAGC. There is also Doug, who I have had the pleasure to meet. He is an adult with learning disabilities that impact on his ability to read, write and count. Where the private sector was unable to provide support to Doug with his additional needs, the RAGC saw past what he could not do and nurtured what he could. It watched him transform from a shy young man into a confident 32-year-old with purpose. After the closure meeting, Doug asked a simple but heartbreaking question: “Where do the staff go? What happens to me and my mates?” I was also told of Georgia’s story. Before joining RAGC, she struggled with anxiety and undiagnosed autism, leaving her imprisoned in her own home. The garden centre helped her to develop skills and build confidence, and she even went on to compete in a wreath-making competition. It was the service now under threat that transformed her from someone who could not leave the house to someone who could confidently serve customers—what a transformation. She fears the closure will reignite those same issues that she has worked so hard to manage. The difficulties of day-to-day life are often felt more acutely by adults with learning difficulties. It is the sanctuary that places such as the RAGC provide that makes it imperative we continue to fight for their survival. The Rural Activities Garden Centre makes employment opportunities, personal development and skills curation accessible for those who are often isolated. I have met so many people from right across the community who have volunteered there, gained skills and even moved into permanent jobs as a result. Families feel that their loved ones are cared for, safe and nurtured in this space, and it has given carers and families their own ability to have respite and time to care for themselves.

I congratulate the hon. Member on securing this debate. He will know that the garden centre also provides an essential service to my constituents. I have visited the place for either 20 or 30 years—I am not clear—and it was commended by the former Conservative leader of Hillingdon council, who called it a jewel in the crown. That is why it has come as such a shock that this Conservative administration is now willing to close it with such brutality. Does the hon. Member agree that the council should, even at this late stage, think again and consult properly—including all those volunteers and parents as well as the people who use the centre—to look at a wider range of options? This does not have to happen now: the council just needs to listen to us.

I concur completely with my right hon. Friend. We have both met those affected, their loved ones and their families, and we can really hear and see the value. Unfortunately, that value was not considered in the rushed decision made by the councillors—I will turn to the lack of consultation very soon, and I completely agree with him about that. It is not too late and, like him, I hope that the council thinks again. The Rural Activities Garden Centre is another in a long list of closures at the hands of the local council. Following years of financial mismanagement by the leadership, the modus operandi has become to cut through its crisis. While the council’s cabinet sees nothing more than a line on a spreadsheet, behind this move are adults with learning difficulties, whose lives have been transformed by this service and who risk losing it all as a result of the council’s decision. By its own admission, it views the decision of the closure through the lens of profit. Failure to turn a profit means inevitable closure to Hillingdon council. That was the reason quoted at the recent decision-making meeting, but should social services have to make a profit to survive? To me, it defeats the objective of those services. By that logic, one wonders what will be cut next by Hillingdon council? What other social services or schools will it have in its sights? This heartless approach to community services aside, Hillingdon council’s binary decision making in relation to profit is economically flawed. These services are not costs; they are investments in the future. The National Audit Office calculated that supporting someone with moderate learning disabilities in residential care costs £4.7 million over their lifetime. With proper community support such as the RAGC, that drops by £1 million. We save money while giving people the dignity, purpose and independence they deserve. Perhaps the council’s inability to understand this basic economic principle of investment and returns sheds some light on why it is about to go bankrupt, receiving damning reports from its own chief financial officers. Still, Hillingdon council dismisses the RAGC as merely a “retail service”. Tell that to George, Doug, Oliver or Georgia. Tell the families who have watched their loved ones transform from isolation to independence that this is a “retail service”. I recognise that there are similar stories across the country, unfortunately, scattering services, breaking up communities and destroying what works for short-term savings that create long-term costs, with our most vulnerable communities always the first to feel the brunt. The Rural Activities Garden Centre works. Its clients thrive. Their families are supported. The evidence is overwhelming, but evidence means nothing without political will, and political will means nothing without adequate funding. We are not asking for the impossible. We are asking the council and this Government to back choice and independence for adults with learning difficulties and care packages and to recognise that supported employment is not a luxury to be cut when times are tough; it is a vital investment that pays dividends in human dignity and economic returns for national and local government. The Rural Activities Garden Centre must be saved. Services like it across England must be protected. The people who depend on them deserve nothing less than our absolute commitment to their dignity, their potential and their right to belong. I appreciate the Minister giving up her time to be here today, with so many pressing issues across the health and care system. There are some specific issues I hope she will take away for further consideration. First, I and local families would like to welcome the Minister to Hillingdon to meet disabled adults and those with learning difficulties, to hear their experience of a fragmented system and a council and NHS not working together as well as they could and should, which I hope could inform the broader review of social care taking place nationally. Secondly, the Women and Equalities Committee report in 2023 on inequalities for people with learning disabilities outlined clearly that people with a learning disability, and those who care for them, are the real experts when it comes to their health and care needs. However, aside from the occasional opportunity to feed into consultations, far too often their voices are missing when it comes to decision making at both a local and national level. Their lived experience should be better reflected in efforts to reduce health inequalities and improve outcomes. I hope the Government will look at how they can embed co-production and meaningful engagement in decision making on care packages and services and ensure that those with care packages and support are genuinely consulted and engaged in any service changes. There must also be clearer guidance for providers and commissioners of services about consultations and full equality impact assessments being conducted before services are changed, which has been woefully lacking in this case. Thirdly, the NHS 10-year plan, launched yesterday, included welcome announcements about supporting people with health budgets, giving people personal health plans and a shift to prevention and community-based working for the NHS. Will the Minister address whether we can and should expect the same principles to lead work on adult social care support, too? Fourthly, on enabling joint working, the Public Accounts Committee report in 2017, “Local support for people with a learning disability”, found that people with a learning disability who live in the community have patchy access to healthcare and limited opportunities to participate in the community—for example, by having a job. While the Department has the policy lead for people with a learning disability and care plans, responsibility for their support spans across Government. We even found that to be the case when discussing which Department should respond to this debate. Responsibilities cross the Department of Health and Social Care, the Department for Education, the Department for Work and Pensions and the Ministry of Housing, Communities and Local Government. In its report, the Public Accounts Committee recommended that Government should “set out a cross-government strategy for improving access to health care and opportunities” for adults with learning disabilities to “participate in the community, including employment, as well as how it will measure the effectiveness of this strategy.” I hope we can return to this in future, because clearly all these Departments bear some oversight and responsibility for this important group of the population. Lastly, I hope the Minister will join me in thanking Oliver, Doug, George and Georgia, as well as all the service users and their families, for building this project from scratch, many decades ago, planting the first trees, building the first planters, volunteering to keep it going in difficult times and creating this amazing life-changing project, and now also for their campaign to fight for its survival. I hope that Hillingdon council will think again, take the time to genuinely listen and get the decision right, working with the community. In the absence of that, I hope the Government will prioritise adults with learning difficulties in services like this one. We were elected a year ago today on a manifesto of change, investing in people, transforming life chances and providing everyone with opportunity. These are the things that the Rural Activities Garden Centre, and so many other services in Hillingdon, have done, and can continue to do, for countless people in the borough of Hillingdon.

14:55:00

I thank my hon. Friend the Member for Uxbridge and South Ruislip (Danny Beales) for securing this debate around services in the community for people with a learning difficulty in Hillingdon, and for championing the rights of people with learning difficulties in his area. I welcome those in the Gallery who are here to demonstrate how important services for people with learning difficulties in Hillingdon are to them. I join my hon. Friend in paying particular tribute to Oliver, Doug, George and Georgia for all their work in this area. I am aware that, as a member of the Health and Social Care Committee, my hon. Friend has a keen interest in health and social care matters. He will therefore be pleased to know that the Government have today published their response to the Health and Social Care Committee report “Adult Social Care Reform: the cost of inaction”. I am sorry to hear that Hillingdon council has decided to close the Rural Activities Garden Centre, but as Members know, decisions on local services are for councils to make since they are best placed to understand and meet the needs of their local populations.

I fully appreciate the point that the Minister makes, but will she take advice from colleagues in other Departments on the following specific point? My hon. Friend the Member for Uxbridge and South Ruislip (Danny Beales) and I have been working with different groups and we have sought to register, under relevant legislation, the Rural Activities Garden Centre as a community asset, which would force the local authority to properly consult with us and to engage with the wider community. The council is going ahead with the decision to sell or close in advance of even considering whether it should be a community asset. Will she help us by taking advice, from whichever Department is relevant, about whether or not there is anything we can do, as a Government, to ensure that Hillingdon council abides by the legislation that was passed to protect community assets such as this one?

I will ensure that that issue is raised with the relevant Department. I will say a little more about some of the expectations we place on local authorities to shape their care markets to meet the diverse needs of all local people, as required under the Care Act 2014. This Government recognise the vital importance of co-production and working with people who draw on care and support. To ensure local authorities are meeting these duties, the Care Quality Commission are assessing local adult social care services by publishing a full report and overall performance rating for each local authority. Hillingdon has been rated as “Good” in the CQC’s recent assessment, but the report also includes feedback on areas where the CQC concluded that Hillingdon could improve. It is great to be having this discussion today, on the last day of Co-production Week, an important annual awareness campaign to recognise the benefits of working in equal partnership with people using health and social care provision. Local councils should absolutely involve, engage and consult adults with learning difficulties on their care plans, as well as on wider decisions that affect their care and support, and their lives in general. We are committed to encouraging genuine co-production between social care professionals, local authorities, policymakers and, crucially, people who draw on care and support, to design a system that works better for everyone—one that is fair, inclusive and puts people first. The Government recognise that investment in local services in the community is vital. That is why we have made available over £69 billion for local government this financial year, increasing core spending power by up to 6.8% in cash terms on last year. For Hillingdon, that means a total of £266.3 million in its core spending power for this year, an increase of 6.2% on 2024-25. We strongly encourage councils to apply elements of good market-shaping practice involving providers. My hon. Friend the Member for Uxbridge and South Ruislip talked about how people with learning disabilities should be worked with across the Government, but actually that applies to all Government, because we seek to serve the people and that includes people with learning disabilities. Yesterday, we published our 10-year plan. I am delighted that social care will, for some people, be a key part of the neighbourhood health services we discussed, but the adult social care system is in need of wider reform. We have already begun that journey, including legislating for a fair pay agreement and the independent commission into social care. Over time, the neighbourhood health service and the national care service will work hand-in-hand with each other to help people stay well and live independently. To conclude, I note my hon. Friend’s invitation to visit Hillingdon and I will ensure that that invitation is extended to the relevant Minister. I once again thank him for bringing forward this important debate, and every Member who has contributed. I hope that Hillingdon council takes notice of this debate. Question put and agreed to.

15:01:00