Last week saw the sad death of
Mary Warnock. Although, quite rightly, many of the reports of her death focused
on the work she had undertaken in the field of ethics and, her work on human fertilisation
and embryology - this world-leading work led to the establishment of the Human Fertilisation
and Embryology Authority in 1991; however, it was her work in education that
came to my mind, and her death and the subsequent reporting of her life made me
think back to my early years as a nurse.
When I qualified as a mental
health nurse, I spent my initial post-qualifying period working as a staff
nurse at Cefn Coed Hospital Swansea. Due to the travelling, (a daily 76-mile round
trip), I left there to work as a staff nurse in the West Wales Learning
Disability Service, near Camarthen. It was a time of great change, as Care in the
Community was introduced. This was a well-funded and politically supported initiative
to close long-stay hospitals and relocate services to more community settings. Despite
not having a learning disability nursing qualification, I was appointed as Charge Nurse
after just one year’s experience. I don’t think this was because I was particularly
able or qualified, more a reflection of how difficult it was in those days to recruit
nurses to work in rural settings.
As part of my ‘induction’ into
the role of a Charge Nurse, I went and spent two weeks at Ely Hospital Cardiff.
Younger readers of this blog may well not know the role Ely Hospital eventually
played in both the care of people with learning disabilities, the training of
healthcare professionals, and the development of systematic reviews of the
quality of care provided within hospitals. Sadly, like many new initiatives in
health care, these developments occurred because of the abuse and neglect of
people, many of whom were at their most vulnerable, by those charged with
caring for them.
In 1967, the story of abuse was
picked up by the News of the World newspaper. At one time this was the highest
selling English language newspaper in the world. Its main approach to journalism
was mainly based around sensationalism, and it had a reputation for exposing national
or local celebrities’ drug use, sexual peccadilloes or criminal acts. The
allegations were first made by a Mr Pantelides, who worked at the hospital as a
nursing assistant. He could not get anyone at the hospital to listen to his concerns
and eventually took the story to the newspapers.
The story led to the setting up
of the Ely Inquiry in 1969. This revealed a hospital that was isolated from
other parts of the NHS, where there was very little staff training (the only
training event they could find since 1950 was of a Charge Nurse who attended a
course on nursing in the event of an atomic war) and overcrowded wards. The Ely
Hospital report is still regarded as being a significant catalyst for the
development of contemporary learning disability services. The report was
followed in 1971 by the White Paper: Better Services for the Mentally
Handicapped.
During my two weeks at Ely, I saw
much that dismayed me, and I remember writing a report (we didn’t have
computers in those days) in which I tried to carefully articulate my concerns. Sadly,
like Mr Pantelides, I am not sure anyone paid any attention to what I had
written. Thankfully, following the introduction of Care in the Community, Ely Hospital
went into decline and was finally closed in 1996.
Mary Warnock also chaired a committee
of inquiry into the rights to education of children with a learning disability.
The inquiry ran from 1974 – 1978 and produced a powerful report that in my mind
was just as important at the work she undertook in the field of human fertilisation.
Perhaps these days some might see her conceptualisation of children with learning
disabilities as being ‘God’s children’, and that they, like all children,
walked on a single road, but reaching different stages along it, as outmoded. Some
might disagree with the metaphor she used, but what it allowed was for the articulation
of the need to recognise a ‘continuum of need’ upon which individual children
could be assessed according to their own specific needs and not simply through
some diagnostic and often meaningless categorisation. As such, she advocated
that children with a learning disability should be placed in mainstream schools,
who should make special provision in responding to each child’s specific needs.
Although her recommendations were
enshrined in the 1981 Education Act, it was a time of financial austerity in
the UK and many of her recommendations were not adequately financed and as such
implemented effectively. Thankfully, there have been many changes in the way education
is provided for children with special educational needs and disabilities (SEND).
The Children and Families Act (2014) brought a clear expectation that such
children should be taught in a mainstream school, and that every teacher is a
teacher of children with a SEND. I never met Mary Warnock, but I am sure she
would have been pleased to see such inclusion finally being realised, albeit so
long after she made her recommendations. She was one great woman, and a woman
whose life’s work has changed the lives of millions of other people across the world.
May she rest in peace.
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