Volume 1

Report of the Committee of Enquiry into Mental Handicap Nursing and Care.

  • Great Britain. Committee of Enquiry into Mental Handicap Nursing and Care.
Date:
1979
Catalogue details

Licence: Open Government Licence

Credit: Report of the Committee of Enquiry into Mental Handicap Nursing and Care. Source: Wellcome Collection.

    39/204 (page 21)
    of nurses. In particular the Committee recommended that ‘“‘a new caring profession” for the mentally handicapped should emerge gradually. The Briggs modular nurse training, with its emphasis on common elements rather than particular skills, went against the trend of mental handicap nursing which was becoming more and more specialised, and the idea of a new caring profession caused concern among many mental handicap nurses. It was in this atmosphere of anxiety and uncertainty that our Committee was established in 1975. The most recent development in the field of mental handicap has been the publi- cation of the White Paper on the Mental Health Act?* which occurred too late for us to consider any implications it might have for residential care. Services and Staff 40. In para 3 we explained that we were unable to divorce staffing consid- erations from the structure within which care is delivered. Mental handicap residential institutions are for the most part located in the health service, since the development of local authority homes on any appreciable scale has taken place only recently. The majority of the staff caring for mentally handicapped people are therefore nurses, whose ethos derives from the nursing and medical world. One would expect mental handicap student and pupil nurses to look to other nurses, rather than to residential care staff in local authority homes for mentally handicapped people, for their peer group. For although the two groups of staff may be doing similar jobs their training, conditions of work, organisational hierarchy, career structure, and employing authority are differ- ent; such differences have an important effect on what is being taught. A “nurse”? who is being taught in a “hospital” is bound to receive a different slant to her training from a “residential social worker/houseparent” who is working in a “‘hostel/home’’, even if both types of staff are taught the same subjects. These variables also colour the way in which what is learned in training is put into effect. Our terms of reference required us to focus on the job to be done and how people should be trained to do it, but to carry out our task we had to place training in the context of the services which are available now, or may be available in the future. 41. We were asked to accept as our starting point the pattern of services recommended in the 1971 White Paper. Briefly these were a shift in the balance from hospital to community care with a rapid expansion in local authority services, a relative reduction in the numbers cared for within the hospital service, and the development of a decentralised hospital service which would be able to link closely with local community services. The White Paper recommended that children should not be removed from their own neigh- bourhood for residential care except as a last resort. There was also the commitment to improve, but not to extend, the existing large hospitals. The White Paper figures suggested that an increase in local authority residential places of more than 600 per cent was required, alongside a drop of nearly 50 per cent in hospital places. Thus, even without our recommendations, services for mentally handicapped people are in a state of change. As the balance of services shifts, so too the staffing of the services will change, with many more staff being employed by social services departments and with better nurse/patient ratios in health authorities. Staff will therefore need to be trained to cope with a variety of surroundings. In addition to this the White Paper figures themselves may need to be amended in the light of experience. For Zk