David K Affleck
In this essay:
- The management challenge
- Joint planning: the National Agenda
- Making it happen
- Conclusion references & appendices
Setting the Scene
Before my arrival in East Lothian in July 1970, my experience with people with a learning disability had been very limited. Two events however stand out in my memory. The first was a visit of observation to Lennox Castle hospital outside Glasgow in 1966, (then a home to 1490 adults and children assessed as having a mental handicap) and being introduced by the consultant to two twin women with Downs Syndrome who had reached the age of 55. This was seen as a real achievement for them and for the unit, as at that time, it was considered unusual for people with this condition to reach this age, and even more rare for twins to do so. The second was a medical opinion on a 17-year-old Aberdeen youth who had been involved in petty crime as a child. He came from a large ‘anti -social’ family with a mother who was a real challenge to the care agencies. The psychiatrist recommended that he should be committed to Ladysbridge Hospital in Banff because his offences were now including indecent exposure and he was assessed as having a mental handicap.
My arrival in East Lothian in 1970 came at a time of hope for parents of children and adults with learning disability. A small group of friends had set up a voluntary organisation called The East Lothian Association of Mental Health. They had approached the County Council for East Lothian about 1967 seeking action on the development of a day centre as a response to legislation passed in 1960 enabling Local Authorities to develop services in the community rather than institutional care for adults with a mental handicap. The Council responded with the view that the need for this was not proved and it was suggested that they set up a centre themselves and the position would then be reviewed. I regularly heard their chairman, Willie Hands, a former Town Councillor of Haddington, give an account of how they struggled in inadequate premises with a small band of parents and friends until eventually the County Council rented them the former Knox Institute School. In 1969, meetings had been held with the new Director of Social Work, Maurice Speed, to have proper services developed. The report he made to the new Social Work Committee in April 1970 referred to the urgent need for a capital programme for purpose built adult training centres. Subsequent minutes refer to the following action:
- 12 August 1971. The sub-Committee visited Prestonkirk House Old People’s Home to ascertain whether the Home or a site within the grounds of the home might be used to provide a replacement for the existing Knox Institute Senior Training Centre. It was decided to seek sites in a more centralised location.
- 30 October 1972. A meeting attended by John P, Mackintosh M.P. in which it is confirmed that Haddington Town Council would now be prepared to sell the former Slaughter house site at Gifford Gate.
- 11 January 1973. The minute entry notes that one of the planning conditions required that the building be on a domestic scale and designed with traditional materials.
- 1 November 1973. Approval to the project in the Capital Plan at a cost of £110000, with July 1974 given as the start date.
- 12 December 1974. A decision to close the Knox Institute on Friday 13 December following an engineer’s report and that the Director of Social Work should write to parents to explain the reasons for the early and possible prolonged closure.
- 9 January 1975. The revised Capital Plan identifies an increased estimate of £315,000 and an estimated completion date of November 1976.
Throughout this period, there was considerable activity by the members of the voluntary organisation with major pressure on John Mackintosh. He played a significant role in October 1974 after I alerted him that the approval papers were being held back at the Scottish Office. This was at the time of his attempt to get the parliamentary seat back from Michael Ancram. Within 48 hours, the papers were signed allowing the Council the privilege of borrowing the necessary capital.
In December 1995, I was asked by a BBC researcher why there were so few East Lothian adults living in the Algrade village community home at Humbie. I explained that Algrade had been set up by two very committed teachers and with support of some parents from Midlothian as an answer to the need for an alternative to hospital services and with no other local options available. The East Lothian situation had also involved key individuals and parents but had concentrated on community-based options and had fought a campaign for many years to bring that about. These were people who did not accept the possible long-term closure of the service on 13 December 1974 and who had found an alternative within 24 hours.
The personal contribution of Lady Alys Reece was also a major factor in the development of East Lothian services and I was honoured to contribute to the service in thanksgiving for her life on 21 January 1995. I included in my comment that it was ironic that some weeks earlier, it had been discovered that the roof of the new centre had a design fault so that we had to repeat the task of coping with rainwater dripping through the roof. Six months later the need for further emergency action arose because the remedial work had not been authorised. Again, there was the advice that everyone would have to be sent home until the building could be made safe. That was said to be the way the problem would be solved in Edinburgh. I had to intervene and make it clear that other options had to be found and that ‘the Edinburgh solution’ was not acceptable to the example handed on to us by Alys Reece and Willie Hands.