In August this year, the High Court in London awarded £6.6 million pounds to Leo Whiten, a seven-year-old boy who had suffered brain damage as a result of medical negligence at the time of his birth. Leo now has cerebral palsy, limited mobility, cannot stand or walk unaided, and has no functional speech. His mother noted that: “He will never be able to live independently, will not be capable of any form of employment and will never have the necessary mental capacity to be able to manage his own affairs.”
Awards of this kind are usually divided between annual payments and a lump sum. The annual payments are to meet the additional costs required to live with a disability and the resulting loss of earnings, while the lump sum (in this case £2.7 million) is to meet costs already incurred and to compensate for the distress caused by the injury. Estimates of additional costs take into account life expectancy and the level of social care required, which in Leo’s case is needed for 24-hour/day. The additional healthcare costs that might be needed by Leo are of course met by the NHS, and Leo will also be eligible for statutory disability benefits, which are currently £73.60/week for the care component and £51.40/week for the mobility component at the highest rates.
Very few people who are disabled from birth receive compensation payments to cover their loss of earnings and their need for social care. Instead, they depend on services provided by local authorities. Funding for these has increasingly been devolved to individual disabled people, ostensibly to increase their personal control over the services they receive. But these ‘individual budgets’ are not an entitlement like the disability benefits - they are paid purely at the discretion of local authorities. As central government grants have been reduced, local authorities have responded by tightening eligibility criteria for social care and reducing levels of payments. Public funds have as a result met an ever-smaller proportion of the true costs of social care and amount to very much less for people with severe disabilities than the sums paid to Leo Whiten.
Leo, like other people with severe disabilities, will not pay personally for using healthcare or for attending school, which means that these costs fall on the public purse. However, many people with severe disabilities from birth require more intensive healthcare interventions than the rest of the population, including the use of expensive specialist services. Special education for people with severe disabilities is also more expensive than that provided in ordinary primary and high schools. This all means that the lifetime cost of severe disability (both for the public purse and for families) amounts to several million pounds per person.
Faced by these circumstances, both families and governments are tempted to resort to miracle cures, and there are many persuasive charlatans able to supply them. Some families have spent large sums of money sending their child to Florida in the belief that swimming with a particular set of dolphins can ameliorate Autism. Others have paid to be trained in a technique which involves constant manipulation of a child’s arms and legs, all of which is supposed to train his or her brain to overcome Cerebral Palsy. Since this level of intervention can not be sustained, parents come to blame themselves for their child’s continued disability.
For governments, charlatanry takes a different form: there is a sustained denial of the impact of severe disability, coupled with a pollyannaish belief that people with severe disabilities from birth can, with a bit of help, attend ordinary schools (and hence avoid the cost of special education), find an ordinary job in the open labour market (and hence be ineligible for social security), and use ordinary (and cheaper) non-specialist health services. Policies of this kind have a particular power because they can be presented as liberating, and can be contrasted with the sad history of the stigmatisation and de facto imprisonment of people with severe disabilities. But this is the radicalism of fools. It means that disabled people are less likely to get the services the need, and more likely to be incarcerated. The Department of Health has run down its inpatient care for people with intellectual disability who have mental and/or behavioural disorders. This has been promoted and legitimised by its now-defunct Valuing People Support Team. But mental disorders and behavioural disorders have not been magicked away, and there has been a compensating expansion in residential and inpatient care by the private sector. This can take the form of ‘downwards substitution’, in which people who need skilled nursing care get cheaper residential care, provided by untrained and over-stretched staff. The Winterbourne View case (exposed by television rather than the formal ‘quality assurance’ bodies) shows the results.
Of course, some people have benefited from these changes. They include the former head of the Valuing People Support Team, who has now moved to a senior position in the main private company providing residential care in England.
Awards of this kind are usually divided between annual payments and a lump sum. The annual payments are to meet the additional costs required to live with a disability and the resulting loss of earnings, while the lump sum (in this case £2.7 million) is to meet costs already incurred and to compensate for the distress caused by the injury. Estimates of additional costs take into account life expectancy and the level of social care required, which in Leo’s case is needed for 24-hour/day. The additional healthcare costs that might be needed by Leo are of course met by the NHS, and Leo will also be eligible for statutory disability benefits, which are currently £73.60/week for the care component and £51.40/week for the mobility component at the highest rates.
Very few people who are disabled from birth receive compensation payments to cover their loss of earnings and their need for social care. Instead, they depend on services provided by local authorities. Funding for these has increasingly been devolved to individual disabled people, ostensibly to increase their personal control over the services they receive. But these ‘individual budgets’ are not an entitlement like the disability benefits - they are paid purely at the discretion of local authorities. As central government grants have been reduced, local authorities have responded by tightening eligibility criteria for social care and reducing levels of payments. Public funds have as a result met an ever-smaller proportion of the true costs of social care and amount to very much less for people with severe disabilities than the sums paid to Leo Whiten.
Leo, like other people with severe disabilities, will not pay personally for using healthcare or for attending school, which means that these costs fall on the public purse. However, many people with severe disabilities from birth require more intensive healthcare interventions than the rest of the population, including the use of expensive specialist services. Special education for people with severe disabilities is also more expensive than that provided in ordinary primary and high schools. This all means that the lifetime cost of severe disability (both for the public purse and for families) amounts to several million pounds per person.
Faced by these circumstances, both families and governments are tempted to resort to miracle cures, and there are many persuasive charlatans able to supply them. Some families have spent large sums of money sending their child to Florida in the belief that swimming with a particular set of dolphins can ameliorate Autism. Others have paid to be trained in a technique which involves constant manipulation of a child’s arms and legs, all of which is supposed to train his or her brain to overcome Cerebral Palsy. Since this level of intervention can not be sustained, parents come to blame themselves for their child’s continued disability.
For governments, charlatanry takes a different form: there is a sustained denial of the impact of severe disability, coupled with a pollyannaish belief that people with severe disabilities from birth can, with a bit of help, attend ordinary schools (and hence avoid the cost of special education), find an ordinary job in the open labour market (and hence be ineligible for social security), and use ordinary (and cheaper) non-specialist health services. Policies of this kind have a particular power because they can be presented as liberating, and can be contrasted with the sad history of the stigmatisation and de facto imprisonment of people with severe disabilities. But this is the radicalism of fools. It means that disabled people are less likely to get the services the need, and more likely to be incarcerated. The Department of Health has run down its inpatient care for people with intellectual disability who have mental and/or behavioural disorders. This has been promoted and legitimised by its now-defunct Valuing People Support Team. But mental disorders and behavioural disorders have not been magicked away, and there has been a compensating expansion in residential and inpatient care by the private sector. This can take the form of ‘downwards substitution’, in which people who need skilled nursing care get cheaper residential care, provided by untrained and over-stretched staff. The Winterbourne View case (exposed by television rather than the formal ‘quality assurance’ bodies) shows the results.
Of course, some people have benefited from these changes. They include the former head of the Valuing People Support Team, who has now moved to a senior position in the main private company providing residential care in England.
