SHRC Tick Tock Report Blog

Iain GillonSCLD Publication

The publication of the Scottish Human Rights Commission’s (SHRC) Tick Tock report is a watershed moment for people with learning disabilities in Scotland.  The report is unequivocal that no one in Scotland should be living in an institutional setting.  It provides strong recommendations and a human rights framework to accelerate and measure progress towards achieving deinstitutionalisation across all settings. 

The report explains that ‘institutionalisation’ is about much more than the type or size of a particular building or living arrangement.  It encompasses isolation and separation from community, the denial of choice over someone’s support, who they live with and where, and a lack of control over day-to-day decisions due to a particular living arrangement.   

This lack of autonomy and loss of personal choice has been a common experience for people with learning disabilities in Scotland over many decades.  Many people have been marginalised, traumatised, and made vulnerable to abuse.  And while there has been significant progress towards independent living over the last 30 years, people with learning disabilities remain in institutional settings. 

The 2018 Coming Home report focused attention on this issue and led to the Scottish Government’s Coming Home Implementation Plan which set a target of greatly reducing inappropriate hospital stays and ‘out-of-area placements’.   

The SHRC report outlines a significant lack of progress with this work to date.  And it criticises the Coming Home plan for failing to adopt human rights-based standards, and asserts that it would not have delivered the right to independent living for people even if it had met its objectives.    

The report underlines that Scotland’s existing ‘structures, policies and interventions are currently inadequate in relation to realising a human rights-based process of deinstitutionalisation’By employing a set of human rights indicators, the report highlights an absence of appropriate data with which to measure progress and enable planning.  It also points to a lack of transparency and accountability around the £20m Community Living Change Fund, which was allocated to HSCPs to drive change, as well as a failure to adequately monitor the delivery of community support or the allocation of local spending. 

In all the SHRC report makes nine recommendations.  It calls for a concrete action plan to replace all institutional settings in Scotland with independent living support services.  It says this plan must meet the UN guidelines on deinstitutionalisation including appropriate monitoring, accountability and the meaningful participation of disabled people, including survivors of institutionalisation. 

The report calls for a timeline for mental health law reform to ensure compliance with the Convention on the Rights of Person with Disabilities (CRPD) and for the proposed Human Rights Bill for Scotland to place strong duties on public authorities to comply with the right to independent living.   

The report also cites wider human rights considerations.  It highlights that institutionalisation impacts the right to liberty, the right to private and family life and, potentially, the prohibition on inhuman and degrading treatment.  These are fundamental human rights issues for people with learning disabilities, that are protected in domestic law by the Human Rights Act, and which the report says the Scottish Government must take seriously. 

Another issue which the report raises is the harm caused by institutionalisation, past and present.  In the 1970s, as many as 8,600 people with learning disabilities lived in large scale, long-stay hospitals all across Scotland.  The report identifies a need for mechanisms that facilitate truth and reconciliation processes and provide redress for the scale and personal impact of past and present transgressions. 

The SHRC report offers a powerful critique and its recommendations provide a catalyst for reform at every level. 

This includes increased transparency and appropriate accountability structures alongside effective strategies and joint working to ensure that all monies are used to deliver independent living support aligned with UN standards. 

Central to this is ensuring people with learning disabilities have suitable homes within their chosen communities.  This necessitates providing people with genuine choice over their living arrangements together with bespoke care packages and a range of accessible housing options.   

There is scope here to learn from the hospital closure programme in the 1990s and early 2000s which used bridge financing to transition large numbers of people with learning disabilities into the community.   

Finally, in addition to enshrining the right to independent living in Scots Law, a key challenge remains how to reform mental health law so that people with learning disabilities are no longer detained in hospital without therapeutic need.   

The SHRC report underlines the need for urgent change. SCLD believes the challenge now, for all stakeholders, is to identify and deliver practical solutions which enable all people with learning disabilities to realise their right to independent living in the community.  

SCLD wishes to work with all stakeholders who aim to respect, protect and fulfil the rights of people with learning disabilities, by applying the recommendations of this report.