The joint investigation by the Healthcare Commission and Commission for Social Care Inspection into learning disability services at Cornwall Partnership NHS Trust identified systematic abuse of people in a number of the trust’s learning disability services. In response to the publication of the Commission’s joint report on 6 July 2006, my right hon. Friend the Secretary of State and I made a commitment to ensure progress against the local and national recommendations made in that report. This commitment to maintain an ongoing involvement and focus on improvements was our recognition of the severity of what was uncovered in Cornwall and the need for significant change locally, as well as the need to ensure that the circumstances that led to those events do not occur elsewhere.

As stated in my written ministerial statement on6 July 2006, Official Report, column 48WS, and my right hon. Friend’s response to an urgent question on the matter on 11 July 2006, Official Report, columns 1253-61, Cornwall Partnership NHS Trust was placed on special measures following a recommendation by the Healthcare Commission. Although the special measures apply directly to Cornwall Partnership Trust, the trust, Cornwall and Isles of Scilly Primary Care Trust, NHS South West and Cornwall county council have developed an action plan to deliver on the recommendations stemming from the investigation’s findings. The strategic health authority, the Healthcare Commission and Commission for Social Care Inspection have agreed this action plan and the local NHS and county council in Cornwall are working in partnership to deliver on the action plan. Progress is subject to quarterly reviews between the Department, the Commissions, the local NHS and Cornwall County Council and covers both the special measures and all the local recommendations in the Commission’s joint inspection report. The multi-agency action plan identifies both critical early actions to particular and immediate change as well as actions for longer-term sustainability. The external team appointed on the recommendation of the Healthcare Commission will remain in place for a period of 12 months, as recommended in the report. Progress against these actions will be subject to a review by the regulators in July 2007 that will report back to my right hon. Friend, the Secretary of State.

Progress at a local level is encouraging, with a clear agreement for action to be taken forward. The university of Birmingham is undertaking an external review of the trust’s board and will report to the SHA in November. The review will assess the robustnessof existing working arrangements and make recommendations for improvement.

Progress is being made locally on commissioning modern community services and appropriate supported living schemes to ensure that people are living in suitable settings—this work is taking into consideration the needs of people who were living in Budock hospital and the trust’s supported living services, as well as future commissioning requirements. Work on developing a strategic commissioning framework will include the integration and redesign of services together with workforce development and training.

A multi-agency team, led by Cornwall county council, is meeting monthly to ensure an overview of all adult protection issues. Police investigations are continuing and, to date, no charges have been brought. A new adult protection police constable has been appointed and is working with local services. Progress is being made with the development of local self-advocacy and carers groups, including engagement with national and local organisations with expertise in family leadership and advocacy.

Progress continues to be made in respect ofthe investigation’s national recommendations on registration of services, assessments and person-centred planning, safeguarding and robust local arrangements for dealing with abuse:

the chief executive of the national health service has written to strategic health authority chief executives and chairs to ask them to take action to ensure that NHS bodies that provide services in a housing association, voluntary or charitable sector are registered with CSCI and, if they are not, apply for registration immediately;

I am holding a conference with representatives from learning disability partnership boards across England on 9 November. I will remind these local multi-agency groups of their role in reviewing arrangements for joint working The Department has published guidance on the role of the director of adult social services, who has a lead role in safeguarding vulnerable adults in their local population;

the Department will be working with the regulators to consider the performance framework with a view to improving how we monitor learning disability services;

the Department continues to take forward a series of policies to safeguard and protect adults, including the Safeguarding Vulnerable Groups Bill and implementation of the Mental Capacity Act 2005. Proposals to amend the Mental Health Act to close the Bournewood “gap” are progressing;

the Safeguarding Vulnerable Groups Bill, due to be implemented from 2008, would require all employers, including those in the NHS, to refer individuals to the new independent barring board that the Bill will establish. Employers will be under the duty to refer where they have or might have ceased to use an individual on the grounds that they have harmed a child or vulnerable adult or other relevant grounds. The definition of vulnerable adult includes all adults receiving a health service;

the Department published “No Secrets” in 2000. This says that each agency should monitor and evaluate policies (3.13) and this should also happen together as a multi agency committee (3.18). Either a summary or evidence report should be submitted to the local adult protection agency;

the Safeguarding Vulnerable Groups Bill would require all staff working with patients in the NHS to be subject to the requirements of the scheme when it is implemented; and

initially new staff will be subject to the requirements of the scheme. Existing staff will not be checked to begin with, but provision for all NHS staff to be checked at some point in the future has been made.

As stated in July, the Healthcare Commission will be carrying out an audit of all learning disability health services provided by the NHS and independent sector. This audit is currently being piloted in three locations and will be rolled out nationally in January 2007. The Healthcare Commission will start engaging with services now to ensure that they are well prepared to respond robustly to the audit. The national health service chief executive’s letter to strategic health authorities has set out our expectations for compliance with the Healthcare Commission’s audit and the importance of effective commissioning and delivery of learning disability services. This makes clear that inthe light of what has happened in Cornwall and the subsequent formal investigation report by the Disability Rights Commission into health inequalities experienced by people with learning disabilities and mental health problems, strategic health authorities and primary care trusts should ensure they have sufficient skilled learning disability commissioning capacity in their establishments and that these people should engage in local and regional inter-agency “Valuing People” development work. The Department will strengthen the commissioning of learning disability services, and we will consider a stronger role for local authorities as part of this.

My right hon. Friend the Secretary of State for Health, has written to national health service chairs asking them to working closely with their chief executives on this agenda.

In addition, the Department’s newly appointed director general of social care has written to directors of adult social services reminding them of their duty to provide assessments of people’s needs as set out in the NHS and Community Care Act 1990.

A further update to the House on overall national progress across the learning disability agenda will be made in December 2006.