Reconfiguring support for people with MP (Member of Parliament) syndrome: A cost-effective proposal for the 21st and a 1/2th century

Image from http://www.urbanghostsmedia.com/2009/09/images-of-abandoned-raf-binbrook/

Background

People with MP syndrome (or P-WiMPS) are a small but highly resource intensive cohort of people in England. There are currently 650 people identified with MP syndrome in England, all of whom are supported in a single specialist day facility in London, popularly known as the House of Commons. There are also a much larger number of people with proto-MP syndrome (otherwise known as Prospective Parliamentary Candidacy), some of whom go on to develop full-blown MP syndrome. An equivalent number of people with MP syndrome recover from the syndrome, although a disproportionate number are at risk of later developing the closely related Peer Spectrum Disorder. On the same site as the House of Commons, there is also a national specialist centre for the assessment and treatment of Peer Spectrum Disorder, known as the House of Lords. Together (with smaller community-based facilities such as Portcullis House) these make up the Westminster Foundation Trust.

The Problem

Despite recent Government attempts to modestly reduce the number of people with MP syndrome using the House of Commons, numbers have remained largely static at around 650 people since 1801 (http://en.wikipedia.org/wiki/Number_of_Westminster_MPs ), as regularly documented in the Dimblebum Election Night Census. The number of people with Peer Spectrum Disorder treated in the House of Lords has fluctuated greatly over time, from a maximum of 1,330 people as recently as 1999 to the current 774 places (http://en.wikipedia.org/wiki/House_of_Lords ).

The Westminster site is composed of a large Victorian complex that is no longer fit for purpose – both the House of Commons and the House of Lords do not have sufficient bench space for collective vocational ‘taster’ activity sessions in their respective ‘chambers’. Despite heavily subsidised meals and regularly prescribed ethanolazine, high further PRN doses are administered on a daily basis. The overcrowded nature of the Westminster site also makes the provision of seclusion rooms problematic.

 

Despite the specialist nature of these settings, unacceptable levels of challenging behaviour, albeit with different profiles, are present in the House of Commons and the House of Lords. In the House of Commons, prevalence rates of Oppositional Defiant Disorder can approach 50% and rates of hyperactivity, attention seeking and verbal aggression are even higher. Incidents of physical aggression requiring the attention of the police and verbal aggression outside the institution have also occurred, and patients are liable to mass debate with little apparent provocation. In the House of Lords, nonorganic hypersomnia is the most common disorder. The presence of TV cameras within the Westminster site has resulted in widespread public revulsion at the practices happening within it.

Past attempts at deinstitutionalisation have not been successful. Whilst people with MP syndrome notionally still have homes in their local communities (known as constituencies), Westminster can be hundreds of miles from these ‘constituencies’. P-WiMPS in practice spend so much time in ‘temporary’ residential placements near the Westminster site (the longest of these placements can last for decades) that connections to their ‘constituencies’ can become tenuous and their ‘home’ communities hostile.

There is also increasing public concern about the quantity of hard-working taxpayers’ money being spent on these services. In 2012/13, the net cost of administering the House of Commons was £201 million (http://www.parliament.uk/documents/commons-committees/Admin-accounts-2013.pdf ). Placement fees charged for P-WiMPS (typically broken down into ‘salaries’ and ‘expenses’ included £103 million in ‘expenses’ in 2013/14 (http://www.bbc.co.uk/news/uk-politics-29173700 ). As the ‘salary’ component of P-WiMPS’ fees vary so much, a total is difficult to determine (http://www.politics.co.uk/reference/mps-pay-and-expenses ), but is estimated to exceed £45 million per year. This results in a total unit cost for P-WiMPS at the Westminster site of £537,076 per person per year.

People with Peer Spectrum Disorder are currently being treated at a somewhat lower unit cost. The total cost for the House of Lords for 2012/13 was £88 million (http://www.publications.parliament.uk/pa/ld/ldresource/43/43.pdf ) - a unit cost of approximately £114,000 per Peer per year.

The Proposal

As Nigel Evans, a person with MP syndrome himself, has pointed out, “There is always going to be a need for secure units, so I don’t see how every patient can be released into the community quite frankly. And I don’t really see the benefit of moving patients to smaller units around the country, as I’d still say there’s a need for big and more centralised institutions so that economies of scale kick in.” (http://www.lancashiretelegraph.co.uk/news/11756016.CLOSE_IT_DOWN__Expert_advises_national_NHS_chiefs_to_shut_down_Calderstones_Hospital/ )

Given the unsuitability, high refurbishment costs and high market value of the current Westminster Foundation Trust site, this proposal aims to achieve economies of scale through relocation to a more suitable site.

This site has been identified as RAF Binbrook (http://en.wikipedia.org/wiki/RAF_Binbrook ) in Lincolnshire. A former airfield, this site already has the essential features for cost-effective support for both P-WiMPS and P-WiPSD, including a well-maintained barbed wire perimeter fence. Existing watchtowers will be converted to remote-controlled ‘Hey there buddy, just making sure you’re Okely Dokely’ Nodes, which will be monitored from highly specialised staff in the former air traffic control tower (amphetamines will be provided to facilitate cost-effective shift patterns).

The current house-like atmosphere of the Westminster site will be preserved in two architecturally thrilling open plan corpuscules, where residents can flow freely between their bunk beds, the toilet and the food troughs. To celebrate both the old and the new sites, these will be named the Hangar of Commons and the Hangar of Lords.

Nissen huts on the site will be preserved in their current states of picturesque dereliction for use as ‘Time To Yourself’ havens of seclusion. Behavioural management will be state of the art, using equine pharmacological transfer technology – in a wholly new development to the UK, Xylazine will be routinely placed into the food troughs and the water supply. Residents will also have the opportunity for vocational training under the exciting new ‘Frack With a Garden Trowel’ scheme and will grow their own food through the ‘That’s a Turnip for the Books!’ programme.

Support from Antisocial Investment Inc (“You’ll believe a vulture can smile”), allied to the sale of the Westminster site and the closure of all ‘constituencies’ and temporary residential placements, will allow Westminster Foundation Trust to be transformed into Saint Binbrook’s Corp. We are confident of the success of this model of provision, and are already exploring further potential sites with the Nuclear Decommissioning Authority.