Sixty Second Interview with Liz Sayce
An 18 month Disability Rights Commission study found widespread health service discrimination against people with learning difficulties and mental health problems. Liz Sayce, director of communications and policy at the Disability Rights Commission talks to Amy Taylor about the findings.
The study found that people from both groups were more likely to suffer major illness, develop serious health conditions at an early age and die of them sooner than other people. What do you think are some of the reaons behind this?
People with learning disabilities and/or mental health problems have a full set of the big health risk factors. They are highly likely to live in poverty. Many take psychiatric drugs, which can cause problems like obesity and diabetes. Diet, exercise and smoking are issues – and in some health and social care settings it is not easy to eat well or get the exercise you might want. Finally people can miss out on the health promotion, screening, assessment and treatment they need.
Were you surprised by how much discrimination you found?
FRANKLY YES! We would expect a health service committed to tackling killer diseases LIKE heart disease, stroke, some cancers, diabetes, and respiratory illness to target these high risk groups for early intervention and treatment. Instead we found some checks and treatments offered less often than for other citizens and some big problems even in accessing healthcare and screening services. We’ve shown for the first time the triple jeopardy DISABLED people experience IN HEALTHCARE – more likely to get Britain’s most serious illnesses; more likely to get them young; and more likely to die of them fast. There is some excellent practice, but many services are not meeting existing disability rights legislation, and are not ready for the new Disability Equality Duty.
What do the government and health authorities need to do to improve the situation?
Government needs to take these particular physical health needs beyond the silo of mental health and learning disability policy – and make them the mainstream priority of national programmes to reduce health inequalities and improve primary care. Change should be driven through the GP contract and commissioning guidance – and through serious performance management and inspection. Health service commissioners need to commission services for their whole population – particularly high risk groups – and build disability equality and access into every contract, whether the service is in the public, voluntary or private sector.
The DRC has warned that it will mount a legal challenge against the government and health authorities if they fail to build the study’s findings into their plans over the next year to implment the disabiltiy equality duty which comes into force in December. Why do you think such a threat is required?
The Disability Equality Duty, in force from December 2006, is designed as a tool to close gaps of inequality between disabled people and other citizens. The DRC’s investigation provides the essential evidence base on health inequalities and what can be done to redress them. Many professionals and policy makers are keen to act – but the law is there to ensure priority is maintained on groups of people who do, after all, face the shortest life expectancy, the greatest health problems and the biggest difficulties accessing services.
The government has comitted itself to introducing an optional annual health check for people with learning difficulties in the past but this is yet to become a reality. Do you think this would be a helpful policy?
We commissioned research that showed that unmet health need is very high amongst people with learning disabilities, especially more serious learning disabilities – and can be picked up by health checks. It is time for the government’s long-standing commitment to health checks to be turned into practice.