Legal threat to government over discrimination by health services

The government could face a legal challenge under disability equality laws after a major investigation uncovered widespread health service discrimination against people with learning difficulties and people with mental health problems.

The 18-month Disability Rights Commission study found 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.

Yet despite their poorer health, they were less likely to receive adequate treatment or be offered health checks, and faced barriers accessing services.

Investigators who analysed eight million health records and studied one local health board in Wales and three primary care trusts in England, encountered “complacency” and “lazy fatalism” in health services with an assumption the two groups
“just do die younger” or “just won’t look after their health”.

The commission has warned that it will take action against the government and health authorities if they fail to build the study’s findings into their plans over the next year to implement the disability equality duty, which comes into force in December.

DRC director of policy and communications Liz Sayce said the government must embed the needs of both groups within its health inequalities programme. “Reducing health inequalities is not just about reducing inequalities between one area and another but between one group of citizens and another.”

Local commissioners must also commission services to “plug the gaps” and reach out to people with mental health problems or  learning difficulties, Sayce added.

And she called for better training for staff, particularly to avoid “diagnostic overshadowing”, in which staff assumed all health problems were connected to psychiatric problems or learning difficulties.

The Department of Health has promised to convene a meeting of senior staff to work with the commission on a full response to the report, which will be published at the turn of the year.

Health minister Rosie Winterton said the government agreed with the “broad thrust” of the DRC’s recommendations and had already started to act.

She added: “We have also allocated £42m in 2006-7 to primary care trusts to help them implement the Valuing People white paper.”

Main findings of DRC report
● People with learning difficulties are much more likely than other citizens to have health problems, including obesity and
respiratory disease.
● People with mental health problems are more likely to have problems such as heart disease, high blood pressure and
● People with schizophrenia are almost twice as likely as other citizens to have bowel cancer.
● Women with schizophrenia are 42 per cent more likely to get breast cancer.
● The rate of obesity among people with learning difficulties is 28 per cent, compared with 20 per cent for the overall
● In primary care, both groups are less likely to receive some of the expected health checks and treatments.

Bert Massie, chairman, Disability Rights Commission:
“Tackling health inequalities is high on the government agenda, yet there has been a deeply inadequate response from health
services and government to target these groups.”

Andrew McCulloch, chief executive, Mental Health Foundation and Foundation for People with Learning Disabilities:
“These groups have been vulnerable to poor health for centuries. We would argue for public health programmes aimed at and tailored to the two client groups.”

Jane Harris, campaigns manager, Rethink:
“We’ve all got bodies and minds, there’s just a question of whether the government can make the rhetoric about holistic care a reality. At the moment I don’t see where that is happening.”

David Congdon, head of campaigns and policy, Mencap:
“People with a learning disability get a raw deal from the health service. Most of it is to do with a lack of training and understanding of their needs. So often their conditions go unrecognised and undiagnosed so they suffer.”

Andy Bell, director of public affairs, Sainsbury Centre for Mental Health:
“ There’s a sense in which people identified as having one particular problem don’t always get the care for other things.”

Further information
Equal Treatment: Closing the Gap
More on the disability equality duty

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