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Campaigners have repeated their call for more to be done to meet the health needs of people with learning disabilities and mental health problems—who, they say, continue to be failed by the NHS in England and Wales.
One year after its damning report into the delivery of health care to disabled people, the Disability Rights Commission, the statutory watchdog organisation for people with disabilities in England, Wales, and Scotland, says in a new report that little has changed to bridge the gap in health care.
Only two strategic health authorities in England—North East and South West—have developed adequate schemes to comply with new laws on disability equality that came into force in December 2006, says the report. Of the remaining eight authorities six have schemes that are unacceptable and two—Yorkshire and the Humber and London—have failed to address the issue of equal rights for people with disabilities in any way.
The report recommends that the Equality and Human Rights Commission, which took over the role of the Disability Rights Commission on 1 October, take legal action against those authorities that fail to produce acceptable schemes.
Bert Massie, former chairman of the Disability Rights Commission, said, “Inexplicably there are still no coherent national strategies for tackling the unequal levels of healthcare experienced by disabled people. If the NHS decided to provide no services for the people of Birmingham there would be an outcry, yet deciding to leave out millions of disabled citizens appears to be acceptable.
“This woeful failure is clearly unacceptable, legally and morally. Failing strategic health authorities must be forced to act or face legal action.”
Last September a report from the commission, Equal Treatment: Closing the Gap, found that people with mental health problems or learning disabilities have worse physical health and die younger than the general population (BMJ 2006;333:565 doi: 10.1136/bmj.333.7568.565). Despite this they are less likely than other people to receive treatment or preventive care, and most have difficulty in seeing their GP.
In its latest report an independent panel convened by the commission to look at how primary care services had responded to the recommendations made last September has found little evidence of change. It found, for example, that although annual health checks for people with disabilities were introduced in GP contracts in Wales, no progress had been made in England.
The report says, “Accusations of institutional discrimination are not unfounded given the level of inaction to tackle the significant health inequalities evidenced. For many people with learning difficulties and mental health problems this is quite literally a matter of life and death.”
It blames the Department of Health for the lack of action, claiming that the department's attempts to influence practice through “policy and incentives” are not working. The independent panel says that negotiations between the health department and the BMA must be concluded urgently so that regular health checks for people with learning disabilities in England can be introduced. Local health service planners must assess disabled people's needs more urgently and improve services for them, it says.
Moira Fraser, head of policy at the Mental Health Foundation, said, “To read this report is very frustrating, because the physical healthcare needs of people with mental health problems continue to be ignored. Simple steps could make such a significant difference if only [their needs] were made a priority . . . It should not be acceptable that people who live with a mental illness get unequal access to healthcare services.”
Paul Jenkins, chief executive of the mental health charity Rethink, said, “The end result of this institutional discrimination is that people with severe mental illness die on average 10 years younger than the general population.” He welcomed the report's recommendation that legal action should be taken against strategic health authorities that refuse to act. “It is time to get tough and to start dragging authorities that refuse to act to save lives through the courts,” said Mr Jenkins.
He said, “[The] secretary of state for health, Alan Johnson, told the Labour party conference this week that he would tackle health inequalities head on. Here is the ideal place to start. People with severe mental illness face levels of discrimination that would not be tolerated by any other group in society.”
Equal Treatment: Closing the Gap—One Year On is available at www.drc-gb.org.