National Health Service

NHS faces legal action over inadequate physical health care for mentally ill and learning disabled

The NHS could be sued for failing to provide adequate primary care services for people with mental health problems and those with learning disabilities..

The Disability Rights Commission (DRC) issued the warning yesterday on the back of a report criticising the health service for “complacency” and a “lazy fatalism” of accepting that people with mental health problems and those with learning disablities “just do” die younger, are incapable of looking after their health or attending GP appointments.

The DRC report was based on research into eight million primary care records, plus one health board in Wales and three England primary care trusts.

The research found people with mental health problems, particularly those diagnosed with a severe mental illness (SMI), have higher rates of obesity, smoking, heart disease, diabetes, respiratory disease, and stroke than the rest of the population.

Specifically, it found that women diagnosed with schizophrenia are 42% more likely to get breast cancer, andthat people diagnosed with schizophrenia are 90 per cent more likely to have bowel cancer, the second most common killer disease in Britain.

Bert Massie, chairman of the DRC, said: “Our investigation has revealed shocking levels of ill health among people with learning disabilities and people with mental health problems, yet their needs are often unmet or they face unnecessary barriers to accessing services.”

The DRC has accused the health service of discrimination. Almost half of disabled and mentally ill respondents in a DRC survey complained of “barriers” when arranging to see their GP – such as derogatory reception staff, inflexible appointment systems, lack of knowledge on the side-effects of powerful psychiatric medication, or being struck off from GP lists for being too demanding.

The DRC’s report, entitled Equal Treatment: Closing the Gap, calls nationally for learning disabled people and those with mental health problems to be targeted for health checks and for an end to “diagnostic over-shadowing” whereby professionals effectively ignore a person’s physical ill health by presuming every ailment is related to their mental ill health.

The health minister Rosie Winterton said she agreed with the “broad thrust” of the raft of DRC recommendations.

She highlighted that, in August, £7m was allocated to eight primary care trusts to employ “well-being” nurses to work in partnership with GPs, health and mental health staff to deliver health checks and blood tests to SMI people, advise them on diet and exercise, and support them to access primary care services.

Yet, the DRC says that if there is no genuine improvement, the NHS could feel the force of the Disability Discrimination Act.

From December, a “Disability Equality Duty” means disabled patients and those diagnosed with a mental illness could sue trusts for not making “reasonable adjustments” in providing equal access to primary care services.

Such “reasonable adjustments” might mean GPs – or nurses – having to give more consultation time to people with difficulty retaining information, or ensuring that people with agoraphobia do not have to wait in a busy GP waiting room.

The Department of Health said a response to the DRC report will be published early next year.

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