Learning Disabilities: Health and Social Care Access
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The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)
My Lords, I am pleased to respond to this Question for Short Debate, and I congratulate the noble Lord, Lord Scriven, on securing what, as we have heard, is a very important debate. I also congratulate him on his commitment to improving outcomes for those who have a learning disability. Personally and publicly, I also want to acknowledge—I will use the noble Lord’s words—how raw this is for him. As well as giving my condolences on the death of his nephew Myles, I can only say that I genuinely believe that, as Myles’s uncle, he pays the greatest tribute to the memory of his nephew as he strives to improve services. It is a mission with which I fully associate myself and the Government.
I also want to acknowledge the other losses of the bereaved—not just those of noble Lords sitting here in the Room but those outside too. I have listened to the debate closely and if I am honest, what I am about to say can only in part meet some of the very real questions, and a number of the proposals too. I will do my best and I commit to raising the points made with my honourable friend Minister Zubir Ahmed, in whose portfolio this sits. I know he will welcome, as I have done, the contributions today.
I will pick up as many points as I can in the time that I have. All noble Lords, including the right reverend Prelate and the noble Lord, Lord Crisp, made the point that the health inequalities faced by people with a learning disability are totally unacceptable. I certainly align myself with that. We are committed to driving change. The 10-year health plan gives me hope in this regard because it outlines our ambitions to tackle health inequalities and speaks to the point the noble Lord, Lord Crisp—not exclusively but particularly—made about the need to see the whole person. That is what is missing generally, and it is what the 10-year health plan seeks to tackle, including driving that critical shift from treatment to prevention. The two issues that are presented by this debate are inseparable. I am grateful to the noble Lord for the way he has presented that.
I therefore say at the absolute outset to the noble Lords, Lord Scriven and Lord Addington, that a near 20-year life expectancy gap is not acceptable under any point. I also thank the noble Lord, Lord Addington, for saying that the shortcomings and concerns we are debating have been going on for many years, and what is important is that commitment to change. The noble Lord, Lord Crisp, who spoke of the experience of his brother-in-law Gareth, also spoke of good practice in Derbyshire. We should commend all those who do this and learn from it.
To the point about reasonable adjustments, there are clear legal requirements on health and care organisations and their staff. I hear what noble Lords say clearly: yes, that is all very well but it is not happening. But it is worth reminding ourselves that, under the Equality Act 2010, public sector organisations are required to adapt their approaches in a very practical sense, as the noble Lord, Lord Addington, called for, so that their services are accessible to disabled people as well as to everybody else.
I am grateful to my noble friend Lady Ramsey for bringing Patsy into the Room again. NHS England is rolling out a reasonable adjustment digital flag, as we have spoken about here. That will continue and it is to ensure that, in the way that she rightly demands, key information about a person and the reasonable adjustments needed for their care and treatment are to be recorded in care records. I say to my friend the noble Lord, Lord Addington, that a new information standard was published in December 2025, such that all publicly funded health and social care service providers must be able to share, read and write reasonable adjustment data by 30 September. Training on this digital flag is freely available.
Turning to the safety of people with a learning disability while accessing health and social care, the NHS learning disability improvement standards provide a framework to support NHS trusts and organisations in assessing the quality of their services, because we have to see consistency and improvement across the NHS. There is guidance available on the use of health and care passports to support personalised care for people with a learning disability, and for autistic people.
I say to the noble Baroness, Lady Hollins, that I am deeply saddened by the tragic circumstances of the death of David Lodge. I send my condolences to David’s friends and family. In response to the noble Baroness, who called for a way forward, and the noble Lord, Lord Scriven, who raised whether this can all be a tool for change, because it is not currently—I heard him say that—I know that the noble Lord recently met the Minister for Health Innovation and Safety, Zubir Ahmed MP, as I mentioned. I understand that my colleague the Minister has agreed to work with the noble Lord, Lord Scriven, to continue to hear insights from those with lived experience and wider stakeholders. The Minister is currently working with officials to explore options to improve the process, because we know there is a lot further to go to get ICBs to meet the expectations they have upon them. All these points have rightly been raised on ensuring accountability, reducing inequalities and preventing avoidable deaths. That work will absolutely continue, and I look forward to noble Lords taking part in it.
The noble Baroness, Lady Hollins, asked whether there are any plans to establish a specific inquiry or committee. Currently, there are no plans to do this; however, as I have said, the Minister is very much on the case. On wider action to improve health outcomes, I absolutely hear the points made by the noble Baroness not only in your Lordships’ House but to me personally before this debate, for which I am grateful. If we are talking about those with learning disabilities, we are talking about not just episodes of care but building relationships to enable the correct care for that person; I use the word “person” very definitely in this regard.
Reference was made to the Health and Care Act 2022 and the requirements that it contains. The Government have published a code of practice setting out their expectations on training delivery, and we continue to roll out the recommended Oliver McGowan mandatory training package. I can tell the noble Earl, Lord Effingham, that more than 3 million people have completed the first part of the training, and funding has been provided to support greater uptake this year.
On the point about health checks, the Secretary of State recently wrote to all GPs to emphasise the importance of identification, recording and the quality of the checks themselves.
A number of very pertinent points have been made. I assure noble Lords that they will all fed into the move towards improving the situation for those who have learning disabilities. We owe them nothing less.