Health Inequality: Autism and Learning Disabilities

Baroness Jolly Excerpts

Thursday 10th May 2018 Grand Committee

[Baroness Jolly (LD)]

My Lords, I too thank the noble Lord, Lord Touhig, for introducing this debate. I declare my interest as listed in the register.

People who have never been involved with learning disabilities are unclear about what they really mean. People with a learning disability will have the emotions of an adult—they can fall in love, worry, get cross and be jealous—but it is the reduced intellectual ability that affects them for their whole life. They are subject to mental health problems and early-onset dementia.

Learning disability is subject to the Equality Act and the United Nations Convention on the Rights of Persons with Disabilities. Somebody with a learning disability should be able to expect good NHS treatment. They should also expect clinicians caring for them to make reasonable adjustments. In the questions after yesterday’s Statement, I raised the issues of funding, clinician training and the provision of suitable written material, and I will not revisit them now. However, I should like to raise the issue mentioned by the noble Lord, Lord Crisp—access to NHS sight tests.

People with a learning disability are at high risk of sight problems. Adults are 10 times more likely to be visually impaired and six in 10 will need glasses. Most people think that sight tests are easy to access, but for many people with more complex needs they are not. No targeted scheme is run by the NHS or NHS England, unlike GP health checks or special dental care. For years, the same tariff of around £20 has been paid by NHS England to deliver these sight tests. This covers about half the cost of a standard high-street test, let alone the service that someone with more complex needs requires.

The outcome is that many people with learning disabilities are instead sent to use the sight-testing services at hospital eye clinics. Without any national scheme, parents are at a loss as to where to go. Half of the children in special schools have a vision problem. Around 45% of children of the age of 11 in a special school will not have had a sight test. This makes for a poorer quality of life than would otherwise be the case. Therefore, will the Minister look at whether an NHS England scheme in the community and in special schools, which four in five children with more severe learning disabilities attend, is a possibility?

As I mentioned, people with learning disabilities have rights, and this lack of appropriate treatment is an unacceptable face of discrimination. Therefore, will the Minister please investigate this and get back to us? I might also suggest that perhaps a much longer debate than this one is required on this well-ignored group.