Learning Disabilities: Health and Social Care Access

Lord Addington Excerpts

Thursday 26th March 2026 Grand Committee

[Lord Addington (LD)]

My Lords, the most depressing thing about this debate is that it has been decades since I first spoke in a debate that pointed out that anybody with a learning disability or autism will have very bad health results and die early. That is an established fact. My noble friend said that you cannot change the past, but let us at least learn from it. We have been doing this for a long time with various Governments.

It turns out that our medical system is based on somebody telling a medical professional what the matter with them is by responding to certain, usually verbal, stimuli. Any group that has not been able to do that has always suffered badly. For example, it is an established fact that people using sign language have suffered badly. If we are going to do something about that, we will have to make some reasonable adjustments—that is the expression we are using here. If we do not do that, we will continue to get bad results because the medical profession will get involved only when something becomes obvious. We have all been told, again and again, “You should have seen a medical practitioner sooner”. We are guaranteeing that that will happen here if we do not find a way to assess those needs and get in earlier.

For anybody who has a communication problem or is communicating through one person that is going to be worse still. An example is the fear of an individual, usually a parent, who thinks, “What happens to my child with a disability when I’m not around?” The emphasis on that has been made very clear. It might be another relative who is doing the caring or somebody else. According to everything that we have heard today, they are quite right to be frightened when they are going through that.

We also have a system that has a series of flags coming up. As my noble friend pointed out to me, it is great having a flag, but what do we do when we see it? Until we get that ingrained in the training and structure—indeed, until somebody’s life is made more than a little unpleasant if they are not doing it—we will not get change. Every time we have a system that works in a certain way and we want to deviate slightly, what is required is to play the system and get around it.

I will repeat another bit of black humour. It is often said that the first thing a disabled child who wants to do well should do is to choose their parents carefully in order to give them that advantage. I am afraid that that still applies. What are we doing to make sure that when we have a system in place, action is taken? Then, if we have a system in place, are medical professionals told—even if they are not trained to do it themselves—how to communicate with somebody with autism who takes things very literally? How do we get that information out to them? If the patient has certain types of learning difficulties, how do they get in touch with somebody to receive health checks? Those checks normally depend on tick boxes, so how do we avoid that? How do medical professionals extract information from that person, given that we depend on their assessment of their health? If they cannot do it, a prolonged examination will be needed. All of that is clear. If you follow it through, there is an iron logic to it, and it has not changed. It is an accepted system.

I will ask the Minister a few questions. On the flagging system, what is the process to make sure that people react to flags? Where would a medical professional go to get help interpreting and extracting information from a person who has certain types of communication or perceptual difficulties? That is particularly the case if the parent or carer is not readily available. Is there a process? If not, there should be because we are guaranteeing more failure if we do not have one.

These are the things that we have come back to over and over again for years. They have been said with more eloquence and knowledge than I can manage today. Unless the Government can start to address this, we will come back to this subject again in a new form because nothing will have fundamentally changed. I hope this Government will at least move this project on because, let us face it, it is well overdue and needs to be given a good hard push, or even a kick.