Covid-19: Effect on People with Learning Disabilities

Charlotte Nichols Excerpts

Tuesday 15th December 2020 Westminster Hall

[Charlotte Nichols (Warrington North) (Lab)]

It is good to see you in the Chair, Ms Ghani.

I congratulate my hon. Friend the Member for City of Chester (Christian Matheson) on securing this important debate. Among the most important duties of a Member of Parliament is to speak up for the voiceless, and he has done a proud service today. I join him in paying tribute to the campaigning efforts of his constituent Angela, an exceptional woman whom I have been lucky enough to meet.

One of the overriding messages that we have heard in 2020 is that we are all in this together. Whether people have found it comforting or frightening, it has characterised our national response, but it is not really accurate. My hon. Friend the Member for Sheffield, Hallam (Olivia Blake) is right to raise the abject failures that have taken place in some aspects of provision for those with learning disabilities. The twin crises that we have faced and continue to address—the health and economic emergencies caused by the covid pandemic—impact people differently. We have learned so much about the groups who are more susceptible to serious illness and death from covid—older people, those who are overweight, those with comorbidities and, because of housing conditions and frontline jobs, ethnic minorities. We are still learning about who is suffering most from the economic impact—young people and those in precarious employment and the hospitality sector. Those differential impacts were raised powerfully by my hon. Friend the Member for Bethnal Green and Bow (Rushanara Ali).

Above all, vulnerable people suffer the most, including those with learning disabilities. Even before the pandemic, they faced serious health challenges. In 2017 the Equality and Human Rights Commission found that 42% die prematurely. Last year, the learning disability mortality review found a median life expectancy of 61 for men and 59 for women, which is more than 20 years less than the national average. People with learning disabilities are four times more likely to die of a treatable health condition. That was the situation before covid.

What we have heard today has been shocking but not surprising. We understand why guidance for ambulances and hospitals was written in haste in March, but clearly it did not fully consider the needs of people with learning disabilities—with all the consequences that we have heard today. The ambulance services’ guidance must be amended. As we have heard, it has been interpreted to mean that people over the age of 16 cannot be accompanied to hospital or bring documents with them. That leaves people with learning disabilities terrifyingly exposed, given the challenges that they face in communicating their medical needs. I hope that the Minister can now confirm that that is being changed.

What I have described has certainly contributed to the lack of reasonable adjustments being made, as has the number of learning disability nurses who have been redeployed—I have seen the figure of 34%. That has left people with learning disabilities even more exposed, as their needs are not met. Will the Minister set out what she is doing to restore and expand that crucial expertise?

The number of people with learning disabilities who were given “Do not attempt to resuscitate” notices was appalling, partly because initial guidance led to many being wrongly defined as frail. Although that guidance was reversed, many individuals may still have such notices on their records, without their knowledge, and that could have tragic consequences for their future healthcare. What is the Minister doing about that?

The Minister will recognise the wider challenge of remote consultations, which are particularly difficult for people with learning disabilities in situations where non-verbal cues and body language cannot be seen. They also increase the chance of diagnostic overshadowing, where behaviour is attributed to a learning disability rather than being considered a symptom. That has apparently been an issue with NHS 111. The NHS long-term plan is to remove one third of face-to-face appointments for out-patients, which includes the use of more remote consultations. Will the Minister assure us that people with learning disabilities will be prioritised for in-person consultations, and can she explain what guidance is being put in place for autistic people in in-patient care settings to go home for Christmas? Autism charities have warned that autistic people in residential care will have to self-isolate for 14 days when they come back from visiting their families this Christmas. That is not fair on those who need routine and support. The Government must make their guidance autism-friendly.

That all shows the need to consider the most vulnerable when making important decisions. Equality impact assessments must be made by central Government. That is something that local authorities are routinely obliged to do. Was such an impact assessment made on the guidance for ambulances and hospitals and, if so, what steps were taken to mitigate impacts? If not, what discussions were had with Mencap before the policies were introduced?

People with learning disabilities have suffered and died disproportionately in this pandemic, so can the Minister explain why only those with severe and profound learning disabilities have been prioritised for vaccination, rather than everyone in that highly vulnerable group? When will unpaid carers receive the vaccine?

Following the Government’s easements, which reduced statutory adult social care support, 69% of people with a learning disability reported in a Mencap survey that their social care support had been cut or reduced during the pandemic. What will the Minister do to ensure the support that those families and individuals badly need? The Government have an obligation to support the most vulnerable citizens first. I look forward to hearing the Minister’s reply.