Disability: Premature Deaths

Lord Addington Excerpts

Monday 17th October 2016 Lords Chamber

[Lord Addington (LD)]

My Lords, what first led me to put my name down for this debate was the simple fact that when it comes to any minority group that is interacting with a public service, particularly the health service, if there is a communication problem you suddenly see problems in the results. If they cannot access the system, you suddenly find that they are not getting the best out of it.

The fact is that most forms of healthcare are based on a doctor talking to a patient. The noble Baroness stole some of the thunder from my speech by pointing this out, but all the groups that have problems with what we would regard as normal conversational communication suffer in terms of healthcare and when interacting with virtually all other structures of the state, and indeed goods and services. Extracting information from the patient to ensure appropriate treatment is bound to be more difficult. If you know you are going to interact with this group, you have to have some way of correcting that situation otherwise you are guaranteeing a level of failure. There are various bits of legislation coming through at the moment, and if everything was working correctly I am sure the noble Baroness would not have bothered tabling this debate. However, it is quite clear that it is not.

There are contributing factors—for instance, lifestyle. We know it is very difficult to get people with learning disabilities into activities like sport because there is no structure for them, and that leads to other health problems later on. However, if we are talking simply about the interface with a GP or a nurse or receptionist—the noble Baroness was right to mention those who are the gatekeepers to the service—unless there is training in this area, we are going to have problems.

If an employee does not have generalised training, they must at least have some awareness that means they know when they should back off and call in the experts. We need it to be acceptable to say, “I need help and support”, without it going against that employee. Think about it: if you are in a job where you are supposed to deal with a person in this situation, you should be able to think, “Do I have the authority and the right to ask for extra help to deal with the situation?”. In many situations, to do so fundamentally undermines your professional competence. Unless we allow that, we will not get the best outcomes, because people bluff to get through the situation—it is a natural reaction and we have all done it in our own worlds. You want to cover up the fact that you are having problems with something you are expected to be able to do. Unless you can call in expertise, and know that that is okay, you will have problems.

I could go on for a considerable time giving more examples, but at this time of night and with a maiden speech on its way which is probably much more interesting than mine, I will cut my remarks off here. Unless we embrace the idea of preparation to call in expertise and making it acceptable in the work environment so to do, we will continue to have these problems. What we are talking about here is only one manifestation of the problem. It is not just within the health service, it is within all services. It involves continuing conditions and stress, and mental health comes in later. Setting a good example from the Department of Health would be a simple step forward. It would be good to hear tonight an assurance that it is acceptable—indeed, required—to have that flexibility.