25 – Health

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Overview

In the UK there have been restrictions since 2010 on what had once been common place operations, for example: joint replacements, cataract operations, and for carpal tunnel syndrome.[1] These are the types of operations which if left can lead to further impairments and the worsening of already existing impairments, as such they are disproportionately affecting disabled people. By 2012 52,000 people had been denied common operations or procedures with over 125 treatments being curtailed or stopped together since 2010. Among them were pain management and hysteroscopy which diagnoses problems in the womb, this is significant for disabled women.[2] Nearly a quarter of NHS ‘walk in’ centres open seven days a week and offering out of hours ‘care’ have closed meaning that groups less likely to be able to register with a General Practitioner such as those with learning difficulties, disabled refugees, asylum seekers, people with drug dependency, and disabled homeless people have lost services.[3] The closure of the direct out of hours telephone service ‘NHS direct’[4] this year has added to pressure on hospital accident and emergency units, many of which have also been closed across the country. Many of these closures have meant that disable people in rural areas face increased travel to an accident and emergency unit and have less access to out of hours medical attention. ‘Disabled people are restricted in accessing health care and report less satisfaction with their medical care. More objective evidence is needed, especially in the UK, to clarify the true level of access to health care in people with disabilities’.[5]

Mental health services

Provision of mental health services in the UK has retrogressed over recent years. The mental health charity MIND reported mental health services as being underfunded, over stretched and under resourced[6] In 2011 False Economy reported that 50,000 NHS posts including 6,000 mental health staff were to be cut with some NHS Mental health trusts planning to cut up to 15% of staff[7].The mental health charity SANE reported closures of 72 services for people with mental health needs in 2011[8]. In 2012 there was the biggest drop in mental health spending for a decade. In the same year investment in mental health for working-age adults dropped by 1%, once inflation is taken into account, to £6.63bn. For the elderly the recorded fall in real terms spending was 3.1% to £2.83bn[9].In 2013 there was a further fall of 1% with evidence showing that spending in some areas on mental health is 3 times less than on other services[10]

Sterilisation of people with learning disabilities

In August 2013 a court ruled it in the ‘best interests’ of a man with learning difficulties/disabilities to have a vasectomy. He had seemingly already said he did not want more children; he already had a son by his girlfriend also with learning difficulties/disabilities. It was deemed by the court that the man couldn’t organise contraception.[11] An application for the same man had come to the courts in 1999 but was refused. It was the first case to come before the court for a man. In 2011 a case was due to come before the court of protection of a pregnant woman with learning difficulties/disabilities for forced sterilisation to take place at the time of a caesarean operation. There was no stated medical or life-saving reason for this to take place[12]. The mother of the woman later withdrew her case.[13] Such cases demonstrate a lack of respect for the right of people with learning disabilities to make decisions about their own healthcare and family life.

Health insurance

Securing life insurance is a problem for disabled people; for example, an insurance web site says:

“Of course there are always some people that we cannot get cover for and this is very hard for us as we talk to every client that we speak to personally. This is usually the case if the disability has had a significant impact and thus a potential restriction on life expectancy, or there are a combination of risk factors that insurers are not willing to cover. In these circumstances there are specialist providers we can contact, or if you are over the age of 50 there are a number of insurance providers we can recommend who do not ask about your medical background. Please note however that over 50s plans generally do not pay out for death in the first two years of cover”.[14]

Disabled people are not treated equally for life insurance in the UK. It is important to note that due to the increasing privatisation of health care, private medical insurance is more likely to be a necessity than an added optional cost. The impact on disabled people and those with long term health conditions is likely to be severe in accessing health care.

Poor health outcomes for people with mental health conditions

People with mental health conditions suffer huge health inequalities, for instance people with a severe mental illness (SMI) are likely to die sooner than people without one: “It is distressing that in the 21st Century someone with a mental health condition will typically die between 15 years (for women) and 20 years (for men) earlier than someone without”.[15] One in three of the 100,000 ‘avoidable deaths’ every year have a mental illness[16]. According to Rethink’s ‘Lethal Discrimination’ report[17] this issue is virtually ignored across Government.[18] Also if you have a SMI you are more likely to die of other health conditions for instance: 28% of people who have had a stroke and have schizophrenia die compared with 12% of people with no serious mental health problems. 28% of people with chronic obstructive pulmonary disorder (COPD) who have schizophrenia die, compared with 15% with no serious mental health problems.[19] People with severe mental illness (SMI) are more likely to smoke but less likely to be offered support to quit. [20

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