I beg to move,
That this House has considered the Fourth Report of the Women and Equalities Committee, “Unequal impact? Coronavirus, disability and access to services: full Report”, HC 1050.
It is a pleasure to serve under your chairmanship, Sir Graham, and I thank my colleagues on the Committee for their work on both the inquiry and the report. I am pleased to see the hon. Members for Jarrow (Kate Osborne), for Liverpool, Riverside (Kim Johnson) and for Lanark and Hamilton East (Angela Crawley) participating in the debate.
With your indulgence, Sir Graham, I would like to highlight that some of the issues we will discuss concern children with special educational needs, and when it comes to autistic spectrum disorders, there was one Member of this House who championed the issue, spoke in pretty much every debate on the subject, and chaired the all-party parliamentary group on autism. Cheryl Gillan is already much missed in this place, not least by me today. I know that she was a real expert and spoke with passion and knowledge in debates such as the one we are having today. I am sure she would have been present to put on record her thoughts about access to services for children with autistic spectrum disorders.
Relevant to this debate is our interim report, published in September last year, which was intended to inform the first six-monthly review of the Coronavirus Act 2020 temporary provisions. I will start by drawing attention to an important outstanding issue in this context—one that has not received a great deal of attention. The temporary provisions included unused provisions that relaxed requirements for sectioning under the Mental Health Act 1983, provisions that curtailed or restricted hard-won rights of disabled people to get the care and support that they needed in their everyday lives—the so-called Care Act 2014 easements—and a power to modify duties under the Children and Families Act 2014 in relation to assessment and provision for children with special educational needs and disabilities.
We welcomed the Government’s decision last year to repeal the unused Mental Health Act 1983 provisions. We very much welcome the recent decision to remove the Care Act 2014 easement provisions, and we look forward to this happening as swiftly as possible. Perhaps my hon. Friend the Minister for Disabled People, Health and Work will chase that up with the Minister for Care at the Department for Health and Social Care. Although the easements were not widely used, their availability in statute exacerbated a perception, which has existed among disabled people right from the outset of this crisis, that their rights are somehow seen as less important than other people’s.
The outstanding issue from our interim report is that one of the temporary provisions affecting young disabled people remains in place. The power to modify education, health and care plan duties was used by way of national notices issued by the Secretary of State for Education in May, June and July. The power remains available in the Coronavirus Act. My view is that this power must be removed.
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are in a very different place in the pandemic. As the Minister for Children and Families acknowledged in a recent letter to me, there is much less need for the additional flexibilities, yet the power is being retained, for the time being, as a contingency. The Government have said they will act to remove temporary provisions as soon as they are no longer necessary. They have done so in relation to the mental health and social care provisions. It is an important matter of principle: the Government must not hold on to emergency powers a moment longer than they absolutely need to. Removing the power to modify duties in relation to children’s and young people’s education, health and care needs would send a clear message to children and their families that the Government fully support their right to receive the provision they need. I see no reasonable justification for keeping the Secretary of State’s power to modify duties in statute any longer.
Over the last year, my Committee’s work has emphasised the unequal impacts of the pandemic on three groups of people with protected characteristics under the Equality Act 2010; women, groups of black and minority ethnic people, and disabled people—the subject of the debate today, who have received, sadly, relatively little attention. Yet the adverse effects on disabled people have been starkly disproportionate, including tragically high death rates. The chance of dying from covid was more than three times greater for someone with a disability than for someone who was not disabled. The chance of dying for a person with a learning disability was probably more than six times greater than that of the general population. A young person aged between 18 and 34 with a learning disability was some 30 times more likely to die than a young non-disabled person.
Our inquiry heard evidence about decisions and policies that might have contributed to those tragic statistics, such as a relative slowness to protect people in a range of social care settings, and a lack of clear and accessible information for disabled people. That is why we called for a discrete independent inquiry into the causes, including the decisions made by Government. The response, “Now is not the time,” will inevitably start to wear thin. The Government should commit to an independent inquiry, including into what led to disabled people feeling the brunt of the pandemic, and they should set out a timetable not just for its start but for its completion. They should do so now.
A major theme in our full report was the Government’s consultation and communications with disabled people during the pandemic. We heard that disabled people felt excluded and ignored. Witnesses pointed out that effective consultation with disabled people could have made it possible to avoid some of the problems that they faced early in the pandemic, such as a lack of accessible food shopping. Disability charities told us that the Government were talking to them, but in broadcast mode—not listening and not resolving problems effectively. When the Government did communicate with disabled people, their communications were not always psychologically informed, and too often they exacerbated disabled people’s already heightened anxieties. There was confusing guidance on shielding, and it was sometimes poorly thought through and poorly timed—for example, a text message sent at the weekend before important changes to guidance were issued on the Monday.
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want to see evidence that the Government have learned from what happened. Right from the outset, from the Prime Minister’s letter to the nation in March explaining the need to stay at home, communications have not been fully accessible. There were no accessible versions of that letter for several days. I know that a great deal of work is going on in the Cabinet Office to provide the shopping list of accessible communications asks put forward by disability charities last year; but the Government could and should go further and faster. I find it utterly incomprehensible, for example, that the Government have still not arranged in-person British Sign Language interpretation of their televised covid briefings. I raised that issue with the Prime Minister at the Liaison Committee in January, and the hon. Member for Lewisham, Deptford (Vicky Foxcroft) raised it again very effectively at Prime Minister’s Question Time yesterday. On neither occasion was a proper response forthcoming. The reasons relied on in written responses—that there is not enough space in Downing Street, or that there is not enough time to make arrangements—are weak. Surely the Government could have found space during the recent media suite refit. I am unsurprised that campaigners have resorted to judicial review, but I am surprised that the Government have not sought to resolve the issues swiftly and simply by finding both the space and the inclination to include a BSL interpreter.
Practices in health and social care added to disabled people’s perceptions that their lives were less valued than others. The guidelines issued by the National Institute for Health and Care Excellence on the use of the clinical frailty scale in making decisions about who should receive critical care if NHS resources had been overwhelmed were potentially discriminatory against disabled people. We heard from disabled people that, while they accepted that the guidelines were swiftly amended, it left a very bad taste.
Extremely concerning issues about the inappropriate use of “do not attempt resuscitation” notices, or DNARs, have been much more prolonged. The Government asked the Care Quality Commission to investigate in October last year, and last month the CQC found that that hundreds of inappropriate DNARs had been applied. These issues demonstrate a deeply worrying lack of concern for the rights of some groups of disabled people.
We all understand the pressures that people were under early in the pandemic, but more than 10 years on from the Equality Act 2010, it is shocking that disabled people’s rights were not properly considered in the formulation of policies and practices in health and social care. That is why we recommended a robust response to prevent such mistakes being repeated. We called on the Government to allow the Equality and Human Rights Commission to issue a statutory code of practice on the public sector equality duty, to provide greater legal certainty about the actions that public authorities must take to prevent discrimination. Greater certainty would provide more effective protection, so the Government’s dismissal of our recommendation is extremely disappointing. Their argument that the status quo is sufficient flies in the face of recent experience. If there is not a statutory code of practice, how will the Government prevent these issues from arising in future public health crises? Again, we have to learn from experience.
The pandemic has very clearly emphasised and exacerbated known systemic problems affecting disabled people. We know that the SEND system is facing a crisis. The aims of the Children and Families Act reforms have never been consistently achieved. Services for children with SEND are too often inadequate. In too many places, the integrated education, health and care services envisaged in the 2014 Act have never materialised.
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speak as a member of the Bill Committee that way back in 2012 or 2013 scrutinised the Bill that became that Act. We spoke endlessly in our debates about parents having to fight to get their children the services they need. However, parents are still struggling in an overly bureaucratic system and the evidence that they gave us through our inquiry was that they are still using the word “fight” when describing their attempt to get their children’s needs assessed and provided for. The Government acknowledged that in announcing their SEND review, but that was in September 2019, more than 18 months ago. The experience of children with SEND and their families during the pandemic must provide the impetus to sort these problems out. We called for the review outcome to be published in the first quarter of this year, but we are still waiting. The Government’s response to our report acknowledges the importance of these issues. The Government say they need more time to get the reforms right. Of course time is needed to grapple with the complex issues in the SEND system, but if much more time elapses people will start to question whether SEND is the priority that it ought to be.
The same is true of the review of adult social care. There is no doubt that the devastating experience of the pandemic in social care settings was exacerbated by systemic issues of funding, of workforce—including pay and staff turnover—and a lack of proper integration with NHS services. That is why we were disappointed in the spending review settlement for social care and disappointed that there was nothing on social care in the Budget. We only know that the Government intend to bring forward their proposals for social care later this year. That needs to happen sooner rather than later.
There are positives in the Government’s response and I do not denigrate the hard work that is undeniably going on in the Department for Environment, Food and Rural Affairs in relation to disabled people’s access to food and in the Cabinet Office on accessible communications; and the work that the Disability Unit is putting into the national strategy for disabled people. The Government have opportunities in the national strategy, the social care review and their SEND review to understand the particular problems faced by disabled people, their carers and their families in the pandemic, to understand the part they have played in those problems, and to start putting things right and restoring trust. I urge my hon. Friend the Minister in his response to make it clear that the Government will grasp those opportunities and do so in a timely fashion.
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