There’s been a lot of talk about protecting the most vulnerable from Covid-19. Well it hasn’t quite worked out that way. People dependant on social care have been left dangerously exposed. Thousands have died.
In the early days of the crisis, back in March, Boris Johnson and his inner circle flirted with the flaky concept of herd immunity, ostensibly to build resilience among the fittest while throwing a protective cordon around those most at risk. The idea was to allow the virus to flow between our fortifications, eventually exhausting itself while shielding the frail. We know what happened with that.
When we talk of those most at risk we tend to think of the elderly and the frail. But there is another very large minority who are equally vulnerable — the disabled. There are over 10 million people with a disability in Britain, half of whom have a serious disability that requires significant support, and one and a half million with a learning disability.
Figures published by the Care Quality Commission this week reveal that here has been a 134 per cent increase in deaths of people with learning disabilities, almost all of them Covid-19 related. Preliminary figures show an increase in deaths from 1,370 to 3,765. Another alarming finding is that many are younger than the general population.
It is a shocking increase. People with learning disabilities and/or autism already face significant health inequalities. They often have poorer physical and mental health than other people. We know for example that people with learning disabilities are dying earlier than they should from preventable causes.
In a barely-veiled criticism of the government’s testing strategy, the chief inspector of the CQC’s Adult Services said: “We already know that people with a learning disability are at an increased risk of respiratory illnesses, meaning that access to testing could be key to reducing infection and saving lives.” This raises two questions: why are they not being prioritised; and what is being done to keep them safe?
This sense of being defenceless has been rammed home by a particularly cynical legislative sleight of hand buried in the Coronavirus Act 2020. This effectively suspends the hard-won statutory rights of the disabled which are enshrined in the Care Act (2014) and which ensures that they are properly to be supported by the state.
The Care Act, and the Mental Capacity Act before it, are intended to help the disabled live a full life and receive support that fits their needs. The “easements” permitted under the Covid-19 Act have caused huge concern among disabled people. A number of legal actions have been launched challenging local authorities that have exercised their option to “ease” their responsibilities under the Care Act.
For those who do not have a disabled person in their lives it’s worth explaining what these easements could mean in practice.
Those of us who have a loved one that is elderly, frail, disabled or all three and is reliant on the state directly or indirectly for support, know that fighting their corner is a relentless battle with the care bureaucracy.
For someone with a disability in lockdown, already isolated — say someone who needs help getting dressed, getting food in, going to the shops, even watching the telly — it would be devastating if their carers fall ill. They would be left with minimal support and their local authority would now be under no legal obligation to meet their needs under their agreed Care Plan. So far only about eight local authorities have served notice of easement and most are facing a legal challenge.
Now you might argue that if a council finds itself so depleted and short of staff that it has to make hard decisions about the allocation of resources it should be free to do so without fear of being pursued in the courts. You might even argue that at a time when the virus can strike anyone anywhere the disabled should take their chances just like anybody else.
These are difficult times and it’s reasonable to cut local authorities some slack. But if the Care Act and its provisions are right in principle, surely they’re especially right in a pandemic.
This is the most serious public health crisis in a century. It is immoral to curtail the fundamental rights of those who are most in need of support and those whom the government has singled out for special protection.
Having cut local authority budgets by over 40 per cent in the past 10 years the government is in effect now saying to local authorities on the one hand “protect the vulnerable, do what you can — but if you can’t, don’t worry. We have your back.”
Our care system is scandalously neglected. The elderly, the frail and the disabled sit, out there in our peripheral vision and only really come into focus — and onto the front pages — when something really bad happens: care homes devastated by Covid; Winterbourne View; the appalling treatment of young people with autism banged up in Assessment and Treatment Units (ATUs) brought to light by reporters like the Mail on Sunday’s Ian Birrell.
Matt Hancock, the Health Secretary, said on March 13: “We are working closely with partners from across the social care sector to ensure local authorities, care providers and our health and social workforce are prepared to take action to protect our most vulnerable”
For people with a disability, soundbites such as “we will do whatever it takes” and “we’re all in this together” ring especially hollow. It’s high time we had a properly integrated policy to meet the needs — and the aspirations — of the disabled under a senior cabinet minister who fights their corner. As long as responsibility is split between the Health minister and the Work and Pensions minister, disability will always play second fiddle.