Forty years ago on 1 October 1973 I started my first full time job as a trainee social worker with the Lancashire County Council. I went on working for the Council till 2009. As a trainee I had to do some studying and produce a long essay and mine was called ‘The Cost of Handicap’. It is interesting that the terminology has changed and we would now talk about disability not handicap having accepted that it is how we in our society organise things that results in people having difficulty living their lives because they have a problem with mobility, hearing, sight or similar physical function ,a learning disability or poor mental health. Indeed over the last 40 years we have for example made level access much more common, added audio to pedestrian traffic lights, have buses, trains and taxis that have space for wheelchairs, many people have text phones and we have a health passport to help people get recognition of their individual requirements.
My report talked about the social, emotional and financial costs mentioning isolation, stereotyping and scapegoating. I explored the possibility of depression, anxiety and stress associated with dependence. Finally I looked at the higher costs of heating, special diets, medicines, equipment, holidays and the difficulties of employment and managing on benefits.
There were grounds for optimism in the 1970s as the Chronically Sick and Disabled Person’s Act passed in 1970 was introduced and Local Authorities were expected to know how many people living in their area had a disability and having identified their needs take action to enable them to improve their quality of life. People were provided with equipment including telephones, funds were available to assist with the cost of adapting houses and planners began to consider including features such as ramps and lifts when designing buildings.
Big Health Day
However when I recently went to an event called a Big Health Day at which we listened to people with learning disability and their carers, I was reminded that there is a lot still to do. We might change the environment but attitudes can remain unaltered and a short film highlighted some of the situations which arise when people are trying to do everyday tasks like booking a taxi, seeing the doctor or holding down a job. Some of the carers spoke about accompanying their relative to hospital and being seen by the staff there as a replacement not a supplement to the staff role as carer for the patient.
I also went to the Learning Disability Partnership Board and took part in discussions about hate crime and the role an organisation called Resolve can play in tackling this.
So are things better than they were in the last century?
I think they are. We no longer have hundreds of people living in long-stay hospitals like Brockhall and Whittingham, we can and do make good use of the technology available to manipulate the physical environment there are telehealth and telecare programmes, mobility scooters, digital hearing aids and so on but there is still a way to go.
At a recent presentation in the CCG, Jules Wall, our head of Diversity, Equality and Human Rights, reminded us that if we get Equality we automatically get quality and we have to consider the impact of our work on all members of our community. The best way to do this is to tell people what we plan to do and listen to what responses we get.
I am interested to know other people’s opinions, so get in touch to let me know what you think about progress to mitigate the costs of disability since the 1970s and importantly the suggestions you have about what could and should be done in the next few years.
Chair, NHS Blackburn with Darwen Clinical Commissioning Group