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Abstract
The Independent Inquiry into Access to Healthcare for People with Learning Disabilities reported in July 2008. Based on a public consultation, a review of research and evidence and the views of witnesses and stakeholders, the Michael Inquiry concluded that there are risks inherent in the care system for people with learning disabilities and that they are largely due to a failure to make 'reasonable adjustments' to services, as required under the Disability Discrimination Act. The Inquiry found evidence of a significant level of avoidable suffering due to untreated ill-health, and a high likelihood that avoidable deaths are occurring. Although the report highlights examples of good practice there are some appalling examples of discrimination, abuse and neglect. The article makes ten essential recommendations for urgent change across the whole health system and the Inquiry team report contains practical illustrations of how to implement them.
Keywords
learning disability; health risk; inquiry; reasonable adjustment.
Introduction
The establishment of the Inquiry by the then Secretary of State for Health Patricia Hewitt last summer had Its roots In Mencap's report Death by Indifference (2007) and the Disability Rights Commission Formal Investigation Equal Treatment: Closing the Gap (2006). Both these reports highlighted fallings In access to, and delivery of, appropriate treatment In primary care for physical health problems among people with learning disabilities. Death by Indifference described the circumstances surrounding six people with a learning disability who died while In the care of the NHS. Their stories were shocking. For the Inquiry team, and perhaps also for Patricia Hewitt who met the families who had lost loved ones, there was a powerful awakening to awareness that perhaps those individuals and their families were not alone. Perhaps their experiences were not isolated.
This is why, in addition to an investigation of the individual cases by the Parliamentary and Health Service Ombudsman, the Inquiry was established. Not only were there questions about the circumstances of the individual cases, there were also questions about how widespread the problems might be across the NHS as a whole. And if a significant level of avoidable health risk should be identified for people with learning disabilities, then the Inquiry team's urgent task was to understand the reasons why, and make practical recommendations to mitigate the risks...