However, embedded in a brilliant strategy was an anachronistic abomination.
This was my e mail to Mark Harrison, CeO of the Norfolk Coalition of Disabled People and Chair of the Joint Strategic Board running the Strategy for monitoring Personalisation in the county of Norfolk.
As a member of NCODP I'm participating in the training for monitoring the joint personalisation agenda and I'm excited at being able to take part in this project which I know, from involvement in national activities around personalisation, is one of the schemes leading the way. But, as a mental health survivor as well as a physical disability service user (and I'm not necessarily speaking on behalf of NSUN here) I'm horrified at the specific exclusion of disabled people with mental health problems.
The Disability Discrimination Act 2005 defines a disabled person as a person with "a physical or mental impairment which has a substantial and long-term adverse effect on his (sic) ability to carry out normal day-to-day activities."
The joint strategy implementation plan sets out principles and outcomes, several of which are breached by the exclusion of people with mental health problems in addition to breaches of the UN Convention on the Rights of People with Disabilities.
Additionally, because this omission treats those with mental health disabilities less favourably that those with physical and sensory disabilities, in my opinion it is discriminatory.
I do understand that there are cultural and structural barriers here but we have all recognised that the personalisation agenda will mean, of necessity, extensive cultural and structural changes in the way services are delivered and those are no excuse for this gross anomaly.
Can you please respond.
This mailing was sent on 29th November, 2009. By 12th February 2010 I had still received no response to my mail and I wrote the PPlog entry “Personalisation Progress???” for that date below.
At the NCODP training module of week beginning 15th February I had the chance to mention the non response to the NCODP Manager. He said he recalled a ‘letter’ to me from Mark Harrison. A few days later he forwarded to me an e mail from Mark Harrison dated 14th January with the comment it had been sent to the wrong e mail address.
This is my reply to that e mail from Mark Harrison:
Hello Mark.As an organisation we were invited to engage in this process starting with physical and sensory impairments with a commitment to broaden the approach at a later date.
This is in reply to your e mail to me of 14th January 1010 which - thanks only to a recent discussion with Peter de Oude - I received on 04.03.2010.
And,I agree that the artificial organisation around specific impairment groups is unhelpful.
I take it from this that the NCODP involvement in this Joint Strategy is of a pragmatic nature with which you are personally not entirely comfortable. You do too, point out that the service users participating in NCODP’s operation of the Joint Strategy are from the whole community, including mental health.
However, I am strongly of the opinion that the segregation of disabled people with physical and sensory impairments from people with mental health problems (and presumably, as has been pointed out by another user on the project has, learning difficulties) by Norfolk County Council is indirectly discriminatory (see below) and, rather than NCODP colluding with it, we should have challenged it, reporting it to the Care Quality Commission and the Equality and Human Rights Commission in the face of refusal to change.
All the current thinking is inclusive and not segregationist and it is recognised that to single out sections of the community for a lesser quality and provision of service is inequitable. Guidance and regulation set out in
Putting People First, CQC Performance Judgement for Adult Social Services, the Darzi Reportand
New Horizons,for example, talks of the importance of commissioning integrated services for the whole community.
Adult social care will also take responsibility for championing the rights and needs of older people, disabled people, people with mental health needs and carers within the local authority, across public services and in the wider community.(Putting People First - shared vision)
I have to express extreme concern about the particular exclusion of people with mental health impairments in the primary care sector.
Returning to the question of inequity and discrimination, Ed Mitchell, in his Legal Update article for Community Care Magazine tells us local authorities are being prosecuted for breaches. He advises us that:
“ of particular relevance is the general disability equality duty . Contained in section 49A of the Disability Discrimination Act 1995, this requires public authorities to have regard to a range of needs in carrying out their functions, for example the need to promote equality of opportunity for disabled people.”
While I am confident that the Joint Strategic Strategy for People with Physical and Sensory Impairments is discriminatory in the present sense by selectively treating one section of the community less favourably than another, the Draft Code of Practice for the Equality Bill awaiting implementation tells us clearly about:4.4 Indirect discrimination
The indirect discrimination provisions primarily aim to address forms of discrimination which, while they do not explicitly entail or propose different treatment, in practice disadvantage people with particular protected characteristics.
Indirect discrimination occurs where:
a) a service provider applies to everyone a provision criterion or practice which disadvantages (or would disadvantage) a person with a particular protected characteristic
b) a provision criterion or practice generally disadvantages (or would disadvantage) those who share that protected characteristic, and
c) the service provider cannot justify the provision criterion or practice.
It also occurs where a provision, criterion or practice deters (or would deter) a person from doing something such as using a service because it would be applied to them.
5.6 What is ‘less favourable’ treatment?
A person (B) is treated ‘less favourably’ if he or she is put at a disadvantage compared with others. If the disadvantage is obvious, it will be clear that the treatment has been less favourable:
for example, B may have been denied a service or given a poorer service. Being denied a choice or excluded from an opportunity is likely to be less favourable treatment."
In addition the Equality Bill deals with colluding bodies - if we take the example below as representing the Joint Strategic Board and NCODP respectively we can see the dilemma:"Clause 107. 3.15 Instructing, causing or inducing discrimination
It is unlawful for a person to instruct, cause or induce someone to discriminate against, harass or victimise another person, or to attempt to do so. This only applies where the person giving the instruction is in a relationship with the recipient of the instruction in which discrimination, harassment or victimisation is prohibited.
Both the recipient of the instruction, and the intended victim, may bring action for a breach of this provision, whether or not the instruction is carried out, provided the recipient or intended victim suffers detriment as a result.
Example: A GP instructs his receptionist not to register any Gypsies or Travellers. If the instruction is complied with then the patient who is rejected may have a claim against the GP and the receptionist."
I hope you are able to take all this in the spirit of friendly criticism as well as an expression of concern at what I believe is Norfolk County Council’s foot-dragging attitude to equality and full and proper service provision.