Labour’s integration plans could see NHS take over social care

Leading disabled campaigners have welcomed Labour’s plans for “full integration” between the NHS and the social care system, but have raised concerns about putting the NHS in charge.

Andy Burnham, the shadow health secretary, said he wanted to see “whole person care”, with “one budget, one service co-ordinating all of one person’s needs: physical, mental and social”.

Burnham suggested that the exclusion of social care from the NHS explained why it had never been able to break out of its “medical model” mentality.

He said that giving the NHS responsibility for coordination of both health and social care would allow it to “raise the standards and horizons of social care, lifting it out of today’s cut-price, minimum wage business”.

Burnham pointed out in a speech announcing his proposals that £104 billion a year was spent on the NHS but only £15 billion on social care.

He also launched a major health and care policy review, under the shadow care services minister, Liz Kendall.

Professor Peter Beresford, who chairs the national user-led Shaping Our Lives network, welcomed Burnham’s recognition that calls for integration were “unlikely ever to work so long as they are separate competing organisations, based on different funding systems and fundamentally different principles for access and entitlement”.

He said integration could not come soon enough, because of the “national emergency” intensified by “rising numbers of older and disabled people”.

But he said he was worried that Burnham “seems to be turning to the NHS for the solution” to integration.

He said: “This won’t work. It’ll mean an unhelpful return to a medical model when we know that a social approach is crucial here.”

He added: “It’s time Andy started talking to service users, carers and their organisations. They’ll give him a really helpful steer for developing sustainable policy.”

Sue Bott, director of development for Disability Rights UK (DR UK), said she was pleased that a national politician was “really trying to get to grips with the crisis that there is in social care”, and said her organisation was “very much in favour” of integration.

But she said she was concerned that the culture in the NHS was “very different” to that in social services.

She said: “Although we often have issue with the attitudes that disabled people experience in social services, nevertheless we would say that there tends to be a much better, empowering culture in social services.”

She said integration would need to be a “genuine coming together”, and added: “If it is simply the NHS taking social services under its wing, then that really is not going to work for disabled people.”

Bott said DR UK would support Burnham’s “whole person” approach, and recognised that the difference between health and social care services was “very arbitrary” and meant disabled people often failed to receive the services they needed.

Burnham also talked in his speech at the King’s Fund in London about the key issue of social care funding reform, but focused on older people and said nothing about working-age disabled adults.

Disability News Service asked Burnham’s spokesman whether the shadow health secretary agreed with proposals from the Dilnot commission on funding reform that social care should be free for all people with “eligible” needs who become disabled before the age of 40.

He said: “Andy’s been clear he supports the Dilnot proposals as an important first step to addressing the crisis in all social care.”

But when asked to clarify exactly what he meant by this, he failed to comment further.

24 January 2013

News provided by John Pring at www.disabilitynewsservice.com

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VisitEngland announces new marketing campaign to develop and promote accessible tourism

VisitEngland have unveiled plans for a national marketing campaign to promote accessible tourism in England. The national tourist board will work with five destinations to develop exciting itineraries with top class accommodation and attractions that provide a warm welcome for all visitors including those with access needs.  The campaign, a first of its kind, will be promoted through marketing activity starting in late Summer 2013, and is designed to highlight the fantastic tourism experiences on offer to all across the country.

VisitEngland will work with Leicester Shire Promotions, Visit Brighton, NewcastleGateshead Initiative, Bath Tourism Plus and Chester & Cheshire to identify tourism businesses in their area that provide particularly excellent levels of service to visitors with access needs – such as those with hearing and visual impairments, wheelchair users, older and less mobile people and people with pushchairs.

The national tourist board will then work with the destinations and businesses to ensure that they all meet the same high standard of accessibility, focusing on key issues such as customer service and visitor information. This will incorporate a number of VisitEngland’s tools and resources, such as Access Statements and online disability awareness training.

The campaign is funded by £100,000 from the Government’s Regional Growth Fund (RGF) plus contributions from partners. It will provide a cost-effective opportunity for English destinations to showcase their accessible tourism businesses and attract more visits from disabled travellers and their companions; a sector worth almost £2billion a year to the domestic tourism industry*.

Paralympic Medallist and TV Presenter, Ade Adepitan, commented:

“VisitEngland’s accessible tourism campaign is a fantastic example of Paralympic legacy.  Promoting destinations in England which are easily accessible and cater to the needs of disabled visitors should inspire all of us to take a break here at home, with the peace of mind that our specific needs will be met so that we can enjoy our holidays to the full.”

James Berresford, VisitEngland’s Chief Executive, commented:

“The RGF money is a huge boost for accessible tourism in England; these new itineraries will showcase the best this country has to offer to all visitors, regardless of disability. We know that accessible tourism in England is worth almost £2billion, and we want to harness this growing, high-value market to become internationally recognised as a leading destination for people with access needs.”

This marketing activity is phase two of a three-year investment project called ‘Growing Tourism Locally’.  Funded by £19.8million from the RGF, the project aims to generate £365million in additional tourism spend over the three year period and inspire more Britons to take more holidays at home.  The project should help to stimulate employment to grow jobs in the tourism sector by 9,100 over the three years.

The total investment of the three-year campaign will be approximately £41m including £19.8m from the Regional Growth Fund, £9m from VisitEngland, £12m leveraged from the national and local tourism sector.

Redundancies at Disability Rights UK, but boss says survival not at risk

The country’s most influential disabled people’s organisation (DPO) has insisted that its survival is not at risk, despite being forced to make several staff redundant, including one of its most high-profile campaigning voices.

Disability Rights UK was only formed last January from a merger between RADAR, the National Centre for Independent Living and Disability Alliance.

But it admitted this week that one of its six directors, Neil Coyle, has been made redundant – although he will stay in post until April – while another, Mark Shrimpton, will move to a part-time role. Two other members of staff will also lose their jobs, leaving a core of about 30 staff.

Disability Rights UK (DR UK) said that it was “operating in a very tough economic environment”, in which many DPOs faced “major funding challenges”.

The organisation has had a mixed first year.

It has made a number of significant campaigning contributions, including helping to lead the Hardest Hit alliance and influencing the government in key policy areas, and has provided services such as helplines and online information for disabled people.

But it has also faced criticism for convening the government’s new Disability Action Alliance, and helping the outsourcing giant Capita win a lucrative disability assessment contract.

Liz Sayce, Disability Rights UK’s chief executive, has continued to face attacks from some disabled activists over a report she wrote for the government in 2011 that recommended ending government support for the remaining Remploy sheltered factories, and closing those factories which were “not viable”.

Coyle, who has built an impressive campaigning reputation on disability rights through his work for the Disability Rights Commission, Disability Alliance and DR UK, said there was “huge financial pressure on DR UK”, which had not delivered on its “high expectations for fundraising” in its first year.

He told Disability News Service that he had some concerns about the impact of the cutbacks, and that it was “a massive shame” that some potential projects DR UK had been developing would now have to be dropped, including one he was working on to measure the cumulative impact of the government’s cuts and reforms on disabled people.

He said: “The challenge is to make sure we are as able to campaign, as influential and maintain a high profile and deliver for our members.”

When asked whether there was a threat to the future of Disability Rights UK, he said: “It is a tough environment for everyone. We need to run a very tight ship.”

Sayce insisted that DR UK’s survival was not at risk, and it would continue to have a “high policy and campaigning profile”.

She said: “Everybody in the charitable sector would say it is tough. I would much rather not have to lose posts, but we have tightened up our structure in order to be sustainable.

“One of the things we are doing is building income streams of our own that are not dependent on short-term project grants.”

One of these is providing disability rights expertise to the equality advice helpline formerly run by the Equality and Human Rights Commission, but she said such outside work would have to be “absolutely to the benefit of disabled people”.

She pointed to DR UK’s successes in its first year, with more than half a million people using the “unrivalled” information on its website, across benefits, independent living, education and apprenticeships, while more than 7,000 people had used its helplines.

And she said it had recruited a new board of “diverse people with lived experience of mental and physical health conditions and impairments”, set up new projects to provide better opportunities for apprenticeships and support to use personal budgets, published new guides, and influenced policy change in areas such as social care, changes to the personal independence payment (PIP) and improvements to the Access to Work scheme.

She praised Coyle’s “tremendous achievements” in “raising the profile of disability rights and influencing policy, particularly on welfare reform”, and his “significant track record in working to break the link between disability and poverty”.

Coyle added: “In just one year I am pleased to have sustained pressure to improve PIP plans, ensured the negative press portrayal of disabled people is highlighted and tackled, and involved over 5,000 people in our policy and campaigns achievements.”

News provided by John Pring at www.disabilitynewsservice.com

Portas high street review ‘is making life harder for access campaigners’

A review by the government’s “high street tsar”, Mary Portas, has made it even harder to secure access improvements to local shops for disabled people, according to a leading access consultant.

Tracey Proudlock has been trying for more than three months to discuss her concerns with Portas, but has so far had no response.

Last year, the government chose 27 English towns to take part in pilot projects aimed at transforming their high street, the first recommendation taken up from an independent review of the high street’s future, carried out by the retail expert.

But the Portas review failed to make a single mention of disabled people in its 47 pages, although there was a brief reference to the need for older people to have “the same great access to high streets that they have to out-of-town centres”, in a section in which she called for high streets to be “accessible, attractive and safe”.

Proudlock said she fears the review’s focus on deregulation and “freeing up red tape”, and making life easier for retailers, has filtered through to local authorities, who now shy away from telling high street businesses to improve access.

Proudlock, a wheelchair-user, last year asked four retailers near her home in Muswell Hill, north London, to remove a step at the front of their premises while builders carried out “high value work” inside.

All four refused to remove the step, she said, while her local council failed to force the shops to do so as a condition of their planning applications.

Proudlock first wrote to Portas on 12 October last year, telling her how her local Liberal Democrat councillor had said that Haringey council – which is Labour-controlled – “did not want to burden retailers” and so would not campaign with her to remove steps from her high street, because of the Portas review.

She has now written two letters – sent by registered post – to Portas’s office, and made follow-up calls and sent emails.

Proudlock, a member of the government’s own Equality 2025 advisory network of disabled people, but speaking in a personal capacity, said: “I was trying to change things where I live, but Portas was quoted as the reason why it wouldn’t happen.”

Portas has so far been unavailable to comment.

A spokeswoman for the Department for Communities and Local Government said it was “committed to supporting the high street so it’s a place for everyone to enjoy”, which was why it had already implemented “virtually all” of the Portas recommendations, doubled small business rate relief for new and smaller shops and “outlined new proposals tore-activate empty shops”.

She said local businesses must comply with the Equality Act and building regulations, but added: “We actively promote good design which is crucial to improving the high street and would urge local authorities to look at locally imposed red tape and byelaws that may have an adverse affect on the high street.”

But when Disability News Service asked whether the government believed the Portas review had made it more difficult to improve access on the high street, she declined to comment further.

Haringey council has so far been unable to comment.

News provided by John Pring at www.disabilitynewsservice.com

McVey invites ridicule as she dismisses her own PIP figures

A minister has refused to admit that her government has tightened eligibility for support for people with the highest mobility needs, even though her own department’s figures prove that it has.

Esther McVey, the Conservative minister for disabled people, was giving evidence to the Commons work and pensions committee for the first time since her ministerial appointment.

She repeatedly insisted that she wanted to provide “clarity” on the replacement of disability living allowance (DLA) with the new personal independence payment (PIP) for working-age disabled people.

But McVey then claimed that the latest changes to the assessment criteria for the PIP mobility component would not lead to fewer disabled people receiving the enhanced rate, even though she was told by Labour MP Sheila Gilmore that the government’s own document shows the changes would mean 51,000 fewer people eligible by 2018.

Despite the government publishing them last month, McVey refused to comment on the numbers, saying she was only “accountable” for the reforms until the next election in 2015.

She said the government’s 2018 figures were “hypothetical”, because there would be a review of the PIP reforms in 2014, and added: “I don’t think it’s correct to pursue those incorrect [Department for Work and Pensions] numbers.”

McVey claimed the latest changes provided “clarity” to “what was otherwise a very vague criteria”.

Previous drafts of the PIP eligibility criteria stated that a claimant who could not walk “up to” 50 metres without using a self-propelled wheelchair would be entitled to the enhanced rate of the mobility component of PIP, making them eligible to lease a Motability vehicle.

But last month’s final draft of the assessment criteria states that a PIP claimant would be eligible for the enhanced rate if they “can stand and then move more than one metre but no more than 20 metres, either aided or unaided”.

The move from 50 metres to 20 has caused concern and anger among disabled activists, peers, MPs, and a string of disability organisations.

Gilmore told McVey that 20 metres was “a very short distance”, and asked whether it was “purely coincidental” that the numbers who would be eligible for the enhanced rate in 2018 had fallen following the latest changes.

Gilmore said after the meeting that the changes were now “as clear as mud”, accused DWP of being “deceptive” in the way it had consulted people over the changes, and said McVey’s refusal to discuss DWP’s own 2018 figures was “absurd”.

The disabled Liberal Democrat peer Baroness [Celia] Thomas said the sudden change from 50 metres to 20 had “shaken my faith in the whole process”.

She added: “It’s a terrible mess and just shows how stupid they were to alter the regulations at the last minute.”

A Department for Work and Pensions spokesman again declined to admit that eligibility had been tightened.

Meanwhile, Baroness [Tanni] Grey-Thompson has warned fellow peers that the “lack of consultation with disabled people and all supporting evidence from experts in disability access as to what distance enables practical mobility and participation mean that there is a real risk that this issue will be open to judicial review”.

Lord Freud, the Conservative welfare reform minister, insisted that the change “has made it clearer and simpler” and “has not changed the numbers affected”.

But after Lord Sterling, the Conservative chair and co-founder of the Motability car scheme, said there was “concern among disabled people” at the change from 50 metres to 20 – believed to be the first time he has spoken out over the PIP changes – Lord Freud agreed to consider “further communication with the relevant parties” on the issue.

Lord Freud was also asked by peers why the government had left out from the criteria the need to be able to perform the activities laid out in the PIP assessment “reliably, safely, repeatedly and in a timely manner”, another key issue that campaigners have been raising since the final draft was published last month.

Baroness Thomas, her party’s former work and pensions spokeswoman, said the number of appeals would “rocket” and there would be “such a period of uncertainty in so many ways for so many people”, if the words were not included in regulations.

At present the words are included in guidance, which does not have the same statutory force as regulations.

Lord Freud said the government was “urgently” looking at how to put the words into the regulations “in a way that works legally”.

News provided by John Pring at www.disabilitynewsservice.com

NHS reforms ‘open door to better communication services’

A new project could improve augmentative and alternative communication (AAC) services “for a generation”, by taking advantage of the government’s major reforms of the NHS, according to a prominent disabled activist.

The Department for Education project aims to improve provision of AAC services – communication aids such as picture boards, communication charts, sign-supported speech, and electronic speech devices – across England.

AAC-users have been campaigning for years for successive governments to improve services, and address the regional variation in quality.

Simon Stevens, the disabled consultant and activist who is consulting stakeholders across the midlands and east of England as part of the project, and an AAC-user himself, said services were currently “patchy”, particularly for adults, while sourcing funding “has always been hard”.

He said the project provided a “unique opportunity” for people “to have a say in how AAC is commissioned under the new NHS arrangements”, and added: “Since this is a time of change, it is a time of opportunity.”

He hopes AAC-users and carers will now “have the opportunity to say what they want from any new services, starting from a blank sheet to highlight current strengths and weaknesses of current services to help see what is really needed”.

Some AAC services are currently provided through “specialised health commissioning” arrangements, but only in the west midlands.

The health reforms have provided an opportunity to spread these NHS services to other parts of England, from April this year, under the new NHS Commissioning Board.

Stevens said the project was not just looking at high-tech solutions.

He said: “While people think AAC can just be high-tech, it can be as simple as a piece of paper with yes or no on it, or an alphabet board.

“People who have a high-tech solution also often need a low-tech one as a backup.”

Stevens is now coordinating a survey of current and potential AAC-users, families and carers that aims to find out how services could improve.

A quarter of respondents to a survey for a Scope report in 2009 said their equipment had not been funded by a statutory organisation, while the report found “many agencies (particularly education, health and social care) refer people on to other agencies, claiming that the responsibility for funding lies with another body”.

Stevens said: “I would personally say this is still the case from my understanding, and this is certainly a great opportunity to change this for a generation and this is why this survey is so important.”

Anna Reeves, the government’s national AAC coordinator, said: “It is widely recognised that AAC provision is variable across the country and for different ages.

“Some areas in the country have local AAC services and/or AAC equipment budgets for children, some for adults, some for both, some areas have nothing in place.”

The project aims to map existing provision of AAC services and compare it with national standards, and develop good practice guidelines for developing local services.

The project will also assess whether it is feasible to use technology to deliver AAC services remotely, allowing changes to be made to computers or communication aids without the need for home or hospital visits.

24 January 2013

News provided by John Pring at www.disabilitynewsservice.com

Government stats show most new ESA claimants are not ‘fit for work'

New figures show for the first time that a majority of new claimants of out-of-work disability benefits are – eventually – found not “fit for work”.

Conservative ministers – particularly the former employment minister Chris Grayling – have previously made much of figures that they claimed showed most new employment and support allowance (ESA) claimants were able to work and so were ineligible for support.

But the latest Department for Work and Pensions (DWP) figures show that – once the results of appeals are fed through – a majority of new claimants are being awarded ESA, which replaces the old incapacity benefit.

The new figures show that – of those whose work capability assessment (WCA) has been completed – 52 per cent of people who started their claim between March and May 2012 were originally found fit for work.

Another 27 per cent were placed in the ESA support group, with 21 per cent in the ESA work-related activity group, for those disabled people expected to move eventually into jobs.

But the figures also show that it appears to take at least a year from when a claim starts for any subsequent appeals to be heard, a large proportion of which – somewhere between 30 and 40 per cent – result in the original decision being overturned.

And figures for July, August and September 2011 – the latest months released so far for which the results of appeals show a significant impact – reveal that less than half of claimants are being found fit for work, with 48 or 49 per cent unsuccessful in their ESA claims.

The tables released by DWP suggest that the proportion found fit for work will fall even further, with even more people given the support they need through ESA, once the results of appeals from claims begun in 2012 are fed into the statistical system.

Disabled activists and many other campaigners are convinced the WCA is still inflexible and deeply unfair, although the new figures suggest that changes to the assessment by the government, following independent reviews by Professor Malcolm Harrington, have improved it to some extent.

Last week, Labour MP Kevan Jones said the coalition had “blood on their hands” because of suicides caused by the WCA.

Former Labour minister Michael Meacher told fellow MPs in the same debate that he could not “begin to do justice to the feelings of distress, indignation, fear, helplessness and indeed widespread anger” at the way people had been treated.

A DWP spokesman referred Disability News Service to a press release in which Conservative employment minister Mark Hoban said the new ESA figures showed “that the improvements we have made since 2010 are making a real difference”.

He compared the 27 per cent of people now being placed in the support group – for those considered unable to work – with between 10 and 11 per cent in the early stages of the WCA, from December 2008 to May 2010.

But when asked by DNS to comment on the figures adjusted for appeals – which give the clearest picture of the numbers eventually being found fit for work – the DWP spokesman said: “Mark has made his comment around the statistics. I don’t think we would comment beyond that at the moment.”

The new DWP figures also show that the proportion of successful appeals against being found fit for work has continued to fall.

For claims begun in 2009, it was as high as 41 per cent, but the latest figures – for claims begun in the autumn of 2011 – show the proportion of successful appeals had fallen to 31 per cent.

24 January 2013

News provided by John Pring at www.disabilitynewsservice.com