UK’s historic decisions on social care should be ‘ground zero’ for Covid inquiry, say DPOs

The choices made by the UK state on how the social care system is structured mean that the impact of the pandemic in this area should be “ground zero” for the Covid inquiry’s investigations, disabled people’s organisations (DPOs) have argued.

Four DPOs told the inquiry that this was because there had been a “terrible inevitability” to the deaths and other harm caused to disabled people who rely on social care.

They pointed to the “shameful” lack of emergency planning there had been, and the “constitutional and economic choices” the UK has made.

Under the current social care system, they said, “disabled people’s lives are absolutely valued less”.

They told the inquiry that the evidence it had heard clearly showed that “central and local government’s incapacity to collect and deploy data concerning the needs of its people in an emergency is a fundamental problem.

“There was ignorance of what services a person receives, from whom, and whether those services are provided, and if not, why not.”

They said the inquiry could highlight in its conclusions the “human cost to disabled people’s visibility” that arises from not having the “integrated data system that health and social care needs”, and how to make the system “effective, national, and trusted by the people that it is foremost there to serve”.

They said DPOs should be funded to work at the design stage of such a system.

Disability Rights UK (DR UK), Disability Action Northern Ireland, Disability Wales and Inclusion Scotland have together been granted “core participant status” in module six of the UK Covid-19 Inquiry, which is examining the impact of the pandemic on the adult social care sector across the UK.

Their barrister, Danny Friedman KC, who delivered their closing statement of module six, said governments should never have allowed the shutting down of “on-site, face-to-face regulator inspections” of care settings during the pandemic.

Family and other visitors were “mostly blanket-excluded”, death certificates were completed by non-attending physicians, inquests were unlikely, and regulators were “publicly admitting their lack of capacity and faith” to manage the control of infection prevention.

In each of the four UK nations, he said, the regulators failed in their “principal objective” to “protect and promote the health, safety and welfare of the people who use care services”.

Friedman – who was instructed by Bhatt Murphy Solicitors – told the inquiry that disabled people living independently in the community were “subjected to straightforward abandonment” because of the emergency care laws known as “easements”, which he said “should not have been introduced”.

He said: “With the threshold for entitlement to social care so high and the means to challenge its refusal so limited, no government should have legislated to allow local authorities to cease meeting pre-existing eligible needs.”

The DPOs said it was “frankly ludicrous” to claim that only eight local authorities had taken advantage of these easements, and they said that those authorities that did not declare easements but still failed to meet disabled people’s eligible needs “broke the law”.

They said that disabled people’s worlds were “turned upside down”.

Friedman told the inquiry: “People went without assistance to get meals; were left in bed for days; soiled themselves in wheelchairs; lost home physio or daily contact visits that forever damaged their bodies or neurological development.”

And, he said, there were “blanket approaches” to the use of do not attempt cardio-pulmonary resuscitation (DNACPR) notices that were “flagrantly in violation of existing guidelines”, with notices signed by clinicians added to records without consultation, while there was “literally targeting” of people with learning difficulties.

There were cases where ambulances would refuse to take residents with a DNACPR notice to hospital, and others where care homes would not ask them to do so.

Former Conservative health and social care secretary Matt Hancock had told the inquiry on 2 July that he believed that inappropriate use of DNACPR notices was “one of a number of narrow conspiracy theories that have grown up in this space” and that if it was more widespread than the single occasion he knew about “it didn’t come to my attention, and if it did happen, it’s totally unacceptable”.

Georgia Bondy, who is working with Disability Rights UK to manage its work on the inquiry, said after the 31 July session: “This module has made clear to the inquiry what many disabled people have known for a long time: when weighed in the balance, the government, the care system and the NHS treat disabled people’s survival as mattering less than non-disabled people’s.”

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