The government and the NHS both failed to pay enough attention to the risks faced by the social care sector at the beginning of the COVID-19 pandemic, a report by MPs has concluded.
But the joint report by the Commons science and technology committee and the health and social care committee also ignores key ways in which disabled people’s rights were breached during the crisis.
The decision to prioritise the NHS over social care led to the “rapid discharge” of about 25,000 people from hospitals into care homes “without adequate testing or rigorous isolation” between 17 March and 15 April 2020, which contributed to the spread of the virus in those institutions, says the report.
The report – on early lessons from the pandemic – says this lack of priority during the early stages of the crisis demonstrated the “longstanding failure to afford social care the same attention as the NHS”.
It adds: “The UK was not alone in suffering significant loss of life in care homes, but the tragic scale of loss was among the worst in Europe and could have been mitigated.”
The report, which focuses on England, partly blames the lack of “prominence” of social care in the Department of Health and Social Care (DHSC), and it says ministers must address the “relative lack of knowledge and experience of social care” within DHSC and senior levels of the NHS.
It adds: “Staff shortages, the lack of testing, difficulties in obtaining PPE [personal protective equipment] and the design of care settings to enable communal living hampered isolation and infection control and the ability to keep covid at bay.”
The social care section of the report focuses on older people and says little about the impact on working-age disabled people, although it does address the disproportionate impact on people with learning difficulties.
It says there was a “high degree of consensus” among witnesses to the inquiry that “existing inequalities” played an important role in the disproportionate risk of death from COVID-19 faced by people with learning difficulties.
But the report ignores broader concerns about disability discrimination by the government as it responded to the pandemic, and within the NHS, and how that could have been to blame for disabled people’s sharply increased risk of dying from COVID-19.
Despite the committee hearing from more than 50 witnesses, no disabled people’s organisation gave evidence to the inquiry, with this week’s 150-page report omitting key breaches of disabled people’s rights during the pandemic.
Researchers backed by the Office for National Statistics (ONS) found in a study published in June that working-age disabled women with higher support needs had been about 90 per cent more likely to die from coronavirus than non-disabled women of the same age, even after taking factors such as underlying health conditions, poverty and whether they lived in a care home into account.
Although this evidence was ignored by the committees, they did examine the disproportionate impact of the pandemic on people with learning difficulties.
They said that deaths were “especially high” among younger adults with learning difficulties, with research suggesting this was partly caused by existing health conditions but also by barriers to accessing NHS treatment.
These barriers, says the report, were caused by restrictions on non-COVID care and rules preventing carers, care workers and advocates from attending hospital with people with learning difficulties.
But the report fails to point out that this barrier also affected many other disabled people, and led to two disabled people – Fleur Perry and Mark Williams – successfully threatening legal action over an NHS England document that prevented disabled people with high support needs being accompanied into hospital by their personal assistants if they became ill.
And although the report draws on ONS reports on COVID-related care home resident deaths, deaths involving COVID-19 in the care sector, deaths involving COVID by region, deaths involving COVID by age, deaths involving COVID by sex, deaths involving COVID by ethnic status, deaths involving COVID by local area and socioeconomic deprivation, and COVID infection rates by household size, it ignores ONS reports on COVID-related deaths by disability status.
The report also fails to draw any conclusions about widespread allegations of wrongful use of “do not attempt cardiopulmonary resuscitation” (DNACPR) orders on people with learning difficulties during the pandemic, despite evidence produced by the Care Quality Commission of concerns across the care sector.
Instead, the MPs conclude that although it was “clear that national NHS guidance was never to apply blanket DNACPRs to any group, the pattern of delayed and unclear guidance to the sector created widespread confusion on their appropriate use and certainly contributed to the perception in the sector that people with learning disabilities were not being valued in the same way as the general population during the pandemic”.
Again, this impacted far wider among disabled people, but this was also ignored by the report.
The report makes only a fleeting mention of the government’s refusal to provide an on-stage British Sign Language interpreter at televised COVID-19 briefings, when similar briefings in Wales and Scotland had done so.
The MPs say only that this “may” have reduced the ability of Deaf people to understand the government’s public health messages and “potentially” reduced “trust and compliance”.
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