Celebrating the National Health Service: Longevity of Disabled People.

Historically the National Health Service is the crown jewellery of the welfare state in the UK. Its successes have become the envy of the world since its inception in 1948. The institution has improved and maintained the lives and health of the nation and its citizens. This is irrespective of sex, gender, ethnicity, age and disabilities. Health care has been free at the point of delivered. Yet, the service is paid for with National Insurance Contributions by the working population in the UK.

Despite its achievements and accomplishments, disabled people (learning and physical disabilities) were not seen as people with equal rights compared to non-disabled people. They were stigmatised and called different names such as the “mongos, cripples, loonies and handicapped”. Besides their castrations, they were locked up in “long stay hospitals” and had very little access to the community. Their life-expectancy was short, in many instances this determined by medical practitioners in the hospitals/homes who pegged it at 40-years-old, while many did not even have the privilege to live up to that age. Their needs were poorly managed and they had no choice of the services/care other than accepting what was available. Most were ill-treated and their outcry rose the issues of “Moral Integrity, Human Rights and Equal Opportunities” for all.

The plights of disabled people touched the hearts and minds of some members of the parliament and clergymen/women in the UK. The proponents for change exploited this opportunity and called for the abolition of the policies and legislation that supported segregation. This was widely supported by many pressure groups who lobbied their constituency members of parliament in the House of Commons. The protagonists sought for change and reforms of the National Health Service and the wider welfare services. This received “A Royal” shield and the birth of the “NHS and Community Care Act (1990). Since then reforms have not stopped but has gained momentum.

Thus, 1990 would be remembered by many people as a year of liberation for disabled people. It also marked the beginning of a road map for reforms in the wider welfare systems and normalisation of disabled people in the wider community. Normalising the lives of disabled people and their assimilation in the community has revived the general public’s attitudes and behaviours towards disabled people of different classifications.  The reforms have made significant changes and improvements in the lives of this client groups as widely observed in practice and in the communities they live.

Reflecting on the attainments and realisations of the reforms, many disabled people now lives over 65-years-old and relatively in good health. Credits are due to the multitude of support systems such as advances in medical sciences, assistive technology, personalisation of services (Direct Payments, Cash for Care) and independent living. These have provided immerse opportunities and lifestyle for the client groups and their caregivers. For example, they are now able to access the community with their personal assistants and socialise with non-disabled people.

Similarly, health and social care professionals are now well educated in practice to understand and respond to challenging behaviours in children and adults with multiple pathology of disability. Every day, we see people with disabilities such as autism and attention deficit and they are expected to cope with their functional activities of daily living in a world, which can often seem bewildering and irrational. Most of the client groups (mild or severe disabilities) may need one form of support or the other therefore, it is imperative that their support systems are not interrupted in order not to confuse their retinue.

This can cause high levels of anxiety and stress, resulting in behaviours that can be difficult for other people to deal with. This could also offer significant trials to professionals who are involved in the provision of education, health and welfare services. Examining the unique tasks facing children and adults with disabilities, their conditions may exacerbate as they are ageing. This would tentatively present some dilemmas to professionals who are supporting them to attend their holistic needs. Thus, support plan or individual programme plans (IPP) for disabled people require continuous monitoring and appraisal of their needs as well as adequate financial and human resources.

The current reforms within health and social care sectors are threaten some of the achievements already made to safeguard the wellbeing of many service users. The danger is that as people with learning disabilities for instance are getting older, they may face the same physical and mental problems of all ageing people. Most would need increasing support to ensure they grow old in a society where their safety and dignity could be maintained.  On the other hand, parents who are the main caregivers for their children with learning disabilities or those with physical infirmities may find it more difficult to cope as they get older. More than often, siblings and other relatives who take on this role struggle to find information they need because they have not been part of care giving.

Consequently, older persons with disabilities who do not have relatives risk a future of increasing isolation hence social work has changed to care management approach. They have little opportunities to rapport with service users as it used to be in the past. They are now responsible for care commission while service users have to source and appoint their own personal assistants and this could be a difficulty for many.  Thus, the unanswered questions within the current welfare systems are who will protect the interests of the vulnerable if their parents are no longer able to? Would the local authorities’ social services departments perform dual roles of commissioning and care delivery therefore, what’s going to be the legal and financial implications for authorities?

In anticipation, adults with profound, moderate or severe behaviours who are living independently with their personal assistants may find it difficult in the long-run when they are aged. There are still many potential issues around; choice and control, managing their personal budgets and finances as well as maintaining health and safety around them. It is been observed in practice that supported or assisted housing is not always appropriate for older adults with disabilities, who might need assistance with physical activities for example, mounting stairs or getting in/out of the bath as well as preparing meals and other domestic chores. Conversely, generic homes for the elderly may not have resources or be suitable for the specific needs of people with challenging behaviours. Longevity of disabled people needs to be celebrated owing to the NHS and community care reforms and continuous re-organisations of the industry.