Published: 05/05/2005, Volume II5, No. 5954 Page 28

Trusts are courting legal action if access to workplaces or services discriminates against disabled people. Some people complain about budget constraints, but having had nine years to meet new requirements there is no excuse, reports Lilian Pritchard

The Disability Discrimination Act 1995 may sound like old news. But the stakes are about to become much higher if trusts fail to provide the right access for disabled people.

The act introduced new measures to end the discrimination that many disabled people face as employees in gaining access to services and as students. The act came into force on 1 October last year, having allowed everyone nine years to undertake an audit and produce a programme of works required and training needs.

It should come as a surprise that anyone has failed to start this process, but the fact that providers such as large NHS trusts, GP practices, dental surgeries and opticians have failed to do anything beggars belief.

Those who have not yet tackled accessibility often blame cost constraints.

Budgeting is a common feature of all our lives, and nowhere more so than for healthcare providers. Changes in funding structures and accountability have made some feel more like accountants, but they have had nine years to allocate money to commission an access audit. This fact will be taken into account by the courts if an action under the act is successful.

The fear of the potential cost of improving accessibility can contribute to delay. The spectre of additional expenses being added to an already difficult budget balancing act is unwelcome.

But there are areas where changes can be made to improve the environment for disabled users without spending any money, such as re-arranging the seating in a waiting area to provide space for a wheelchair user to sit alongside other clients.

A good access audit will provide a client with a range of recommendations that will include management issues as well as capital costs. There may be temporary solutions that are cheap and easy to implement, while costs are added to future capital expenditure budgets to provide a permanent solution.

An access audit will prioritise recommendations and identify the areas that require immediate attention and those which can be planned into the budget for the next few years and should be included in longer-term spending plans. This provides control over expenditure and ensures that money is spent in the most effective way.

There may be recommendations from an access audit that overlap with health and safety or fire regulations and will not require additional expenditure over and above what is already in those budgets.

Fear of facing up to the problems of accessibility will not make them go away.

A planned, well thought-out approach will.

Those who have failed to address the issues should be aware of an investigation being carried out by the Disability Rights Commission into the health inequalities experienced by people with learning disabilities or mental health problems.

There is evidence to suggest that people with learning difficulties and mental health problems get a poor service from some doctors and nurses, with resultant higher mortality rates than the overall population for reasons not related to their impairment. Launched in December 2004, the investigation will put providers - including GPs, health centres and clinics - under scrutiny.

Compliance with the act is one of the investigation's terms of reference. To quote, they want to 'identify measures that successfully facilitate access to quality primary healthcare services for people with learning disabilities and people with mental health problems, and to consider what other measures would be likely to improve such access'.

A copy of each organisation's access audit and the action plan for the implementation of improvements are among the key documents the commission will examine.

There have been nine years to address access issues and there is no more time for procrastination. The findings of DRC research will no doubt influence the scope of future investigations. The Disability Discrimination Act is baring its teeth.

Make sure you are not bitten.

Lilian Pritchard is a self-employed access auditor.

lilian. pritchard@btopenworld. com

Find out more Disability Rights Commission's Equal Treatment: closing the gap www. drc-gb. org/newsroom/ healthinvestigation. asp