Fight for your right to services in budget-cut Britain
As the spending axe falls, Neasa MacErlean examines ways specialist health charities and individuals can beat the system
Saturday 18 December 2010
Frank, a 61-year-old with Down's Syndrome, developed cataracts so badly that he could barely see. He was repeatedly promised an operation but repeatedly made to wait. When, however, he and specialists at the Down's Syndrome Association, started mentioning his rights under human rights legislation, he got his operation within a matter of days.
The example of Frank (not his real name) is currently a rare one but he could turn out to be a legal pioneer followed by thousands and thousands of others. Faced with cuts averaging 4.4 per cent in local government spending and a National Health Service on a flat budget, many of us are going to find ourselves turned down for services that we used to take for granted.
"There might well be a lot less money available," says Frances Woodhead, of Eversheds solicitors.
"The cuts are looming," says a Citizens Advice spokeswoman. "It's a bit of a phoney war now."
The crucial time is April next year when the main effects of government cutbacks make themselves felt across the public sector.
But the Human Rights Act injects a new set of criteria into the debate.
Under this law, public bodies have a "cast-iron legal duty", according to Katie Ghose, former director of the British Institute of Human Rights, to protect people from inhumane and degrading treatment. Even if the Government ends up dismantling the Act, as the Conservatives have proposed, the UK would still have to comply with international human rights law and with the obligations it includes.
Susannah Seyman, of the Down's Syndrome Association, worked with the British Institute of Human Rights to apply the law to help her clients. Most days she is involved in writing at least one letter to a local authority, citing either Article 3 (obligations to protect against inhumane or degrading treatment) or Article 8 (rights to a family life). These two articles, when translated to everyday living, mean such things as not leaving someone needy alone all day or requiring a housing association to let a family move home so that their daughter could participate fully in her school.
"We remind the local authorities which articles of the Human Rights Act they may be in breach of," says Seyman. "This is going to be extremely powerful in the face of all the cuts that are on their way."
She also makes an argument that many others will put forward, that preventing problems or giving swift treatment is often far less costly than letting issues deteriorate.
Speaking of Frank, she says: "They were actually making him very expensive. He was beginning to develop depression. By not providing a minimum of support, authorities can make problems very expensive."
Julie, a 46-year old who competes at international level in orienteering, had a brain haemorrhage and then a stroke in the last four years which left her without speech. But she learnt to speak again by getting to see an NHS speech therapist. Now she is back competing and also working three days a week at her old job in the National Map Centre. But this is largely only possible because she can speak very well again.
"Speech was the most important thing," she says. In the days when she was without it, she was "frustrated and angry ... it was really awful."
But there are only about 5,000 speech and language therapists in the country who deal with adults and Kamini Gadhok, chief executive of the Royal College for Speech and Language Therapists, is worried that their resources and availability to the public are being cut. "Local funders are retreating back into their silos," she says.
Speech therapy is the kind of area which straddles education and health and so it attracts small amounts of funding from different bodies. Gadhok is currently dealing with a situation where a speech therapy service is being funded by three sources, each of which is being cut back. "You are being hit three times, rather than once," she said.
Speech therapy is exactly the kind of area which could lose out in budget cuts. Providing quality of life, rather than saving lives, it is often not seen as crucial. Being preventative (especially as used to resolve early problems for children), it could be seen as being less necessary than more dramatic and better known areas of medical treatment.
But the Royal College is fighting against this, linking its campaign, Giving Voice, to the film The King's Speech which received seven Golden Globe nominations this week and is seen as a front-runner for the Oscars. Colin Firth, nominated for a Golden Globe, plays Elizabeth II's father, George VI, a stammerer who overcame his disability with the help of a therapist and was able to deliver crucial morale-boosting wartime speeches.
Even before the major cuts take place, speech therapy is a service which many doctors do not really understand and where major misdiagnoses can take place. There have been cases of people being threatened with being sent into a long-term care home who turned out to have aphasia, a condition which disconnects the ability to speak from thought processes.
Aphasia, the condition which Julie had, can be treated successfully and produce major improvements in months. People who want to see a therapist can self-refer by contacting their local hospital and asking for the speech therapy team.
With a major review of the NHS announced on Wednesday, there is concern that the situation will become more confusing as cuts coincide with further reorganisation. Sarah Lambert of the National Autistic Society is concerned that an overhaul of the special needs system will leave many parents of autistic children confused about getting education and other services for them. "We are worried that it is going to get harder," she says.
The National Autistic Society is taking steps that many other organisations will copy. "We are looking at how we can do more to enable local campaigners to become local lobbyists," she says. This week's Localism Bill shows just how decision making is moving from London to local areas. While many campaigners – including the recent student protesters – have focused their attention on Westminster, in future ordinary people will start lobbying more at their town hall.
Ways to challenge the cutbacks
1. Take advantage of free assistance offered by Citizens Advice Bureaux in the completion of forms. Everyone can benefit from help filling in forms so that they are error free.
2. Get help if you have a health condition or disability. "When people self-assess, they often overstate their ability," says Neil Duncan-Jordan of the National Pensioners Convention.
3. Put your concerns in writing, keep copies and use the Human Rights Act (see main article) if you feel you are being fobbed off.
4. Watch out for existing services being cut before the next financial year in April. Councils may decide to chop discretionary spending such as that spent on sports centres and therapeutic leisure services for particular groups.
5. Monitor the providers of services that you use. Local authorities will have to go through consultation processes on many cuts and these should be flagged up on their websites. Also consult local health scrutiny committees.
6. Start lobbying against plans to cut services as early as possible.
7. Complain or appeal if you think you have been unfairly turned down. Use the complaints procedures of local authorities and the ombudsman.
8. Try to work with local action groups who often have technical expertise, useful contacts, knowledge and skills.
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