Select Committee · Women and Equalities Committee

Unequal impact? Coronavirus, disability and access to services

Status: Closed Opened: 9 Jun 2020 Closed: 4 Nov 2021 23 recommendations 12 conclusions 2 reports

Unequal impact? Coronavirus, disability and access to services Watch a British Sign Language explainer video for the Unequal impact? Coronavirus, disability and access to services: full Report Watch a British Sign Language explainer video for the Unequal impact? Coronavirus, disability and access to services: interim Report on temporary provisions in the Coronavirus Act. Watch a … Show more

Reports

2 reports
Title HC No. Published Items Response
Fourth report: Unequal impact? Coronavirus, disability and … HC 1050 22 Dec 2020 22 Responded
1st Report - Unequal impact? Coronavirus, disability and ac… HC 386 25 Sep 2020 13 Responded

Recommendations & Conclusions

35 items
1 Recommendation 1st Report - Unequal impact? Coronaviru… Not Addressed

We were unable properly to scrutinise the effects of Care Act easements on disabled people...

We were unable properly to scrutinise the effects of Care Act easements on disabled people because there are no published data, for example on the number and categories of people, or the types of social care services, affected. The Government must demonstrate that it is keeping local authorities’ use of … Read more

Government response AI summary
The government states that Think Local, Act Personal (TLAP) published its findings, but with available data, it was not possible to reach clear conclusions on the specific impact of Care Act easements. The response doesn't commit to publishing additional specific data before future parliamentary reviews, …
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Government Equalities Office
2 Conclusion 1st Report - Unequal impact? Coronaviru… Accepted

Care Act easements are available as a last resort for local authorities, to help them...

Care Act easements are available as a last resort for local authorities, to help them prioritise care and support for people with higher levels of need, should resources become overstretched to a dangerous degree, potentially threatening life. We were concerned about evidence from the Local Government Association that some local … Read more

Government response AI summary
The government reiterates that Care Act easements should only be used when necessary, noting only eight local authorities have used them and none are currently operating under them. Engagement by Chief Social Workers found local authorities followed guidance, and the easements were used appropriately.
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Government Equalities Office
3 Recommendation 1st Report - Unequal impact? Coronaviru… Accepted in Part

We acknowledge that steps have been taken towards greater transparency in the Care Act easement...

We acknowledge that steps have been taken towards greater transparency in the Care Act easement process, notably the publication of an updated list of local authorities using the easements; however, we believe this falls short of a proportionate level of transparency and accountability. The current process is not stringent enough … Read more

Government response AI summary
The government published revised guidance on 1 September, which expects local authorities to record their decision-making process and reasons for using Care Act easements, including demand, mitigation steps, and expected impact. The guidance also notes communication of decisions to stakeholders.
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Government Equalities Office
4 Conclusion 1st Report - Unequal impact? Coronaviru…

The coronavirus pandemic has highlighted and exacerbated pre-existing systemic problems in the social care system,...

The coronavirus pandemic has highlighted and exacerbated pre-existing systemic problems in the social care system, including urgent need for: a more sustainable funding solution; resolution of workforce issues, including low pay, poor progression and high staff turnover; and much closer integration with health services. The pandemic has demonstrated the need … Read more

Government Equalities Office
5 Conclusion 1st Report - Unequal impact? Coronaviru… Deferred

There is broad agreement that the Coronavirus Act’s Care Act easement provisions should be curtailed...

There is broad agreement that the Coronavirus Act’s Care Act easement provisions should be curtailed as soon as possible. They represent a substantial raising of the threshold at which disabled people’s care and support needs must be met. This regression of disabled people’s rights must not be allowed to become … Read more

Government response AI summary
The government stated that the Care Act easement provisions will be kept under regular review, with a decision on suspension to be made by the Secretary of State based on expert advice. They also noted the existing six-monthly parliamentary review process for Coronavirus Act provisions.
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Government Equalities Office
6 Conclusion 1st Report - Unequal impact? Coronaviru… Acknowledged

Had the pandemic been more clearly under control, we would have recommended repeal of the...

Had the pandemic been more clearly under control, we would have recommended repeal of the Care Act easements at the first six-monthly review. However, the current precarious state of the pandemic, combined with the fragility of the social care system, makes repeal a finely balanced judgement call. Throughout the peak … Read more

Government response AI summary
The government states that changes to Care Act duties will be kept under regular review, with suspension decisions based on expert advice and the existing six-monthly review and renewal processes of the Coronavirus Act 2020. They also refer to the Adult Social Care Winter plan …
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Government Equalities Office
7 Recommendation 1st Report - Unequal impact? Coronaviru… Acknowledged

On balance, and subject to our other recommendations to tighten guidance and increase transparency being...

On balance, and subject to our other recommendations to tighten guidance and increase transparency being implemented, we accept that the Care Act easement provisions may need to remain in place over the winter period. The Government should keep the need for the Care Act easement provisions under constant review over … Read more

Government response AI summary
The government states that Care Act easements will be kept under regular review, with suspension decisions based on expert advice and the existing six-monthly review and renewal mechanisms of the Coronavirus Act 2020. It also references the Adult Social Care Winter Plan.
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Government Equalities Office
8 Recommendation 1st Report - Unequal impact? Coronaviru… Accepted

The Coronavirus Act’s emergency changes to the Mental Health Act 1983 were intended for use...

The Coronavirus Act’s emergency changes to the Mental Health Act 1983 were intended for use as a last resort should mental health staff resources be depleted by the pandemic to the extent that people needing assessment or detention in hospital become a risk to themselves or others. These provisions have … Read more

Government response AI summary
The government accepted the recommendation, stating that the Mental Health Act provisions were removed from the Coronavirus Act 2020 on 30 September 2020 and officially repealed in legislation on 8 December 2020.
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Government Equalities Office
9 Recommendation 1st Report - Unequal impact? Coronaviru… Rejected

Assessing needs and securing provision for children and young people meeting the threshold for EHC...

Assessing needs and securing provision for children and young people meeting the threshold for EHC Plans was an extreme challenge for local authorities during the peak of the pandemic earlier this year. Local authorities could not have been expected to meet their EHC Plan duties fully in these circumstances; some … Read more

Government response AI summary
The government states it kept temporary changes to EHC Plan duties under close review and restored full support by July 31st. They do not intend to issue further notices to modify the EHC duty unless evidence changes, thereby implicitly rejecting the need to review processes …
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Government Equalities Office
10 Conclusion 1st Report - Unequal impact? Coronaviru… Not Addressed

The “reasonable endeavours” duty in relation to Education, Health and Care (EHC) Plans is a...

The “reasonable endeavours” duty in relation to Education, Health and Care (EHC) Plans is a nebulous concept, which has been inconsistently interpreted and poorly understood by some local authorities, whose support for children and young people with special educational needs and disabilities fell far short of an acceptable standard after … Read more

Government response AI summary
The government response does not address the conclusion about the 'reasonable endeavours' duty for EHC Plans, instead providing text related to Care Act easements and their review.
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Government Equalities Office
11 Recommendation 1st Report - Unequal impact? Coronaviru… Rejected

If the Secretary of State for Education’s power to invoke the “reasonable endeavours” duty in...

If the Secretary of State for Education’s power to invoke the “reasonable endeavours” duty in relation to EHC Plans is to remain in place, we recommend the Department for Education update its guidance to local authorities to include the factors which must be considered in deciding how the relaxed duty … Read more

Government response AI summary
The government states it does not intend to issue any further notices to modify the EHC plan duty unless evidence changes, effectively rejecting the recommendations to update guidance with minimum standards and examples or to issue notices on a local basis only, as they do …
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Government Equalities Office
12 Recommendation 1st Report - Unequal impact? Coronaviru… Acknowledged

At the time of writing, the Special Educational Needs and Disability (Coronavirus) (Amendment) Regulations 2020,...

At the time of writing, the Special Educational Needs and Disability (Coronavirus) (Amendment) Regulations 2020, which temporarily modify the time limits in relation to EHC assessment and Plans, were due to expire on 25 September. This will add further pressure to local authorities already facing the huge challenge of dealing … Read more

Government response AI summary
The government is working with individual local authorities to support their pandemic response, including managing overdue EHC assessment cases, and identifying good practice. Ofsted and CQC have also been commissioned to undertake interim visits to local areas to understand the pandemic's impact on SEND children …
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Government Equalities Office
13 Recommendation 1st Report - Unequal impact? Coronaviru… Rejected

We consider the section 98 arrangements for six-monthly parliamentary review of temporary Coronavirus Act provisions...

We consider the section 98 arrangements for six-monthly parliamentary review of temporary Coronavirus Act provisions unsatisfactory. The Act prescribes a binary “take all or leave all” vote, which will present MPs with no real choice over provisions which have clear and obvious equality impacts on their disabled constituents and which, … Read more

Government response AI summary
The government rejected the recommendation to arrange separate votes on individual Coronavirus Act provisions, stating that existing mechanisms like the six-monthly review and renewal vote, alongside two-monthly reports, provide sufficient and proportionate parliamentary scrutiny.
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Government Equalities Office
1 Conclusion Fourth report: Unequal impact? Coronavi… Not Addressed

We welcome the Government’s decision to discontinue the Coronavirus Act’s Mental Health Act provisions, which...

We welcome the Government’s decision to discontinue the Coronavirus Act’s Mental Health Act provisions, which potentially relaxed requirements for sectioning, against the grain of overdue and much-needed reforms, and which thankfully proved to be unnecessary in England. We will continue to push for progress towards implementation of our recommendations on … Read more

Government response AI summary
The government response does not address the committee's comments on Mental Health Act, Care Act, or Children and Families Act provisions; instead, it discusses ensuring fair access to food in shops.
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Government Equalities Office
2 Conclusion Fourth report: Unequal impact? Coronavi… Acknowledged

The Government’s focus on people defined as “clinically extremely vulnerable” (CEV) to the virus, while...

The Government’s focus on people defined as “clinically extremely vulnerable” (CEV) to the virus, while rational from a medical perspective, was an inappropriate proxy for the need for support with access to food and had unintended consequences. It was rapidly established and broadly effective for those on the CEV list, … Read more

Government response AI summary
The government states it will ask disabled people about the impact of the coronavirus emergency and, if requested, will include a plan for fair food access in emergencies in the National Strategy for Disabled People.
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Government Equalities Office
3 Recommendation Fourth report: Unequal impact? Coronavi… Acknowledged

We welcome the steps the Equality and Human Rights Commission (EHRC) has taken to emphasise...

We welcome the steps the Equality and Human Rights Commission (EHRC) has taken to emphasise that food retailers’ legal obligations to make reasonable adjustments for disabled people have remained in place throughout the pandemic. We fully endorse its new guidance to food retailers on the steps required to continue to … Read more

Government response AI summary
The government states it has checked its efforts to ensure fair food access for disabled people, made some changes, and will continue to monitor and adjust, but does not commit to publicly stating the importance of reasonable adjustments or promoting EHRC guidance as recommended.
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Government Equalities Office
4 Recommendation Fourth report: Unequal impact? Coronavi… Rejected

We further recommend the Government consider, with disabled people, as part of its consultation on...

We further recommend the Government consider, with disabled people, as part of its consultation on the proposed National Strategy for Disabled People, the steps needed to more effectively adopt a social model of disability in relation to maintaining disabled people’s access to food for the remainder of this pandemic and … Read more

Government response AI summary
The government explicitly rejects the recommendation, stating that existing law is clear enough and a Code of Practice would not improve the situation regarding disabled people's access to food.
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Government Equalities Office
5 Recommendation Fourth report: Unequal impact? Coronavi… Not Addressed

Ministers paused the national shielding programme in August and in September asserted that “we need...

Ministers paused the national shielding programme in August and in September asserted that “we need to get away from the food parcel model”, without offering any evidence of the Government’s assessment of the level of disabled people’s needs for help accessing food, including free food deliveries. Since then, there have … Read more

Government response AI summary
The government's response did not address the recommendation to publish an assessment of disabled people's food access needs or a plan for reviewing local support arrangements; instead, it discussed NHS health checks and mask wearing.
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Government Equalities Office
6 Conclusion Fourth report: Unequal impact? Coronavi… Not Addressed

We will continue to push for greater accountability and transparency while Care Act easements remain...

We will continue to push for greater accountability and transparency while Care Act easements remain available to local authorities and for their swift repeal should the pandemic become more clearly under control before or at the next six-monthly parliamentary review, due in spring 2021. Read more

Government response AI summary
The government's response did not address the committee's conclusion regarding Care Act easements, instead discussing clear face masks and funding for social care, which relates to other recommendations.
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Government Equalities Office
7 Conclusion Fourth report: Unequal impact? Coronavi… Not Addressed

Early in the pandemic, the National Institute for Health and Care Excellence’s (NICE) critical care...

Early in the pandemic, the National Institute for Health and Care Excellence’s (NICE) critical care guidelines and doctors’ inappropriate or blanket use of “Do not attempt resuscitation” (DNAR) notices were potentially discriminatory. While we welcome actions taken swiftly to address disabled people’s concerns, and steps subsequently taken by NICE and … Read more

Government response AI summary
The government's response did not address the committee's conclusion regarding discriminatory practices in DNARs and critical care guidelines, instead discussing social care funding.
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Government Equalities Office
8 Recommendation Fourth report: Unequal impact? Coronavi… Not Addressed

The Equality Act 2010’s Public Sector Equality Duty is intended to ensure public authorities have...

The Equality Act 2010’s Public Sector Equality Duty is intended to ensure public authorities have due regard, including in their decision making, policies and service delivery, to achieving the Act’s objectives, which include the elimination of discrimination against groups of people who share a protected characteristic. The Equality and Human … Read more

Government response AI summary
The government's response did not address the recommendation for it to consent to a statutory Code of Practice on the Public Sector Equality Duty, instead focusing on social care funding.
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Government Equalities Office
9 Recommendation Fourth report: Unequal impact? Coronavi… Not Addressed

Prior to the pandemic, people with learning disabilities experienced health inequalities and faced difficulties accessing...

Prior to the pandemic, people with learning disabilities experienced health inequalities and faced difficulties accessing healthcare and receiving accurate diagnoses and effective treatments. They had increased risks of dying from a range of illnesses, including respiratory infections. These problems have been exacerbated by coronavirus, to which, emerging data suggest, people … Read more

Government response AI summary
The government response does not address the recommendation about setting targets for the reintroduction of annual health checks for people with learning disabilities, instead discussing a new plan for education for children with special educational needs.
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Government Equalities Office
10 Recommendation Fourth report: Unequal impact? Coronavi… Not Addressed

The widespread adoption of continuous facemask wearing in health and social care settings has made...

The widespread adoption of continuous facemask wearing in health and social care settings has made effective communication impossible for patients and healthcare professionals who lip-read, and much more difficult for Deaf people who use British Sign Language and people with disabilities which mean they are more reliant on facial expressions … Read more

Government response AI summary
The government's response discusses funding for special educational needs and disability (SEND) education, not addressing the recommendation regarding clear facemasks or the request for updates on their distribution and assessment of need.
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Government Equalities Office
11 Conclusion Fourth report: Unequal impact? Coronavi… Deferred

We were disappointed with the 2020 Spending Review’s financial settlement of £300 million in additional...

We were disappointed with the 2020 Spending Review’s financial settlement of £300 million in additional grant funding for local authorities’ social care in 2021/22. We believe it falls considerably short of what is required. We agree with the Health and Social Care Committee that an increase in funding for social … Read more

Government response AI summary
The government states it will consider the committee's findings regarding the inadequacy of social care funding when developing the UK National Strategy for Disabled People.
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Government Equalities Office
12 Recommendation Fourth report: Unequal impact? Coronavi… Not Addressed

The Government must bring forward a social care reform package, which includes the whole sector,...

The Government must bring forward a social care reform package, which includes the whole sector, in this financial year. There has been a tendency by successive governments to focus on the problem of rising costs of caring for elderly people, particularly in care homes, and the unfairness of being forced … Read more

Government response AI summary
The government's response discusses optional training for Ministers on communicating with disabled people, completely failing to address the recommendation for a comprehensive social care reform package addressing funding, workforce issues, and integration of services.
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Government Equalities Office
13 Conclusion Fourth report: Unequal impact? Coronavi… Not Addressed

Our interim Report made several recommendations about how the Secretary of State should use his...

Our interim Report made several recommendations about how the Secretary of State should use his powers in relation to duties towards children and young people’s educational, health and care needs, if they are required again during the pandemic. We also made recommendations about the Government’s guidance to local authorities on … Read more

Government response AI summary
The government's response highlights its efforts to provide accessible information about Coronavirus and collaborate with disability organizations, but it does not address the committee's points on the Secretary of State's powers or guidance regarding children and young people's SEND needs.
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Government Equalities Office
14 Recommendation Fourth report: Unequal impact? Coronavi… Not Addressed

Delivering effective support for children and young people with SEND during a public health crisis...

Delivering effective support for children and young people with SEND during a public health crisis was inevitably a massive challenge, to which some local authorities were unable to rise. The pandemic demonstrated and exacerbated a widely acknowledged pre-existing crisis in SEND provision. As set out in our interim Report, many … Read more

Government response AI summary
The government's response discusses British Sign Language provision in the House of Commons, completely failing to address the recommendation on prioritizing and publishing the SEND review.
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Government Equalities Office
15 Conclusion Fourth report: Unequal impact? Coronavi… Acknowledged

We welcome the Government’s educational catch up fund made up of £650 million to be...

We welcome the Government’s educational catch up fund made up of £650 million to be allocated across all schools and £350 million for pupils in more disadvantaged schools to access subsidised small group tutoring and mentoring.

Government response AI summary
The government responded that it would 'think about looking at what happened during the Coronavirus emergency afterwards', a vague statement that did not specifically engage with the committee's welcome of the educational catch-up fund.
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Government Equalities Office
16 Recommendation Fourth report: Unequal impact? Coronavi… Not Addressed

We agree that catch up funding should be weighted towards children who have been “hardest...

We agree that catch up funding should be weighted towards children who have been “hardest hit” by disruption to their education. We know that many children with special educational needs and disabilities (SEND) will be in the hardest hit group; many received little or no support earlier this year. We … Read more

Government response AI summary
The government's response discusses the Equality Hub's work on making coronavirus information accessible, completely failing to address the recommendation for increased and ring-fenced catch-up funding for pupils with SEND or an additional strand of specialist provision.
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Government Equalities Office
17 Recommendation Fourth report: Unequal impact? Coronavi… Acknowledged

There was a clear divergence of opinion between some disabled people and their organisations, who...

There was a clear divergence of opinion between some disabled people and their organisations, who felt excluded and ignored by the Government, and Ministers, who described their engagement with disabled stakeholders during the pandemic as very positive, open and effective. Addressing perceived weaknesses in the Government’s consultation and engagement with … Read more

Government response AI summary
The government acknowledges the importance of disabled people influencing policies and outlines existing engagement methods, stating they will consider this input for the UK National Strategy for Disabled People, but does not commit to new consultation mechanisms.
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Government Equalities Office
18 Recommendation Fourth report: Unequal impact? Coronavi… Rejected

The way the Government has communicated with disabled people has, on occasions, caused confusion and...

The way the Government has communicated with disabled people has, on occasions, caused confusion and compounded already keenly felt anxiety. The chosen method and timing of communications with people categorised as clinically extremely vulnerable, and therefore likely to be living under very considerable stress, has sometimes been poorly thought out, … Read more

Government response AI summary
The government rejects the recommendation, stating that training for Ministers and officials is optional rather than a mandatory requirement.
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Government Equalities Office
19 Recommendation Fourth report: Unequal impact? Coronavi… Acknowledged

The accessibility of the Government’s communications to disabled people during the pandemic has been poor...

The accessibility of the Government’s communications to disabled people during the pandemic has been poor from the outset of lockdown in March. The Government has been far too slow to address concerns, notably about the lack of British Sign Language interpretation of government television briefings. Accessibility should have been baked … Read more

Government response AI summary
The government states its desire for accessible information and its ongoing efforts to provide it in accessible ways, working with disability organizations, but does not commit to fully implementing the specific list of asks from RNID and other charities by the recommended deadline.
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Government Equalities Office
20 Recommendation Fourth report: Unequal impact? Coronavi… Acknowledged

NHS health and publicly funded social care services are legally required, by the Accessible Information...

NHS health and publicly funded social care services are legally required, by the Accessible Information Standard, published under section 250 of the Health and Social Care Act 2012, to provide health and care information to patients and service users in a way they can understand. The aim is to ensure … Read more

Government response AI summary
The government acknowledges the importance of accessible information and states that departments already have legal obligations under other laws, with guidance provided by the Equality Hub, but does not commit to extending the Accessible Information Standard as requested.
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Government Equalities Office
21 Recommendation Fourth report: Unequal impact? Coronavi… Deferred

We agree with organisations representing Deaf British Sign Language users that we should set a...

We agree with organisations representing Deaf British Sign Language users that we should set a good example in the accessibility of our public oral evidence sessions. It is regrettable that we did not provide live BSL interpretation and subtitles via www.parliamentlive.tv, particularly as we were scrutinising the accessibility of the … Read more

Government response AI summary
The government agrees with the recommendation for more British Sign Language provision in Parliament but defers responsibility to the House of Commons and its committees to develop and implement a plan.
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Government Equalities Office
22 Recommendation Fourth report: Unequal impact? Coronavi… Deferred

In the light of starkly disproportionate and tragic data on death rates from coronavirus of...

In the light of starkly disproportionate and tragic data on death rates from coronavirus of disabled people, including shocking figures for deaths of people, including young people, with learning disabilities, there must be a discrete independent inquiry into the causes. It must be a wide-ranging inquiry, including consideration of the … Read more

Government response AI summary
The government defers a decision on establishing an independent inquiry into disproportionate coronavirus death rates among disabled people, stating it will consider the matter after the pandemic is under control.
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Government Equalities Office

Oral evidence sessions

3 sessions
Date Witnesses
2 Sep 2020 Antonia Williams · HM Treasury, Helen Whately MP · Department of Health and Social Care, Justin Tomlinson · Department for Work and Pensions, Martin Woolhead · Department for Environment, Food and Rural Affairs, Sarah Baker · Disability Unit, Vicky Ford · Department of Education, Victoria Prentis · Department for Environment Food and Rural Affairs View ↗
22 Jul 2020 Ali Fidy · Independent Provider of Special Education Advice, Celia Ingham-Clark MBE · NHS England, Charlotte Ramsden · Association of Directors of Children’s Services, Kate Terroni · Care Quality Commission, Professor Gillian Leng CBE · NICE (National Institute for Health and Care Excellence), Simon Williams · Local Government Association View ↗
24 Jun 2020 Edel Harris · Mencap, Fazilet Hadi · Disability Rights UK, Ms Ayla Ozmen · Action on Hearing Loss, Sarah Hughes · Centre for Mental Health View ↗

Who gave evidence

17 witnesses
WitnessOrganisationSessions
Ali Fidy · Chief Executive Independent Provider of Special Education Advice 1
Antonia Williams · Director of Public Services HM Treasury 1
Celia Ingham-Clark MBE · Medical Director for Clinical Effectiveness NHS England 1
Charlotte Ramsden · Vice President Association of Directors of Children’s Services 1
Edel Harris · Chief Executive Mencap 1
Fazilet Hadi · Policy Manager Disability Rights UK 1
Helen Whately MP · Minister of State Department of Health and Social Care 1
Justin Tomlinson · Minister of State (Minister for Disabled People, … Department for Work and Pensions 1
Kate Terroni · Chief Inspector Adult Social Care, Integrated Car… Care Quality Commission 1
Martin Woolhead · Deputy Director for Vulnerabilities Department for Environment, Food and Rural Affairs 1
Ms Ayla Ozmen · Head of Research and Policy Action on Hearing Loss 1
Professor Gillian Leng CBE · Chief Executive NICE (National Institute for Health and Care Excellence) 1
Sarah Baker · Deputy Director Disability Unit 1
Sarah Hughes · Chief Executive Centre for Mental Health 1
Simon Williams · Director of Social Care Improvement Local Government Association 1
Vicky Ford · Parliamentary Under Secretary of State for Childr… Department of Education 1
Victoria Prentis · Parliamentary Under Secretary of State Department for Environment Food and Rural Affairs 1

Correspondence

7 letters
DateDirectionTitle
17 May 2021 Correspondence from the Parliamentary Under-Secretary of State for Children and…
13 Apr 2021 Correspondence from the Minister for Care to the Chair relating to the Temporar…
13 Apr 2021 Correspondence from the Parliamentary Under Secretary of State to the Chair for…
18 Mar 2021 Correspondence to the Minister for Care relating to the Temporary Coronavirus A…
18 Mar 2021 Correspondence to Parliamentary Under Secretary of State for Children and Famil…
23 Feb 2021 Correspondence to the Chair from the Equality and Human Rights Commission relat…
5 Nov 2020 Correspondence from the Minister for Disabled People to the Chair regarding the…