This approach to health and social care is widely accepted internationally as a best practice approach, which is rooted in the principles of the United Nations Convention on the Rights of Persons with Disabilities and protected in the United Kingdom by the Human Rights Act. In its report Human Rights and Health and Social Care, the British Institute of Human Rights states that:
“At the core of human rights, are the values of fairness, equality, dignity, respect and autonomy, values which are also at the core of quality health and social care.”
Some of the reasons why a rights-based approach to health and social care is considered to be best practice are that it:
- supports health and social care staff in meeting their professional ethical obligations;
- improves both the quality and effectiveness of health and social care, improves decision-making processes and enhances the health and well-being of all service users;
- sends a message to society that people with disabilities are first and foremost equal persons with human rights;
- leads to more meaningful participation and engagement of people with disabilities in the design and delivery of health and social care services.
- helps health and social care staff to better understand the range of societal and cultural factors that impact upon an individual’s health and well-being; and
- reduces complaints and litigation.
However, despite these benefits and the law underpinning this approach, people with disabilities continue to experience barriers in accessing health and social care and can experience human rights issues including:
- inhuman, degrading or humiliating treatment;
- under-diagnosis;
- questions over their capacity to make decisions;
- lack of accessible information to make informed decisions;
- stigma in relation to sexual and reproductive health;
- difficulties in maintaining family life;
- poor physical access and inaccessible communications systems; and
- institutionalised care with limited funding for independent living and community care.
Recent media reports have also highlighted the issues in making a rights-based approach to health and social care a reality including the Dilnott Report on the funding of care and support and BBC Panorama’s documentary on abuse in a residential hospital. Human rights issues in health and social care have also been exacerbated by the current pressure on resources faced by health authorities, as seen in the case of London Borough of Hillingdon v Steven and Mark Neary.
So how do you make a rights-based approach to disability in health and social care a reality?
A rights-based approach towards disability is not necessarily about introducing anything new, but about improving and building upon what is already in place:
- A health and social care organisation could carry out a review of their policies to ensure they comply with the principles of the United Nations Convention on the Rights of Persons with Disabilities. Such a policy review should identify who will be affected by the policy, which human rights are relevant, who in the organization is responsible and how will these rights be protected and promoted.
- Staff should be trained to understand the implications of the Human Rights Act on health and social care, the rights of people with disabilities and how to practically apply a rights-based approach in their role. Professional bodies should also teach core human rights in all training courses.
- Health and social care organisations should develop a communications strategy to ensure that staff are aware of the commitment to human rights, recognise people with disabilities as holders of rights and understand the implications of a rights-based approach.
- Every person with a disability should be able to access information on services in a format that can be easily used and understood by the individual. Effective communication between health and social care staff and the individual will also facilitate more informed decision making
- The physical accessibility of health and social care buildings and services for people with disabilities should be reviewed and improved. People with disabilities should be included in all consultations.
- Health and social care staff should presume that a person with a disability has the capacity to make decisions and the person should be supported in doing so. Advocacy should be available if needed, to support people with disabilities to identify, quantify and present their needs, priorities and concerns to others, particularly service providers, in a way that is accessible and sensitive to the individual.
Let’s not forget there are many good examples of best practice in applying this approach. There should also be avenues for health and social care organisations to share good practice. Two presentations by the Southern Health and Social Care Trust and the Northern Health and Social Care Trust demonstrated this rights-based approach at the ‘Know the Rights Approach Seminar’ organised by Disability Action’s Centre on Human Rights in June of this year.
You can find out more about implementing a rights based approach to health and social care on a new website for health and social care professionals www.disabilityhealthtoolkit.org