Opinion | Thursday, 16th September 2021
We urgently need to address regional inequalities experienced by disabled people
Disabled adults in the north receive less support than disabled people elsewhere in England, and the pandemic has made the divide bigger
By Professor Chris Hatton from the Department of Social Care and Social Work at Manchester Metropolitan University
Social care policy in England has been under the spotlight in recent weeks. But for many of us familiar with the problems faced by people needing social care support, government plans had nothing to say and nothing to offer. After promising reform, the plans set out by the government skirted over what social care should actually be for and how it should be delivered. In particular, it lacked detail on what will be done to support disabled people across the country to live the lives they want.
There are systemic issues in social care that need addressing, and the regional disparities in support for disabled people is one of them. The recent Time To Act report from the Institute for Public Policy Research (IPPR) North, supported by Manchester Metropolitan University’s Research England Strength in Places Fund, puts this into sharp focus.
North-south divide
The report documents the wide-ranging inequalities experienced by disabled adults of working age in the north of England, where there are proportionally more disabled people. Although there are some gaps in the information available, it’s clear there are north-south inequalities in welfare, unemployment, health and social care for disabled people.
Compared to disabled people in other parts of England, those in the north are less likely to be in paid employment, with the disability pay gap (after London) highest in the north east. Long-term social care spending for working age adults is over £2,500 lower per person in the north compared to England as a whole. This is partly a function of changes to how local authorities are funded which favour wealthier areas with higher council tax and business rate revenue.
Other work has documented wide-ranging north-south inequalities for people generally across education, transport, housing and health services, although public health research rarely mentions younger disabled people. The lack of available information about regional variations in disabled people’s access to these vital elements of infrastructure makes disabled people even less visible in broader ‘levelling up’ debates.
Impact of COVID-19
The COVID-19 pandemic has only served to widen these existing inequalities. Disabled people in the north east in particular have reported lower levels of happiness, life satisfaction and feeling that life was worthwhile during the pandemic compared to disabled people in other parts of England, with the gap in wellbeing between disabled and non-disabled people also highest in the north east. People in the north were also more likely to be on the shielded patient list during the COVID-19 pandemic than people elsewhere in England.
More generally, we know that compared to people in the rest of England, people in the north have experienced higher rates of COVID-19 infection, have been more likely to die from COVID-19 (including people in care homes), and have been subject to longer periods of severe COVID-19 social restrictions. Disabled people across all adult age groups have been much more likely than non-disabled people to die from COVID-19. Across the UK, working age disabled people have experienced the withdrawal of social care and health service support and a lack of effective action to support people through the pandemic.
Social care policy
So, what of the social care changes announced recently? Most obviously, most of the funds raised by the proposed increase in national insurance are earmarked for the NHS rather than for social care. In fact, due to lower average incomes in the north of England, national insurance rises will hit people in the north harder than people in the south.
Even worse, the changes announced are fixated on the personal finances of a relatively restricted number of older people and say nothing about what social care should be for, and how social care should work to support disabled people of all ages to live the lives people want.
The IPPR North report makes clear that for disabled people in the north of England, the north-south divide is pervasive and getting worse. At national, regional, metro mayor and local authority levels, there is much to do.
For example, are levelling up plans going to include issues such as sufficient and accessible public transport, as highlighted by Greater Manchester Mayor Andy Burnham, and housing strategies routinely embodying the principles of universal design? Can local authority community wealth building approaches, such as the ‘Preston model’, be applied to social care support so that social care funding can be invested locally and made to work for local disabled people, rather than that funding disappearing to distant private equity companies?
For these north-south injustices experienced by disabled people to be truly addressed, disabled people need to be visible, and need to be a meaningful part of conversations right from the start. The IPPR North report is an important part of this journey, and I hope that more commitment from government quickly follows.
