Challenging disability discrimination

Under HCPC standards of conduct, performance and ethics, as a practitioner psychologist you must not discriminate against others (1.5); but you must also 'challenge colleagues if you think that they have discriminated against, or are discriminating against, service users, carers and colleagues' (1.6) (HCPC, 2023).

The UN Convention on the Rights of Persons with Disabilities (UNCRPD, 2006) requires training in disability rights and in reasonable accommodation for health-related professionals, who are obliged to provide care of equal quality and to raise awareness of the rights, dignity, autonomy and needs of persons with disabilities. The UK Equality Act 2010 (EqA) imposes obligations on employers, services and education providers. Two forms of discrimination focus specifically on disability (i.e. discrimination arising from disability and failure to make reasonable adjustments).

Discrimination arising from something in consequence of disability (rather than the disability itself) is reported to be more common than direct disability discrimination. This varies greatly with difficulties, for example with video appointments as a result of cognitive impairment; communicating in exams or interviews as a result of autism; in working full-time as a result of debilitating fatigue; and concentrating in an open office or hot-desking due to noise intolerance arising from reduced attention.

The EqA 'is not a minimalist policy of simply ensuring that some access is available to disabled people; it is, so far as is reasonably practicable, to approximate the access enjoyed by disabled people to that enjoyed by the rest of the public (EHRC, 2011). Whilst equality for most EqA protected characteristics is achieved by equal treatment, different treatment is required for persons with a disability who require adjustments to reduce resultant disadvantage (Select Committee, 2016). As noted, equality of treatment typically maintains relative disability disadvantage and is 'insufficient to afford real equality for people with disability and may even militate against it'. Equity requires differential compensatory adjustments or 'universal design' (Tyerman, 2023).

EqA enforcement relies on legal action, yet few can pursue a claim. In spite of the often huge personal cost, enforcement by regulatory bodies is 'patchy at best' with the EqA commonly 'breached without challenge' and 'what little enforcement is happening is insufficient to tackle the systemic or routine discrimination that too many people experience as a simple fact of life' (Women and Equalities Committee, 2019). Difficulties in securing adjustments is widespread including in psychology (Tyerman, 2023). Whilst professionals report lack of time to review practice unless discrimination concerns arise, this risks complaints, professional sanctions and/or legal claims.

Professional duty, CPD and accreditation

HCPC Standards of Proficiency now includes requirements to: understand equality legislation and apply it to practice (5.2); understand the duty to make reasonable adjustments in practice and be able to make and support reasonable adjustments in their own and others' practice (5.4); and actively challenge barriers, supporting implementation of change wherever possible (5.6) (HCPC, 2023).  

I encourage you to draw on the resources below to enhance your own practice. You would also then be better informed should you witness disability discrimination. For example: a service-user with memory problems falls foul of a missed appointment policy; a service lead declines a referral as a result of another disability; you are shortlisting for a post with an unnecessary specification of the ability to drive; colleagues make negative assumptions about an applicant with disability; reasonable adjustments for staff are refused by a service manager or blocked by colleagues (Tyerman, 2023).

Resources

See www.equitynotjustequality.co.uk for:

• Background summaries.
• Disability Discrimination Awareness Questionnaire (DDAQ).
• Disability Discrimination Practice Checklists (DDPCs) (e.g. for professionals, managers, tutors and assistants).   
• Suggested Action including Recommended Reading: for service providers/users, employers/employees, training courses and students/trainees.

Accessing these resources will hopefully reduce the risk of discrimination, whilst addressing HCPC continuing professional development requirements and responding to the WHO (2022) call for urgent action to promote equity for persons with disability.  

References

EHRC (2011). Equality Act 2010: Services, public functions and associations. Statutory Code of Practice. Equality & Human Rights Commission.

HCPC (2023).  Standards of conduct, performance and ethics. London: Health and Care Commissions Council.

Select Committee (2016). The Equality Act 2010: the impact on disabled people. House of Lords Select Committee on the Equality Act 2010 and Disability.   

Tyerman A (2023). The WHO call for urgent action to advance health equity, set in the context of the UN Convention on the Rights of Persons with Disabilities and Equality Act. Clinical Psychology Forum, 368: 33-42. Leicester: British Psychological Society.  

UNCRPD (2006). United Nations Convention on the Rights of Persons with Disabilities

WHO (2022). Global report on health equity for persons with disabilities. World Health Organization.

Women and Equalities Committee (2019). Enforcing the Equality Act: the law and the role of the EHRC. London: House of Commons.