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	TX: 22.02.05 - DRS Health Inequalities PRESENTER: JOHN WAITE

	THE ATTACHED TRANSCRIPT WAS TYPED FROM A RECORDING AND NOT COPIED FROM AN ORIGINAL SCRIPT. BECAUSE OF THE RISK OF MISHEARING AND THE DIFFICULTY IN SOME CASES OF IDENTIFYING INDIVIDUAL SPEAKERS, THE 麻豆约拍 CANNOT VOUCH FOR ITS COMPLETE ACCURACY. WAITE People with schizophrenia die, on average, nine years earlier than someone without that condition. But it's not the mental illness that will kill them, it's a combination of factors, the most significant of which is a lack of physical healthcare. And the Disability Rights Commission has just begun an 18 month investigation into how people with mental illness or learning difficulties are treated within the NHS. Take, for example, the story of a young woman with a learning disability, very active and busy person with a full-time job, who went into hospital for a routine operation. In recovery medical staff assumed that her lack of speech was due to her learning disability, when in fact, as her support worker explains, she'd had a stroke. SUPPORT WORKER I went over to the nurses and asked how she was doing and I asked the nurses if it was usual for a patient that had had a major operation not to speak. The nurses said to me: "Can she talk then?" To which I replied to the nurses: "Yes she talks like you and I." At that stage I began to think goodness me I think she's had a stroke. She's getting upset. ACTUALITY It's alright darling. Because I think you were laying in that bed trying to tell me that there was something wrong with you and you couldn't could you and then in the end it - I clicked didn't I. WAITE Or take the case of one man in his 40s with mental illness and who developed palpitations. He made repeated visits to his GP but his symptoms were put down to anxiety, even though his family had a history of heart disease and his own father indeed had died from heart disease aged just 43. His story's taken up by a friend. FRIEND This went on for several months and I think it was only after he actually turned yellow and his face started to swell up that they realised that actually it was more than just panic attacks. He died within about two or three weeks of that admission. As a result of his death we set up a befriending scheme across the area whereby people can actually access a volunteer to go with them to the doctor or to the hospital to actually get their point of view across more effectively. WAITE Well Liz Sayce is head of policy and communications at the Disability Rights Commission and she's with us. How common a problem is this Liz, with physical symptoms being missed or put down to someone's mental condition? SAYCE Well there's a very big problem of people dying younger because they have a mental health problem or a learning disability but it's not the mental health condition or the learning disability that's killing them. It is a range of factors - it can be living in poverty, it can be exercise, diet, but also surveys of people with mental health problems or learning disabilities say they do find that sometimes doctors or nurses will see their mental health condition but just miss the physical condition that may be underlying it. For example, MIND did a survey that found that 50% of those interviewed said that they thought they had been treated unfairly and examples included things like a woman with a breast lump and it wasn't investigated, she was seen to be worrying, over-anxious, because she was known to have anxiety and depression. I think it's important to say that some people say they have fantastic care from their GPs and from practice nurses, it's certainly not all a bleak picture but we really need to spread the good practice and make sure that the service works for everybody fairly. WAITE So what is this 18 month long investigation trying to find out? SAYCE What we really want to do is pinpoint what is working and we've seen already a lot of good examples. Just to take a few. Kensington and Chelsea Primary Care Trust provide annual health checks, so making sure that they really look systematically at the overall health of somebody with a mental health problem. Other people have done outreach work, so for example, training up women with learning disabilities to tell other women why they need cervical screening, why they should go to the GP. So there's a lot of good practice to build on. Training doctors as well and training medical students with that training being provided by people with the mental health condition themselves. WAITE Well Liz, for the moment, thanks very much indeed because listening to that is a doctor, Dr Hugh Lloyd, who's chair of the Royal College of GPs' mental health task group. Do you accept Dr Lloyd that doctors and particularly GPs often and I'm sure often inadvertently discriminate against people with learning disabilities and mental illnesses? LLOYD I'd have to admit that certainly it does occur but I'd also have to say that there are some examples of extremely good practice, as Liz Sayce was saying. I think a lot of the problem is that our system of healthcare is set up very much in favour of people who are articulate, know what they want, can speak their mind clearly and so it doesn't necessarily take account of the problems of people who have a mental illness or learning disability. WAITE So GPs and nurses - I mean health professionals - are going to have to make that extra effort, aren't they, for people who are none of those things? LLOYD Yes, I think that we're very much aware of this problem. I mean last year the Royal College of General Practitioners held a conference on health inequalities associated with mental illness. So I think we're very much aware of the problem and I think we need to address it by being more adaptable, by giving more time, by making our appointment slots more friendly towards people's needs, if they're afraid of waiting in a crowded waiting room or if they need time to explain their problems more clearly. WAITE And what about a deliberate and separate sort of annual check up for people with a mental condition or a learning disability to make sure that you know about their health, even if they're not able to express it to you? LLOYD Well part of our new contract that was introduced last year was a system to try and reward people setting a register of people with mental health problems and giving them an annual check of their health troubles, both mental and physical, and their medication but sadly nothing was provided for people with learning disabilities and I think this is a very great omission that nothing was provided in that contract to reward good care of people with learning disabilities on an annual basis, which has been shown, good evidence to show that it really helps to improve their health. WAITE Dr Hugh Lloyd thank you very much indeed. Liz Sayce, how do people, just briefly, get in touch with you, to feed their experiences to you and to your investigation? SAYCE Yes we really want to hear from people with learning disabilities, people with mental health problems and also from GPs, practice nurses - anybody involved in health service delivery, what works, what are the barriers, what will really work to improve healthcare for all? And all that information is on the Disability Rights Commission website and you can get it through the 麻豆约拍 website. WAITE You can indeed, you can get all the information on how to do what Liz just said from our website - bbc.co.uk/radio4/youandyours. Back to the Transcripts homepage Back to the You and Yours homepage The 麻豆约拍 is not responsible for external websites

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