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Baroness Hollis of Heigham moved Amendment No. 1:

The noble Baroness said: My Lords, in moving Amendment No. 1, I shall address also Amendments Nos. 2, 3 and 21. The amendments fulfil the promise which I made on Report to ensure that our policy intention is fully realised in respect of public office holders. Debate in the House about public office holders prompted me to revisit the exact drafting of Clause 2. In the process, I realised that although the clause covered appointments, it did not necessarily provide full coverage of duties.

We had intended to protect public office holders not already covered by the DDA, or elsewhere in the Bill, through the provisions in Clause 2 relating to public functions. However, as I have said, the Bill covered only the function of appointing an office holder. The treatment of an office holder once in post was not covered, nor were the arrangements of a public authority for holding elections for some office holders such as parent governors of schools. The amendment would put those omissions right.

New Section 21B(8) of the 1995 Act will be amended to ensure that a public authority's acts vis-à-vis an office holder in post are covered. The amendment will achieve that by ensuring that posts not already covered under Sections 4C to 4F of the DDA will come under new Section 21B through Clause 2. The intended subsection (9) resolves the issue of protection of office holders who are elected.

I repeat that the inserted subsection (9) will ensure that a public authority cannot discriminate against an elected disabled office holder once he or she is in post. The process of election remains not covered. MPs, Peers, MSPs and Members of the Welsh Assembly are excluded. Our revised or supplementary approach to public office holders is warmly supported by the DRC. I am confident that it will have the full support of your Lordships. I beg to move.

Lord Skelmersdale: My Lords, the House will be extremely grateful to the Minister for following up the rather thorny question of who in public office will be protected from discrimination under the DDA. As drafted, the Bill did not make that at all clear. As the Minister told us on Report, she concluded that public office holders would not be covered as comprehensively as the Government had intended, as the Bill did not cover a person holding a post, only the appointment to that post.

The amendments will correct the oversight and are yet another example, should one be needed, of how your Lordships' House, in reviewing the legislation presented to it, corrects a flaw and moves on. Long may it continue to do so, and long may it be allowed to continue to do so.

On Question, amendment agreed to.
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Baroness Hollis of Heigham moved Amendments Nos. 2 and 3:

"(9) Subsection (1) does apply in relation to a public authority's functions with respect to a person as candidate or prospective candidate for election to, and in relation to a public authority's functions with respect to a person as elected holder of, an office or post if—
(a) the office or post is not membership of a House of Parliament, the Scottish Parliament, the National Assembly for Wales or an authority mentioned in section 15A(1);
(b) none of the conditions specified in section 4C(3) is satisfied in relation to the office or post; and
(c) sections 4D and 4E would apply in relation to an appointment to the office or post if—
(i) any of those conditions was satisfied, and
(ii) section 4F(1) (but not section 4C(5)) was omitted.
(10) Subsections (8) and (9)—
(a) shall not be taken to prejudice the generality of subsection (1), but
(b) are subject to section 21C(5)."

On Question, amendments agreed to.

Clause 3 [Duties of public authorities]:

Lord Rix moved Amendment No. 4:

"( ) In determining their duty under subsection (1), public authorities which provide health care services shall pay particular attention to the need to eliminate discrimination against persons with a learning disability."

The noble Lord said: My Lords, the amendment follows on from a recent exchange of letters between the Minister and me. It is an opportunity for her to put on the record the Government's desire to tackle the inequalities faced by people with a learning disability when trying to get access to healthcare. The Minister will know that research shows that preventable mortality for people with a learning disability is four times that of the population at large.

In my recent letter to the Minister, I summarised the case of Victoria, who has severe and profound learning disabilities. Victoria is one of many people who featured in Mencap's Treat me right! report, which highlighted the often appalling treatment faced by many people with a learning disability when trying to access healthcare services. Victoria's mother overheard a doctor saying about her daughter, "That's not coming into my room. It will destroy the equipment". For so many people with a learning disability, that is the terrible and shocking reality.

There is no doubt that the NHS systematically fails people with a learning disability. The Disability Rights Commission is, of course, listening carefully to this short debate. I hope that the Minister's response will
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give it as clear a steer as possible, as it writes its healthcare codes of practice. The issue must be an urgent priority. The current inequalities in healthcare outcomes for people with a learning disability must be tackled. I beg to move.

Lord Skelmersdale: My Lords, the noble Lord, Lord Rix, has made an important point, in highlighting this problem. In this area, I take his words—I think that we all do—as gospel.

With regard to the duty of public authorities, there is a clear need for employees to be trained to recognise and work with those with learning difficulties and to have the care, consideration and patience to do so. Clearly, that was not the case in the example that the noble Lord just gave.

I question the amendment on a technical point: the definition of "learning disability". One wonders whether it includes those with mild dyslexia or only those at the Asperger's end of the scale.

Be that as it may, the noble Baroness may well tell us that the necessity for a public authority to pay particular attention to the need to eliminate discrimination in its health service provision to those with a learning disability is already covered. The original Disability Discrimination Act contained provisions to ensure that adequate safeguards were in place to prevent discrimination against disabled people in the provision of hospital services, and I hope that the Minister will assure us that health services provided by public authorities are also covered by Clause 3. As I understand it, the powers to impose a duty regarding local health services and learning disabilities is covered by new Section 49D, although that duty is not spelt out in the Bill.

Will the noble Baroness assure us that the power in new Section 49D will be used to ensure that public authorities will, in running their health services, social services and other services, take into account not only those with learning disabilities but also all disabilities to be covered by this Bill?

Lord Addington: My Lords, I speak briefly to emphasise the point made by the noble Lord, Lord Skelmersdale. I hope that the Minister will be able to tell us that such things are already covered. If any group is excluded because it is deemed to be slightly too difficult or inconvenient, that will reveal a hole in the Bill that I had not thought to be there. We need an assurance from the Minister that the amendment is not needed.

If groups of people with a different aspect of disability come into play and there is no wheelchair to be seen, people panic. I hope that the Government are sure that they have mended this potential hole in the road.

Baroness Hollis of Heigham: My Lords, I hope that I am able to give the assurances asked of me and that, therefore, the noble Lord, Lord Rix—I will call him my noble friend— will withdraw his amendment. We
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all pay tribute to his work and I think he was anxious to have a government statement in Hansard today, so that the situation is unambiguous.

I fully agree with your Lordships that the purpose of the Bill and of this duty are to make a difference to the lives of disabled people, whether they have a learning disability or any other impairment. It is a sad fact of life that learning disabled people still experience institutional discrimination when they interact with public services. The health sector is no different.

For example, one study that I was reading over the weekend has found that learning disabled people are 58 times more likely to die before the age of 50 than non-disabled people. The statistic is due not to their impairments but to their access to suitable health care. It also gave the example that although 75 per cent of non-learning disabled women take up mammography, only about 25 per cent of learning disabled people do so.

Such figures illustrate why it is so important that the duty to promote equality is implemented effectively in the health sector as in other parts of public life. It is precisely this type of discrimination that the Bill seeks to address.

The Government will be working closely with the DRC to ensure that the duty is implemented effectively. As your Lordships will be aware, we published draft regulations recently that could be made under powers granted by Clause 3. Our consultation document, Delivering Equality for Disabled People, made it clear that the duties will be applied widely across the health sector.

The DRC has already published its draft code of practice on the duty. I am glad that the consultation on the code will include events particularly focused on health issues. I am also sure that the DRC's formal investigation into the health inequalities experienced by learning disabled people and people experiencing mental distress will also be fruitful in informing the development of guidance and best practice.

I hope therefore that your Lordships will accept that we are meeting the spirit of what the noble Lord, Lord Rix, asks for and that he will withdraw his amendment.

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