Breaking the cycle: addressing health inequalities for people with learning disabilities
Health inequalities are a significant concern for marginalised and disadvantaged groups living in Northern Ireland. These disparities result from years of chronic underfunding, systemic failures, and the enduring legacy of conflict. The compounded effects of these challenges have left vulnerable communities struggling to access equitable healthcare and achieve positive health outcomes.
Health inequalities disproportionately affect people with learning disabilities, leading to significantly poorer health outcomes and, in many cases, premature death. Research shows that individuals with learning disabilities die, on average, 10 to 20 years earlier than the general population, often from preventable or treatable conditions. These disparities are driven by barriers in accessing healthcare, systemic underfunding, and a lack of tailored support services.
Recent findings from Mencap’s Healthier Me survey further illustrate the everyday challenges faced by people with learning disabilities when trying to access healthcare. According to a Times article published in October 2024, long waiting times, inadequate communication, and limited specialist provision contribute to worsening health outcomes. At the same time, funding cuts, including the recent announcement of the loss of Department of Health core grant funding for over 230 organisations, is making an already difficult situation even worse.
There is an urgent need to address these inequalities, not only by improving healthcare access but housing, education, employment and in particular, post–19 provision – transition from children to adult services. Services and provision in Northern Ireland differ significantly from the rest of the UK and are not fit for purpose.
The Reality of Health Inequalities
Research has consistently shown that people with learning disabilities face higher rates of preventable illness. People with learning disabilities are far more likely to experience health conditions such as obesity, diabetes, and poor physical health, largely due to difficulties in accessing routine healthcare and health promotion services. We are aware that in some areas, primary care providers and GPs are refusing to conduct call–outs or home visits for individuals with complex medical needs who cannot attend a GP surgery due to their learning disability. This presents a significant barrier to accessing necessary healthcare for these vulnerable individuals.
Most of these conditions are either preventable or manageable, with the right support and intervention, but because of structural barriers in the healthcare system people with learning disabilities often receive delayed or inadequate care, leading to unnecessary suffering and premature death.
Mencap’s recent Healthier Me survey captured the real–life experiences of people with learning disabilities when support to lead happier and healthier lives. Common themes included:
- Healthcare professionals lacking awareness of how to communicate with or support patients with learning disabilities.
- Failure to make reasonable adjustments, such as providing easy–read information or allowing extra time for consultations.
- Lack of inclusion in social settings including physical activity and engagement
The recent loss of Department of Health core grant funding is yet another blow to an already overstretched sector. This funding has historically been used to support community–based services, advocacy, and specialist initiatives designed to reduce inequalities.
Cuts in funding mean:
- Fewer specialist community and voluntary organisations, who play a crucial role in lobbying and advocating for equal access to healthcare.
- Reduced community support programs, which help people with learning disabilities manage their health and well–being.
- Increased reliance on families and carers, who often struggle to navigate a healthcare system that is not designed to accommodate their needs.Without sustained investment, healthcare inequalities will only widen, leading to more preventable deaths and poorer quality of life for people with learning disabilities.
Another inequality for people with learning disabilities in Northern Ireland is the lack of a clear, structured post–19 provision – compared to the rest of the UK. As a result, this may have a significant impact on the health and wellbeing of someone with a learning disability.
In England, Scotland, and Wales, there are statutory frameworks outlining education, training, and social care support for young people with learning disabilities after they turn 19. While these systems are not perfect, they at least provide a legal basis for continued support.
In Northern Ireland, however, post–19 provision is fragmented and inconsistent. Instead of a standardised system with cross–departmental engagement, people must try to navigate a complex process, where services vary depending on where they live. Key issues include:
- Limited access to further education and employment opportunities. Many young people with learning disabilities find themselves with no meaningful activities or training once they leave school.
- A postcode lottery for services. Some areas have relatively good or excellent provision, while others offer little to no structured support.
- Lack of clear transition planning. Families often feel abandoned once their child turns 19, as they struggle to secure continued services.
This inequality not only affects the health and well–being of individuals with learning disabilities but also places additional stress on families, who often must step in to provide care due to a lack of formal support.
We need our government to take urgent action to address the systemic health inequalities faced by people with learning disabilities. This includes:
- Restoring and increasing funding for specialist services and advocacy programs to ensure equal access to healthcare.
- Mandating learning disability training for ALL healthcare professionals to prevent diagnostic overshadowing and ensure reasonable adjustments.
- Reducing waiting times by prioritising people with learning disabilities for timely appointments and specialist care.
- Standardising post–19 provision in Northern Ireland to ensure young people with learning disabilities have access to education, training, and social care, just as they do in other parts of the UK.
These actions are essential to closing the shocking gap in life expectancy and ensuring that people with learning disabilities receive the care and support they deserve. Government must act now to make healthcare truly equitable for all and allow people with learning disabilities to live happy, healthy and fulfilled lives.
Karen Gilgunn is Senior Communications, Marketing and Influencing Lead for Mencap in Northern Ireland.
