Can health services improve to ensure accessible healthcare for all citizens?

As we have seen during Week 1, how people with intellectual disabilities experience health services can be very different to their non-disabled peers. While they are not alone in experiencing barriers to healthcare, by improving their access, we can improve care for many other groups that experience exclusion as well.

In Week 1, we looked at things that all healthcare professionals can do to improve access, such as:

• Identifying and acknowledging that there are barriers
• Challenging negative attitudes to intellectual disability
• Consulting with healthcare experts in the field of intellectual disability
• Including people with intellectual disabilities themselves in the management of their own healthcare

While these are all actions that everyone within the health services can take, it is also important to build more knowledge in health services about people with intellectual disabilities.

Developing career pathways for expertise

In many countries, healthcare is about providing high-quality expert services. In many specialist areas, such as diabetes or cancer, centres of excellence have evolved as a way to provide coordinated care. Clinical leadership pathways have been developed to provide specialised expertise across all different levels of healthcare.

Similarly, the area of intellectual disability also benefits from a recognisable career ladder relating to clinical leadership. This could provide sufficient expertise within this specialist field so that people with intellectual disabilities and their families may be assured of expert care.

Education and policy

Intellectual disability is not universally included in healthcare undergraduate programmes. These programmes need to position intellectual disability as a core and mandatory component of all healthcare and administrative programmes. This will provide all healthcare professionals the opportunities to begin building a foundation of knowledge in the area of intellectual disability.

This training also needs to address stigma, labelling, stereotyping and discrimination. Better training also needs to be available and valued as part of continuing professional development and provide a variety of learning opportunities to all healthcare staff on a continual basis. This investment in education should be accompanied by changes in the health services and that regulatory bodies recognise it as a mandatory educational requirement.

Changing the Health Services

Any changes in the health services are often driven by policy. As we have seen in Week 1, policy is different depending on the country or region in which you live. For those countries that have ratified the UNCRPD, however, there is a commitment to provide ‘the same range, quality and standard of free or affordable health care and programmes as provided to other persons’ and to provide them ‘as close as possible to people’s own communities’.

For many countries, in order to achieve the rights within the UNCRPD, there will need to be changes in how people with intellectual disabilities are treated within the system. There will also need to be more healthcare staff with the kind of knowledge and skills that are covered in this course.

Reflection

• What training do healthcare professionals in your area receive in intellectual disability?
• Are there Continuous Professional Development opportunities on intellectual disability available in your area?
• What can you do to improve some of the issues addressed in this article?