Intended for healthcare professionals

Letters Care in learning disabilities

People with disabilities are not equal from the start

BMJ 2009; 338 doi: (Published 14 April 2009) Cite this as: BMJ 2009;338:b1497
  1. Joyce M Carter, consultant in public health medicine1
  1. 1Liverpool L1 4AZ
  1. joyce.carter{at}

    The ombudsman’s report on complaints about the care of six people with learning disabilities who died while in hospital1 says that their treatment was “a shocking indictment of services which profess to value individuals and to personalise services according to individual need.” It also says that they were treated “less favourably than others, resulting in prolonged suffering and inappropriate care.” Shocking, indeed.

    Recently, the BMJ published an editorial and research papers about screening for Down’s syndrome.2 3 4 They discuss various methods of screening pregnant women and describe the difficulties in deciding whom should be offered what sort of screening and how to make use of the results.

    The introduction to a recent strategy document signed by six secretaries of state begins: “People with learning disabilities are entitled to the same aspirations and life chances as other people.”5 But how can people with learning disabilities get the same life chances as other people when the NHS provides a service to seek out some of them before birth and the law allows them to be aborted up to term?

    The Disability Discrimination Act 2005 requires public authorities to promote positive attitudes towards disabled people. The NHS is a public authority so, arguably, in providing a prenatal screening service for Down’s syndrome it is not promoting positive attitudes towards disabled people. Therefore, should we be surprised that there is evidence that the NHS treats patients with Down’s syndrome “less favourably than others”?1


    Cite this as: BMJ 2009;338:b1497


    • Competing interests: None declared.


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