Disability equality plan

5. Our Priorities

While the 5 ambitions set out in A Fairer Scotland for Disabled people continue to be relevant, given the acute challenges facing disabled people now we are taking forward three priority areas for this phase of the plan:

1. Providing financial support for disabled households.

2. Supporting disabled people’s full inclusion and participation in their lives, communities, and Scotland.

3. Improving Mental Health.

5.1 Financial Support for disabled households

Disabled people continue to be disproportionately impacted by the cost-of-living crisis in the UK today. Disabled people already face higher living costs compared to non-disabled people, meaning many are being pushed into deepening poverty. In 2020-23, the poverty rate was higher for individuals in households with a disabled person, when not including disability-related benefits in the household income.

After housing costs, the poverty rate was 28% (660,000 people each year) for people living within a household with a disabled person, compared to 17% (510,000 people) for those without (Poverty and Income Inequality in Scotland 2020-2023).

Given these levels of poverty, disabled people are at greater risk of food insecurity, with research from the Trussell Trust in 2024 finding that 7 in 10 (69%) people referred to foodbanks in the Trussell Trust network are disabled. Furthermore, an estimated 41,428 households with a disabled person have gone without a warm meal so that they could run or charge essential medical equipment.

On top of all the challenges which come from living in poverty, there are significant barriers that prevent disabled people from accessing support and services that have the potential to ease financial difficulties or improve health and wellbeing.

While we know work does not represent a route out of poverty for all disabled people, disabled people face greater barriers to entering, remaining, and progressing in employment. These barriers include inaccessible workplaces, additional costs in order to access work (including transport, social care, etc), and bias and discrimination in recruitment and in the workplace. We also know that disabled people are more likely to be employed in insecure, low income work, with 27% of disabled workers being in severely insecure work compared with 19% of non-disabled workers from April-June 2023 (The Disability Gap: Insecure work in the UK, 2023) The latest available full year data shows the Disability Employment Gap was 30.2 percentage points in 2023 – the lowest it has been since our baseline year in 2016 when it was 37.4 percentage points.

The reasons for disabled people’s poverty are complex and interrelated, including barriers to work, lower pay when in work, and additional living costs. The UN Committee on the rights of Persons with Disabilities has also found austerity measures to cause gross and systemic violations of disabled people’s human rights, declaring disabled people’s lives a “human catastrophe”.

We must also acknowledge the impact of significant cuts in public sector spending across the whole of the UK due to austerity.

Research by the Disability Benefits Consortium found that on average disabled people have lost benefit payments of around £1200 per year, with those who have the highest support needs losing £2100 in benefits income. The UK Government needs to take urgent action to improve the adequacy of Universal Credit.

The devolution settlement limits what the Scottish Government has to spend to address these significant challenges. As a government we are operating in exceptionally challenging financial circumstances, within strict budgetary constraints. However, we continue to do what we can within this context. For social security, our total investment is £1.1bn more than the Scottish Government receives from the UK Government for social security, and includes an additional investment of over £325m for disability related payments.

Despite fixed budgets and limited powers, we have transformed social security provision in Scotland, establishing a radically different system built on dignity, fairness, and respect. We have introduced 14 benefits, half of which are only available in Scotland. The increase in benefits expenditure is our single biggest increase in the 2024-25 budget, and is over £850m more compared to the 2023-24 budget. This investment is an essential part of our commitment to create a Scotland in which disabled people can live full and independent lives.

Actions

We have identified several actions that can be taken forward as part of this phase of the Disability Equality Plan, focused on:

• Financial support.
• Access to support and services.
• Cash-first support.
• Digital inclusion.
• Energy costs for disabled people.

11. To strengthen the accessibility of the social security system in Scotland for disabled people, we will continue to fund the Social Security Independent Advocacy Service and will conduct an evaluation of the Service to ensure it is reaching its maximum potential.

12. Our benefit take-up work will consider developing ways to measure estimated take-up rates for disability benefits. Developing this information could help Scottish Government focus work to increase awareness and take-up of the disability benefits.

13. We will provide an additional £2 million in funding to support the delivery of the Disability Equality Plan, recognising the level of work needed to improve disabled people’s lives.

14. We will seek to improve access to vital support services for disabled people and increase disability competence in these services through:

• Extending the Advice in Accessible Settings (AiAS) programme to include 2 projects funded in 2024/25 with a specific focus on disabled people - a Glasgow Disability Alliance project and a second partnership between FAIR and The Action Group, both focusing on accessible advice for disabled people.
• Continuing to deliver our Cash First programme, focusing on inclusive and accessible Cash first support to tackle food insecurity, with two partnerships supporting disabled people.
• Exploring the possibility of a partnership project with DPOs and one or more advice agencies. This could include DPOs providing disability competence training for the agencies as well as supporting advice provision for disabled people.

15. Disabled People’s organisations are represented on the Minimum Income Guarantee Expert Group, and we will support the group’s wider engagement with DPOs as required. This will ensure the experiences of disabled people are considered as part of the development of the full report. As a result, the report’s recommendations should reflect how a Minimum Income Guarantee could best support disabled people. The Scottish Government act as a secretariat for this group whose recommendations will be formed independently and will be carefully considered.

16. The Scottish Government believes that a social tariff mechanism is the best way to protect energy consumers, including disabled people, against high costs and to make sure they can afford their energy needs.

Through a recently established working group including energy suppliers, consumer organisations, and DPOs we have co-designed a social tariff mechanism that demonstrates how this policy can work. It is only the UK Government with the powers to deliver such a scheme and we repeatedly called on the previous administration to introduce a social tariff as a way of providing support for those who need it the most. We are pleased to be having more constructive discussions with the current UK Government on delivering this crucial policy and urge them to deliver it as soon as possible.

17. In parallel, we will work collaboratively with energy suppliers and consumer organisations to increase access to and awareness of existing energy initiatives to maximise their impact.

18. By understanding more about the unique barriers faced by disabled people to connect, access, and actively participate in the digital world, we will ensure that disabled people’s needs are supported in the next delivery phase of the ‘Connecting Scotland’ programme.

5.2 Mental Health

Poor mental health can significantly affect day to day life. People with poor mental health can be stigmatised due to their condition and find access to healthcare more challenging. Compared with the general population, people with severe mental illness can have their life expectancy reduced by up to 15-20 years, largely due to a lack of access to care for their physical health. (NHS England, Improving the physical health of people living with severe mental illness, 2024). This may well be compounded for disabled people with existing health and care needs.

Disabled people are more likely to experience poor wellbeing and mental health. This was highlighted recently in the 2023 Life in the UK (Scotland) report by IPSOS and Carnegie that highlighted severe mental ill-health was significantly more common among disabled people than non-disabled people (31% compared to 6%).

The higher rates of poor mental health are also, tragically, reflected in suicide statistics. A recent Office for National Statistics report looked at suicide rates between 2011 and 2021 in England and Wales and found that disabled people had much higher rates of suicide.

For men, the deaths by suicide figure was over three times higher - 48.36 per 100,000 disabled men compared to 15.88 per 100,000 people for non-disabled men. For women, the figure was over four times higher - 18.94 per 100,000 disabled women compared to 4.47 per 100,000 people for non-disabled women.

Many of the mental health challenges faced by disabled people stem from inequality, disadvantage, poverty, and exclusion. This was exacerbated by the Covid-19 pandemic which increased social isolation and loneliness, particularly amongst disabled people. The 2022 Public Health Scotland survey of the Covid Highest Risk List, which would have included many disabled people, found that seven in 10 (71%) respondents reported a negative long-term impact on their mental health from the initial shielding period and more than six in 10 (64%) reported an impact on how lonely they felt. This finding was echoed in the 2022 Scottish Household Survey which found that disabled people are over twice as likely (40%) to experience loneliness compared to non-disabled people (17%).

The Mental Health and Wellbeing Strategy sets out a vision for a Scotland free from stigma and inequality, where everyone fulfils their right to achieve the best mental health possible. It recognises that people are multi-faceted, and that we need support, services, care, and treatment that are person-centred, fully inclusive and in a range of formats. This strategy lays out actions designed to tackle mental health inequalities, including those of disabled people.

Actions

19. We recognise the increased barriers to accessing healthcare for people with disabling mental health conditions; the significantly reduced life expectancy; and the psychological impacts of disability. Poverty and discrimination related to disability are known to be exacerbating factors of poor mental health. Therefore, in delivering our newly published Mental Health and Wellbeing Delivery Plan we will:

• Consider the issues faced by disabled people when scoping, planning, and implementing key actions highlighted in the Inequality Action Table.
• Improve access to, and experience of, mental health supports and services. To achieve this, we will work closely with the Equality and Human Rights Forum and prioritise actions under Priorities 4 and 7.
• Ensure that disability is captured and published as an intersectional cross variable in patient experience surveys including mental health.
• To ensure that the workforce is diverse, skilled, supported and sustainable we will implement the Mental Health and Wellbeing Workforce Action Plan. This includes specific actions to support disabled people in the workplace and those receiving care, recognising the valuable role people with lived experience can play in creating compassionate and accessible services for disabled people.
• Implement the actions set out in the Delivery and Workforce Action Plans Impact Assessments.
• Establish a Mental Health and Capacity Reform Programme looking at the embedding of human rights across mental health services and making improvements to the legislative framework to better uphold and protect human rights.

5.3 Independent Living and Human Rights

Disabled people should have freedom, dignity, choice, and control over their lives. We want to remove the barriers that stop people from enjoying equal access to full citizenship.

The issues around poverty and mental health set out above impact the extent to which disabled people can live independently and fully enjoy their rights. The Scottish Human Rights Commission, together with a coalition of Scottish DPOs warned that disabled people are experiencing ‘unrelenting attacks on their human rights’ in their reports to the UN.

We have delivered on a key Programme for Government commitment by reopening the Independent Living Fund to new applicants. The Fund provides awards to disabled people to enable them to arrange care and support to live more independently.

By reopening the Independent Living Fund, we have already committed to enabling up to 1,000 disabled people in Scotland, who face the greatest barriers to independent living, to access the support they need to lead independent lives. This is in addition to almost 1,900 disabled people who are already supported by the Fund.

Independent Living Fund Scotland also operate the Transition Fund, which offers individual grants to support disabled people, aged 16-25, transition into adulthood, assisting them to take part in community activities, maintain and develop connections, build life skills, and engage as active, participating citizens.

Research has shown that Independent Living funding contributes to fewer admissions into residential care, reductions in crisis interventions, and delivers enhanced capacity within Health and Social Care.

Our budget for 2024-25 provides an additional £2 billion investment in social care and integration, which will include disabled people. This delivers on a commitment to increase spending by 25% over this Parliament two years ahead of our original target. Free personal care has been extended to all adults who are assessed as needing this regardless of age, condition, capital, or income. Nursing care is already free at the point of delivery.

Recently, the Minister for Social Care, Mental Wellbeing and Sport gave a statement to parliament which outlined proposed changes to our plans for a National Care Service, including amendments to the current Bill.

We are not stepping away from our ambitions on social care reform. We will use a mix of legislative and non-legislative means to deliver vital changes to secure a quicker and more sustainable way to deliver our goals. A new Advisory Board will have lived experience at its heart and will drive improvement, making sure services are consistent, fair, and high-quality across Scotland. We are moving ahead with legislation that will ensure reforms to information records and standards, procurement, Anne’s Law, and a right to breaks for unpaid carers remain. These are all areas that stakeholders have told us time and again need to be improved.

We have listened to those accessing or delivering community health, social work, and social care, and we are acting on what they have told us.

These proposals will deliver a National Care Service that improves the experience of everyone who relies on social care, social work, and community health in Scotland.

More information on the National Care Service can be found at: The way forward - National Care Service: factsheet - gov.scot (www.gov.scot)

Actions

20. We will build on the successful reopening of the Independent Living Fund in April 2024 by continuing to work in partnership with ILF Scotland, DPOs, and other stakeholders during its first year of operation to improve and develop access routes to the fund that are more closely aligned to a human rights-based approach and remove/overcome established barriers to access.

21. The Scottish Government will work with the Convention of Scottish Local Authorities (COSLA) to identify options for the removal of non-residential care charges as part of wider work with partners on social care improvement.

22. We will engage with DPOs:

• To continue to explore ways to better protect the human rights of disabled people within Scotland’s devolved powers.
• To explore options for better accountability and oversight of disabled people’s human rights that considers existing Commissioners who provide this and takes account of proposals for a potential Disability Commissioner.
• On proposals to strengthen the role of the Scottish Human Rights Commission through a future Human Rights Bill.
• To ensure widespread communication of the impacts of a future Human Rights Bill for disabled people, recognising the vital role of DPOs in promoting and realising rights for all disabled people.