Inequalities and challenges experienced by disabled people in Scotland: evidence review

Experiences of Services

This Review has found that disabled people face challenges when accessing services.

Inclusion Scotland surveyed disabled people with intersectional protected characteristics including trans people, ethnic minorities and those from low-income backgrounds^[120]. This co-produced research was led by a group of disabled people with lived experience of intersectional discrimination. The survey was sent out to Inclusion Scotland’s networks to collect experiences of accessing services and 96 people responded. Additionally, 13 interviews were carried out with people of different intersectional characteristics.

In the survey, 91% of the respondents felt that they were treated unfairly when accessing public services due to their disability, and 89% said that they regularly avoided services because they were worried about how they would be treated. As a result, 98% of respondents said they regularly avoided services and 74% have changed where they access services^[121]. In addition, 60% of the respondents felt that they were treated unfairly when accessing public services due to their intersectional identity of being disabled as well as at least one other characteristic. Further, one disabled transgender participant spoke about not being able to access an LGBT support group due to inaccessible buildings. The participants in this study highlight that disabled people with intersecting characteristics can be dismissed by professionals, not provided with key information about services they are intitled to and faced with more barriers due to inaccessible structures. This research usefully highlights that disabled people may be disadvantaged in multiple ways and that support systems do not consider intersectional aspects of a person’s identity.

This evidence review also found challenges for disabled people when accessing health and social care services specifically. The Public Bodies (Joint Working) (Scotland) Act 2014 was introduced to integrate and restructure service provision for health and social care in Scotland which led to the development of health and social care partnerships. Integrated care aims to improve patient outcomes and enhance quality of life through community-based support provision, reducing the necessity for people receiving health care to be in hospital^[122]. However, there have also been challenges with successfully achieving the aims of this legislation including funding limitations and a greater need for decentralised accountability and governance processes^[123].

MacPherson et al examined how some of the changes to health and social care impacted the professionals as well as people with learning disabilities receiving community support. A key finding for this study was that resources are being reduced, and support organisations reported uncertainty about whether they would receive continued funding to support disabled people in their communities^[124]. The uncertainty of funding also led to a disconnect between the needs of learning-disabled people wanting to participate in meaningful activities and the possibility of this due to a lack of available or engaged support staff. Further, this study found that the provision of services was inconsistent depending on location with some areas having no available support services for people with learning disabilities particularly those with complex needs or specific age groups, this was the case for both urban and rural areas^[125].

More generally, Glasgow Disability Alliance carried out a survey of 756 of their members and found that many of their respondents found it difficult to access health and support services^[126]. The report found that there appears to be a lack of GPs working in areas of low socioeconomic status despite attempts to restructure health care provision^[127]. GDA, whose members are predominantly residents in urban areas of Glasgow and the surrounding local authorities, found that 85% of respondents were concerned about accessing services, with 85% of these unable to access mental health services, 89% unable to access healthcare appointments and 73% saying that the social care they received did not meet their needs^[128]. Respondents to this survey suggest that this is because of waiting lists for appointments, a tightening of eligibility criteria and that accessing the social care system is stressful^[129]. An additional report from Glasgow Disability Alliance highlighted the intersectional impacts of service provision during COVID-19 for disabled women who felt there was a lack of support during this time^[130].

Services that are not able to fully meet the needs of disabled people may result in a lack of trust. The Scottish Household Survey 2023 showed that overall disabled people were less likely to trust all public institutions and services than non-disabled people^[131]. However, the Scottish Household Survey does not ask participants why they respond in this way, so further research is required.