According to recent reports from the Guardian, individuals with disabilities are facing obstacles when attempting to travel abroad due to limitations set by NHS care boards and local councils. These authorities are often unwilling to allow the use of care funding for services outside the United Kingdom.
Advocates have raised concerns about a “postcode lottery” in England, where a disabled person’s ability to travel internationally is contingent on their local government’s policies or the discretion of officials. This situation persists even when there are no additional costs incurred by taxpayers.
Many disabled individuals have found themselves forced to cancel travel plans at the last minute or go extended periods without breaks, as local authorities deny funding for care abroad, despite having agreed to cover travel expenses. The Guardian has learned of cases where requests for overseas care have been denied by NHS officials, only to be reversed upon the threat of legal action from the individuals involved.
Lucy Robinson, 38, shared her frustrations with the Guardian, explaining that her requests to use her care package for international work events and vacations were denied by health authorities in Oxfordshire. As the president of the European Spinal Cord Injury Federation, Robinson, who is quadriplegic and relies on a team of personal assistants, often needs to travel for her responsibilities. She expressed that this situation has caused her significant stress, stating, “Travel is one of the things that defines my life… My quality of life is based around that. I want to live, not just to exist.”
The challenges faced by individuals like Robinson have led to calls for clearer national guidelines regarding the rights of disabled individuals to take their carers abroad. Typically, care packages provide personal assistants for assistance with daily activities, such as dressing, mobility, and overnight support.
Advocates argue that this issue is not a matter of “holidays on the NHS” since there would be no extra financial burden on local authorities or the health service, which are already covering care costs. In most cases, the individuals receiving care are responsible for their assistants’ expenses and insurance arrangements.
Carol Barraclough, advocacy and support manager at the Spinal Injuries Association, stated, “Refusing to pay for care and support abroad does not deliver any financial savings for the taxpayer. We’d like to see national guidance on this that is effective and clear on the rights of all disabled people to take their carers outside the UK.”
In April, Robinson was informed by the Thames Valley NHS integrated care board (ICB) that her request to attend a conference in Germany was denied because “NHS funding responsibilities cease at the UK border.” Consequently, she had to forfeit work events planned in Norway and Albania and could only attend the conference in Germany when her elderly mother agreed to serve as her 24/7 caregiver.
Following a threat of legal action from Robinson, the care board reversed its decision in June and agreed to fund her care abroad, provided she dropped plans for a judicial review.
Analysis by the Guardian indicates a wide disparity in policies among different councils and NHS bodies. Some explicitly permit overseas care, while others agree in principle but impose various conditions. Additionally, some councils restrict overseas travel decisions to the discretion of officials.
Barraclough highlighted the inconsistencies by saying, “There’s a postcode lottery in NHS care and support policy to allow recipients of funding to take their assistants with them outside the UK.” She noted several instances where disabled individuals have been denied care abroad.
Giselle Hoad, founder of the Adult Social Care Warriors campaign, expressed concern that cultural biases surrounding disability may lead to assumptions that disabled people should settle for opportunities that are closer to home.
In England, disabled individuals can access care funding through two primary sources: NHS continuing healthcare, which supports those with the highest needs, and social care funded by local councils. Anne-Marie Irwin, a solicitor representing Robinson, emphasized that NHS care boards have a legal obligation to meet the assessed needs of disabled individuals, which does not diminish when they temporarily leave the UK.
The Thames Valley NHS ICB refrained from commenting on specific cases but mentioned that it would consider requests for temporary travel abroad on a case-by-case basis, assessing whether it is appropriate to continue providing care while outside the UK, factoring in patient safety and insurance considerations.
Similarly, local authorities share this duty, as indicated by previous court rulings. Chelsea Pettitt, 25, and her family are currently in a dispute with Lancashire council regarding her right to receive care while on holiday. Chelsea, who has cerebral palsy, quadriplegia, and learning difficulties, reminisced about a previous trip to Spain where she felt a sense of belonging. However, her parents were informed by a social worker that she was ineligible for support abroad due to her new living arrangement in supported accommodation.
Despite her care plan stipulating two-to-one assistance for seven nights a year outside Lancashire, the council insists that this care must be utilized to “maintain important relationships” with her family and friends. The absence of national guidelines has left Chelsea’s family uncertain about her rights regarding travel choices.
