Equality denied

If Clodagh Corrigan needs to go to the toilet when she is at work she must use patient facilities.

If she wants to use hand gel for infection control, she must carry her own and if she has to get through a fire door – even in the case of an actual fire – she can only hope that someone a) knows where she is and b) can come and open the door for her.

Dr Corrigan (pictured above) is a specialty doctor in emergency medicine. Among other roles, she is deputy chair of the BMA Northern Ireland council and specialist, associate specialist and specialty doctors committees and newly elected deputy chair of the BMA representative body. She also uses a wheelchair, having been diagnosed with multiple sclerosis 11 years ago, at the age of 29.

And frankly, she is a woman on a mission. It is bad enough, she believes, that the world isn’t set up for people with disabilities and for carers but it is hugely problematic that, in Northern Ireland, the situation is even worse than it is in the rest of the UK. She – with support from the BMA – is campaigning to change this.

‘Most people assume that the 2010 Equality Act applies across all four nations, but it doesn’t,’ she says. ‘In Northern Ireland, we still have the DDA (Disability Discrimination Act) of 1995, which is 30-year-old legislation and comes with a 30-year-old mindset and 30-year-old biases, which have thankfully been largely forgotten. Where we’ve moved on as a people, the old legislation has not.’

There are, she says, big gaps in the DDA, which were filled in the Equality Act. For example, it’s not lawful to discriminate against someone by association in Great Britain but it is in Northern Ireland. This is something that affects Dr Corrigan and her family personally.

‘What it means is that my husband can be refused a job or treated differently on the basis of being married to me as a disabled person,’ she says. ‘A real-life example was in the early days of COVID where he was wearing a mask because he was trying to protect me and one of his bosses started berating him for “wearing his wife’s bra over his face”. In Northern Ireland, there is no legislation that protects him from that kind of treatment.’

The Equality Act – which protects individuals from discrimination, harassment and victimisation based on nine protected characteristics (see section entitled ‘protected characteristics’ below) – is far from perfect, says Dr Corrigan. But the fact it doesn’t apply in Northern Ireland means she and other people with disabilities are denied even a basic level of protection in some areas.

‘The requirements to make reasonable adjustments in the workplace are much the same under the DDA and the Equality Act,’ she says. ‘But when it comes to the adjustments that service providers have to make, it’s very different. Unlike in the rest of the UK, businesses providing a service only have to consider provision of reasonable adjustments, they don’t actually have to provide them.

‘For example, I have yet to find a hairdresser who can accommodate me in my wheelchair because all the local hairdressers have the set up where the sink and chair are combined.

‘They also don’t have to provide a ramp for access – as long as they’ve thought about providing a ramp, they are within the law in Northern Ireland.’

Similarly, schools don’t actually have to cater for students with disabilities (although universities do), she adds. A lot of these issues – including the need for health services to provide access for people with disabilities – are covered in case law, but it is not explicit within the legislation that it supposed to protect people.

‘If we had at least the same protections in Northern Ireland as there are in the Equality Act, there would be more equity of treatment across the board for all disabled people, and for people with other protected characteristics as well.’

Dr Corrigan freely admits that these are issues she didn’t give much thought to before it affected her personally – which is why she thinks it’s crucial people with disabilities are included and listened to and their experiences valued. She was formally diagnosed with MS in December 2014 when she was working as a doctor and mum to a one-year-old daughter.

‘Your health is one of those things that you value after you lose it,’ she says ruefully.

Now, however, she is determined to make a difference for everyone with disabilities, including healthcare workers.

‘My employers now are absolutely fantastic. They’ve made any adjustments that I’ve needed. They’re very flexible in terms of how I manage my work. And they allow me disability leave – I have treatment twice a year. But while my current employers are very good, that hasn’t always been the case.

‘We’re meant to be the caring profession, but my experiences have been very uncaring overall. And if you look at healthcare providers as a whole, there’s not an enormous amount of visibly, physically disabled staff providing healthcare. If you look around any hospital, there’s a perception that there is no reasonable adjustment that can allow you as a disabled doctor, nurse or physio to complete your role. It’s taken a lot of creative thinking and a lot of pushing for me to convince my employers otherwise.’

She cites examples from earlier in her career when she needed to take time off sick and felt ‘threatened’ rather than supported by occupational health and being the subject of gossip when reasonable adjustments were made.

‘When I was training I was told “you can’t be a doctor, mummy and patient – you’ll have to reconsider your career”. There can be ill feeling with people thinking she’s getting an easier ride, when actually you’re working twice as hard to prove you’re half as good,’ she says.

In December 2024, her employer, the Southern Health and Social Care Trust appointed Dr Corrigan as disability advocate. It’s the first trust in Northern Ireland to develop the role. She is working with different departments, including estates and human resources, to advise on improving facilities and employment processes and is already having an effect.

While this is a positive start, there’s a long way to go, says Dr Corrigan. She acknowledges the well-rehearsed resource problems in the health and social care service mean there is little money to make huge changes. But that doesn’t mean there aren’t opportunities for improvement.

‘I took one of the managers from estates round with me recently and asked them to live life from my perspective. I’ve been trying for a long time. For example, I can’t get through the fire doors – there’s no push-pad access. The offices are number-pad-locked and they are too high. I can’t reach them, so somebody has to let me in, and equally the door shuts and I’m stuck inside. We did have a fire in my department in the last few months, and I can’t get out unless someone knows where I am and gets me.’

Her employer is implementing changes as a result of her input. ‘I’m getting push-pad access and they are also going to lower alcohol hand gels because they are much too high for me. Even the hand towels and soap are situated too high, so they’ve committed to lowering the height of things like that, not just in my building, but in the entire trust. It makes a difference not just to service providers but to service users, who deserve to be able to wash their hands as well.’

There are other things too – all the bins are pedal-operated, which means she can’t use them, and there are no accessible staff toilets. ‘It does make me feel a burden because I’m always having to ask someone to hold a door open for me, or lift the bin for me to put rubbish in – it doesn’t exactly make you feel independent or valuable.’

She is delighted that her employer has created the disability advocate role and would like to see others follow suit. But it doesn’t stop there. At this year’s BMA annual representative meeting she won the backing of doctors when she called for the Northern Ireland Assembly to bring equalities legislation at least in line with the rest of the UK.

She also called for the right to carer’s leave. Again, Northern Ireland is out of step with the rest of the UK, where workers are entitled to a week of unpaid leave per year for caring responsibilities under the Carer’s Leave Act of 2023.

‘While it’s something that employers [in Northern Ireland] could grant without legislation, most of them don’t,’ says Dr Corrigan. ‘One colleague came to me in my role as local negotiating committee chair. She had a disabled child, and couldn’t get time off for appointments. Carers aren’t asking for paid time off – just the ability to take time off without the fear of losing their job.’

In May of this year, the economics minister published a briefing paper on options for introducing legislation to mandate carers’ leave in Northern Ireland. But even if it becomes law, it will be too late for some – and won’t address other issues facing carers, such as discrimination by association.

Fiona McEvoy is one doctor who knows what it is like to be discriminated against. As carer for her late husband, who had cystic fibrosis, she was explicitly told that her situation would rule her out of permanent employment.

‘I wouldn’t have called myself a carer then, but in retrospect, that’s what I was,’ she says. ‘My husband was in hospital every three months. At this point, I was locuming in a practice and looking out for a job and one of the female partners said she was thinking of dropping a few sessions. But she basically said to me in conversation that I’d never get a job because my husband was sick so I’d be off all the time.

‘I was so desperate to be kept on that I just nodded and smiled. I told a friend who said it was horrendous, but I just said it was the way things were.

‘At the time, I was covering sick leave for two doctors, my husband was in hospital and my wee girl was about one and a half. I dropped her off to childcare, went to work, did all my sessions, and just ploughed on because I needed to have an income.’

This was 10 years ago. Had the Equality Act 2010 been in place in Northern Ireland, it would have meant she could have challenged anyone who refused to consider her for a post because of her caring responsibilities, she says. But almost as important would be the message the legislation would send out, that such actions weren’t acceptable, and that someone could face legal consequences if they acted in such a way.

So why is Northern Ireland lagging behind the rest of the UK in these respects? There are probably several reasons, not least that politicians only returned to Stormont last year after many years where devolution was suspended, hampering the legislative process. But in practical terms, it’s also the case that health budgets are tight, and there are huge challenges such as the longest waiting times in the UK.

‘There is a financial aspect and we’re told there’s no money, so we can’t do this and we can’t do that,’ says Dr Corrigan. ‘But the flip side is that if you retain your staff with disabilities by making simple adjustments, that will be good for the health service.’

She wants trusts to plan for disability access when they are making changes or upgrading facilities, ensuring a gradual transformation. As things stand, there are missed opportunities because it is not on the radar.

‘The staff toilets in my hospital were renovated in the last 18 months, but you can’t get wheelchairs into the cubicles. So if you’re doing the work, consider the access from the outset.

‘While there might be no money to change things retrospectively, proactive steps should be taken and then you will see that your staff will become more diverse, and you’ll be able to keep staff in post for longer, which can only help with the waiting list.

‘It is the same for carers – if you can keep carers in employment by allowing flexibility and carers’ leave then they are more likely to remain in employment.’