Submission to the UN Committee on Economic, Social

and Cultural Rights

Economic, social
and cultural rights
in Great Britain
December 2022

Equality and Human Rights Commission

equalityhumanrights.com
 Economic, social and cultural rights in Great Britain

Contents
Introduction......................................................................................................... 2

Devolution and geographic scope of this report................................................3

Equality and human rights framework (Articles 2, 3, 4 and 5)........................4

Conditions at work (Article 7)............................................................................6

Poverty (Article 11)............................................................................................. 9

Housing (Article 11)..........................................................................................12

Social care (Articles 11 and 12).......................................................................15

Access to healthcare (Article 12).....................................................................18

Cultural life (Article 15).....................................................................................21

Recommendations............................................................................................23

Contacts.............................................................................................................26

Equality Advisory and Support Service...........................................................26

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 Economic, social and cultural rights in Great Britain

Introduction

The Equality and Human Rights Commission (EHRC) is an

independent A-status National Human Rights Institution (NHRI) and
national equality body. We have a statutory mandate to protect and
promote human rights in Great Britain,1 including by assessing and
reporting on the United Kingdom’s (UK’s) implementation of the
human rights treaties it has chosen to ratify.

This report provides information to the United Nations Committee on Economic,

Social and Cultural Rights (UNCESCR) on the fulfilment of the International
Covenant on Economic, Social and Cultural Rights (ICESCR) in Great Britain
since 2016. It indicates where progress has been made in recent years and
where further work is required.

We encourage the State Party to use the ICESCR reporting process to

strengthen its efforts to tackle inequalities in the enjoyment of economic, social
and cultural rights, and improve compliance with its human rights obligations. We
recognise that the current global and domestic economic context is particularly
challenging and is having an impact. However, the ICESCR requires each State
Party to take action to the maximum of its available resources.

We emphasise that equality and non-discrimination are essential to the

realisation of ICESCR rights. We therefore include evidence about the
experiences of people sharing a range of protected characteristics under
domestic equality law. We also identify ways in which the coronavirus (COVID-
19) pandemic has exacerbated existing equality issues and led to new ones,
noting where action has been taken in response.

We cover a range of rights in our reports to the UN human rights mechanisms.

This means that we prioritise discussion of certain topics here and ensure
coverage of key issues across our reports. For example, though the right to
education is protected under the ICESCR, we discuss this right in detail in our
2022 report to the UN Committee on the Rights of the Child.

In May 2022, the UK Government published the State report on implementation

of the ICESCR.2 It referenced action on several topics that we had raised in our
submission to inform the report. In future State reports, we would like to see

1
Equality Act 2006, section 9.

2
 Economic, social and cultural rights in Great Britain

further evidence on outcomes and greater recognition of the links between

Sustainable Development Goals and the human rights framework.3

Our human rights tracker – an online tool that summarises actions the UK and
Welsh governments have taken in response to UN human rights
recommendations – references our latest reports on human rights.

We have funded the coordination of a civil society shadow report on ICESCR

rights in England and Wales.4 This enables civil society organisations to
participate in the UN process and assist in holding the UK and Welsh
governments to account for their human rights obligations.

Devolution and geographic scope of this report

The UK Parliament has devolved various powers to the Scottish Parliament, the
Welsh Parliament (Senedd Cymru) and the Northern Ireland Assembly. It
remains responsible for England and for reserved matters. Accountability for
complying with the ICESCR lies with the UK Government, with responsibility for
implementation on devolved matters resting with devolved governments.

In accordance with our mandate, this submission covers England and Wales for
all areas, and Scotland for those areas that are reserved to the UK Parliament.
Our recommendations are for the UK and Welsh governments.

2
UK Government (2022), The United Kingdom’s 7th periodic report under the
United Nations Convention on Economic, Social and Cultural Rights [accessed:
26 October 2022].
3
Equality and Human Rights Commission (2019), Briefing on the Sustainable
Development Goals [accessed: 26 October 2022].
4
Just Fair, The International Covenant on Economic, Social and Cultural Rights:
parallel report on behalf of civil society in England and Wales [accessed: 15
November 2022].

3
 Economic, social and cultural rights in Great Britain

Equality and human rights

framework (Articles 2, 3, 4 and 5)

See: UNCESCR Concluding Observations paras 6, 10, 23 and 69, and UN

Sustainable Development Goals 10 and 16.

There is an increasingly divergent approach to the domestic incorporation of

human rights across Great Britain. The UK Government has ratified seven of the
nine core United Nations (UN) human rights treaties but considers that they do
not need to be incorporated into domestic law to ensure their protection.5 The
devolved governments of Wales and Scotland have committed to further
incorporate UN treaties, including through a potential Welsh Human Rights Bill
and Scottish Human Rights Bill.6

The European Convention on Human Rights (ECHR) is incorporated in UK law

through the Human Rights Act 1998 (HRA). In June 2022, the UK Government
published draft legislation to replace the HRA with a Bill of Rights.7 We welcomed
the UK Government’s commitment to maintain the incorporation of ECHR rights
in UK law. We consider that the HRA has improved rights protections in the UK
and that there should be no weakening of its provisions. We advised that further
consideration of this legislation must be subject to wide consultation and robust
parliamentary scrutiny.

The Equality Act 2010 (the Act) protects people from discrimination8 and contains
provisions to advance equality, notably the Public Sector Equality Duty.9 There is
scope for the UK Government to strengthen protections by implementing the Act

5
Committee on the Elimination of Discrimination against Women (2021),
Information received from the United Kingdom of Great Britain and Northern
Ireland on follow-up to the concluding observations on its eighth periodic review
[accessed: 8 December 2022], para 3.
6
Welsh Government (2022), Strengthening and Advancing Equality and Human
Rights in Wales research report: Welsh Government response [accessed: 8
September 2022]; Scottish Government (2021), National Taskforce for Human
Rights: leadership report [accessed: 22 August 2022]; Scottish Government
(2021), New Human Rights Bill [accessed: 13 October 2022].
7
Bill of Rights Bill [accessed: 22 August 2022].

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 Economic, social and cultural rights in Great Britain

in full.10 The Socio-economic Duty in the Act requires public bodies, when making
strategic decisions, to consider how their decisions could reduce inequalities
linked to socio-economic disadvantage.11 The Socio-economic Duty came into
force in Scotland in 2018 and in Wales in 2021. It has not been brought into force
in England.

Following the UK’s departure from the European Union (EU), the proposed
Retained EU Law (Revocation and Reform) Bill will set retained EU law (REUL)
to expire at the end of December 2023, unless ministers choose to preserve it,
create delegated powers for ministers to amend it, or change its status. The
effect of these provisions on equality and human rights protections is uncertain
because of the high volume (at least 2,417 pieces) of REUL and a lack of clarity
about the UK Government’s approach, but it could be significant, including in
relation to employment rights. This, and the implications of this Bill on devolved
competences, is a matter of concern. Any changes arising from this Bill must not
weaken legal protections for equality and human rights, and must receive
parliamentary scrutiny.

8
The Equality Act 2010 lists nine protected characteristics: age, disability,
gender reassignment, marriage and civil partnership, pregnancy and maternity,
race, religion or belief, sex, and sexual orientation.
9
Equality Act 2010, section 149.
10
For example, implementation of section 14 of the Act would prohibit
discrimination on the basis of a combination of two protected characteristics.
11
Equality Act 2010, part 1.

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 Economic, social and cultural rights in Great Britain

Conditions at work (Article 7)

See: UNCESCR Concluding Observations paras 27 and 32, and UN

Sustainable Development Goals 8 and 10.

A socio-economic right protected by the ICESCR is the right to just and

favourable conditions at work. There has been some progress towards narrowing
pay gaps, but pay gaps for women, disabled people and some ethnic minorities
persist.

Though data collected during the COVID-19 pandemic should be interpreted with
caution, the UK’s gender pay gap has decreased from 17.4% in 1997 to 8.3% in
2022, but with geographic variation: 12.5% in South East England, compared to
6.1% in Wales and 5.8% in North East England.12

The UK’s disability pay gap was 13.8% in 2021, an increase on the 11.7% pay
gap in 2014, but also with geographic variation: 16.1% in the East of England
compared to 6.5% in London and 6.4% in North East England.13

In 2019, the ethnicity pay gap in England and Wales was 2.3%, which is the
lowest figure since 2012. There was significant variation between different ethnic
groups: the rate was 15.5% for the Pakistani ethnic group, 7.9% for the Black
African ethnic group, and -23.1% for the Chinese ethnic group.14

The UK Government has committed to explore the cases for mandatory and
voluntary disability workforce reporting and will develop guidance for voluntary
ethnicity pay gap reporting.15 Public bodies in Wales must consider pay gaps
across all the protected characteristic groups.16

12
Office for National Statistics (2021), Gender pay gap in the UK: 2022
[accessed: 22 November 2022].
13
Office for National Statistics (2022), Disability pay gaps in the UK: 2021
[accessed: 22 August 2022].
14
Office for National Statistics (2020), Ethnicity pay gaps: 2019 [accessed: 22
August 2022].
15
UK Government (2021), Disability workforce reporting and (2021), Inclusive
Britain: government response to the Commission on Race and Ethnic Disparities
[accessed: 22 August 2022], no. 16.
16
Equality Act 2010 (Statutory Duties) (Wales) Regulations 2011, section 11.

6
 Economic, social and cultural rights in Great Britain

In October to December 2021, the number of people in employment on zero-

hours contracts was 77% higher than it was in October to December 2013.17
Around 3% of people in employment in the UK are on zero-hours contracts.18
The flexibility of zero-hour contracts may be beneficial in some circumstances,
but people in insecure work are less likely to be entitled to rights, such as
statutory sick pay, a disparity that became particularly significant during the
COVID-19 pandemic.19

Certain groups are more likely to be in insecure work. For example, ethnic
minority women are twice as likely as White men to be on a zero-hours
contract,20 and a greater proportion of 16- to 24-year-olds are on a zero-hours
contract than any other age category.21

17
From January 2020, there was a change in how the number of people on zero-
hours contracts was calculated. However, across both methods the trend has
been one of general increase. See Office for National Statistics (2022), EMP17:
People in employment on zero hours contracts [accessed: 28 November 2022].
For a definition of ‘zero-hours contracts’, see UK Government (no date), Contract
types and employer responsibilities [accessed: 26 October 2022].
18
Office for National Statistics (2022), EMP17: People in employment on zero
hours contracts [accessed: 28 November 2022].
19
Trades Union Congress (2021), Covid-19 and insecure work [accessed: 9
September 2022].
20
Trades Union Congress (2022), BME women twice as likely to be on zero-
hours contracts as white men [accessed: 22 August 2022].
21
Office for National Statistics (2022), EMP17: People in employment on zero
hours contracts [accessed: 22 August 2022].

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 Economic, social and cultural rights in Great Britain

Our inquiry into the treatment of lower-paid ethnic minority workers in health and
social care found that the outsourcing of roles leads to poor pay, insecure work,
a low awareness of employment rights, fear of raising concerns and a lack of
mechanisms to do so.22

Discrimination and harassment in the workplace continue to affect some groups.

For example, in a 2020 survey about the treatment of pregnant women and new
mothers at work, 25% of respondents said they had been treated unfairly during
the pandemic.23 We welcome the Protection from Redundancy (Pregnancy and
Family Leave) Bill, supported by the UK Government, which will address gaps in
protection from discrimination by extending certain redundancy protections to
pregnant women and new mothers, and to people on adoption or shared
parental leave.24

Additionally, workplace sexual harassment remains widespread and under-

reported.25 We welcome the Worker Protection (Amendment of Equality Act
2010) Bill, supported by the UK Government, which seeks to introduce a
preventative duty on employers to take all reasonable steps to prevent sexual
harassment in the workplace and reinstate protections for workers from
harassment by third parties.26

22
Equality and Human Rights Commission (2022), Experiences from health and
social care: the treatment of lower paid ethnic minority workers [accessed: 22
August 2022].
23
Trades Union Congress (2020), Pregnant and precarious: new and expectant
mums’ experiences of work during Covid-19 [accessed: 24 January 2022], p. 5.
See also Equality and Human Rights Commission (2018), Pregnancy and
maternity discrimination research findings [accessed: 22 August 2022].
24
Department for Business, Energy and Industrial Strategy (2019), Pregnancy
and maternity discrimination consultation: Extending redundancy protection for
women and new parents, Government response [accessed: 9 September 2022];
Protection from Redundancy (Pregnancy and Family Leave) Bill.
25
Government Equalities Office (2020), Sexual harassment survey [accessed: 9
September 2022].
26
Government Equalities Office (2021), Consultation on sexual harassment in
the workplace: government response [accessed: 9 September 2022]; Worker
Protection (Amendment of Equality Act 2010) Bill.

8
 Economic, social and cultural rights in Great Britain

Poverty (Article 11)

See: UNCESCR Concluding Observations paras 18, 25, 41, 48 and 54,
and UN Sustainable Development Goals 1, 2, 7, 8 and 10.

In the year to October 2022, the UK Consumer Prices Index, the official measure
of inflation, rose by 11.1%.27 Between March and June 2022, around 90% of
adults in Great Britain reported an increase in their cost of living (a rise from 62%
in November 2021) and they attributed this most to increases in the cost of food,
energy and fuel.28 Parents with dependent children were more likely to report an
increase in their cost of living than people without dependent children.29

Increased costs of living have implications for poverty rates. In 2019–20, 14.5
million people in the UK were in relative poverty (household income below 60%
of the annual median) and 11.7 million people were in absolute poverty
(household income below 60% of the 2010–11 median, accounting for inflation),
after housing costs.30 There was a decrease in poverty in 2020–21, though the
data is subject to uncertainty due to changes in data collection during the
pandemic and may not be comparable with previous years.31

Poverty disproportionately affects some ethnic minorities – particularly

Bangladeshi and Pakistani groups – due to factors including being more likely to
be in lower-paid employment and live in single-earner households.32

27
Office for National Statistics (2022), Consumer price inflation, UK: October
2022 [accessed: 15 November 2022].
28
Office for National Statistics (2022), What actions are people taking because of
the rising cost of living? [accessed: 8 September 2022]; Office for National
Statistics (2022), Public opinions and social trends, Great Britain: 26 October to
6 November 2022 [accessed: 24 November 2022].
29
Office for National Statistics (2022), Parents more likely to report increases in
their cost of living [accessed: 8 September 2022].
30
Francis-Devine, B. (2022), Poverty in the UK: statistics, House of Commons
Library research briefing 7096 [accessed: 23 August 2022], p. 18. See p. 9 for
definitions of relative and absolute poverty.
31
Department for Work and Pensions (2022), Technical report: assessment of
the impact of COVID-19 on the HBAI statistics for FYE2021 [accessed: 23
August 2022].

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 Economic, social and cultural rights in Great Britain

Relative poverty for working-age adults had been broadly stable prior to the
pandemic. Relative child poverty in the UK, after housing costs, had increased
since 2014 to 31% in 2019–20.33 Children in poverty who are part of families with
no recourse to public funds face particular difficulties, and often depend on
community support.34

Research has found that changes to social security between 2010 and 2018 had
a disproportionately negative impact on certain ethnic minorities, disabled people
and women in Great Britain,35 and have exacerbated child poverty.36 The right to
social security must be effectively accessible in practice.37 We are concerned
about failures to make reasonable adjustments for disabled claimants.38

The UK Government’s Levelling Up programme seeks to tackle geographical

inequality.39 However, some sectors that will be the focus of proposed
investments, such as construction, green energy and digital industries, have
lower levels of employment of women, disabled people and ethnic minorities.40
To ensure that these investments advance equality of opportunity, the UK
Government should ensure that training and employment pathways are available
for protected characteristic groups and encourage better employment practices
in these sectors, including through the availability of flexible working.

32
Joseph Rowntree Foundation (2022), UK Poverty 2022: The essential guide to
understanding poverty in the UK [accessed: 4 October 2022], pp. 52-56.
33
Department for Work and Pensions (2021), Households below average
income: an analysis of the income distribution FYE 1995 to FYE 2020 [accessed:
23 August 2022].
34
Work and Pensions Committee (2022), Children in poverty: No recourse to
public funds [accessed: 18 August 2022].
35
Equality and Human Rights Commission (2018), The cumulative impact of tax
and welfare reforms [accessed: 23 August 2022].
36
Social Mobility Commission (2021), State of the nation 2021: Social mobility
and the pandemic [accessed: 23 August 2022], pp. 28-29.
37
Special Rapporteur on extreme poverty and human rights (2022),
A/HRC/50/38: Non-take-up of rights in the context of social protection [accessed:
23 August 2022], para 5.
38
Equality and Human Rights Commission (2022), EHRC taking action to
improve the treatment of disabled benefit claimants [accessed: 23 August 2022].
39
Department for Levelling Up, Housing and Communities (2022), Levelling Up
the United Kingdom [accessed: 23 August 2022].
40
For example, see Women and Equalities Committee (2021), Unequal impact?
Coronavirus and the gendered economic impact [accessed: 23 August 2021],
para 24.

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 Economic, social and cultural rights in Great Britain

The Welsh Government has taken welcome steps to support people facing
hardship, such as through financial support,41 but the causes of poverty are not
being addressed comprehensively within their devolved competences. For
example, the Welsh Government strategy to eradicate child poverty by 2020 has
not been updated.42

41
For example, Equality and Human Rights Commission (2022), Adequate
standard of living and poverty – Government action [accessed: 8 September
2022].
42
Welsh Government (2015), Child Poverty Strategy for Wales [accessed: 21
October 2022].

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 Economic, social and cultural rights in Great Britain

Housing (Article 11)

See: UNCESCR Concluding Observations para 50, and UN Sustainable

Development Goals 10 and 11.

Between 2016–17 and 2019–20, the percentage of overcrowded homes in

England rose year-on-year, from 3% to 3.5%.43 Certain ethnic minorities in
England, particularly Pakistani and Bangladeshi people, are more likely than
White British people to live in the most deprived neighbourhoods and
overcrowded households.44 Data on overcrowding in Wales is not regularly
published, though the 2011 Census showed that certain ethnic minority groups
are more likely to experience overcrowded housing and live in rented
properties.45

The UK Government has committed to address poor housing conditions in the

private rented sector in England, with 23% of homes in that sector not meeting
the Decent Homes Standard in 2020.46 Additionally, though most social housing
in England meets an adequate standard, 11% did not meet the Decent Homes
Standard in 2020,47 with some ‘unfit for human habitation’.48

43
UK Government (2022), English Housing Survey 2020 to 2021: headline report
[accessed: 4 October 2022], annex 1.24.
44
Race Disparity Unit (2020), People living in deprived neighbourhoods
[accessed: 23 August 2022]; Race Disparity Unit (2020), Overcrowded
households [accessed: 23 August 2022].
45
Welsh Government (2022), Housing Overcrowding and Ethnicity: A Literature
Review, Government Social Research report number 59/2022 [accessed: 29
November 2022].
46
UK Government (2022), English Housing Survey: Housing quality and
condition, 2020 [accessed: 10 October 2022], p. 4; UK Government (2022), A
fairer private rented sector [accessed: 5 October 2022].
47
UK Government (2022), English Housing Survey: Housing quality and
condition, 2020 [accessed: 10 October 2022], p. 4.
48
Levelling Up, Housing and Communities Committee (2022), The Regulation of
Social Housing [accessed: 23 August 2022], para 11.

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 Economic, social and cultural rights in Great Britain

In 2017, a fire in a 24-storey residential building led to the loss of 72 lives, mostly
people from ethnic minorities.49 Evidence suggests that the UK Government
knew, or ought to have known, of the real and immediate risk to life posed by the
cladding on the building and failed to take reasonable steps to avoid it.50 The UK
Government has now taken some steps to address risks, though a public inquiry
into the circumstances of the fire is still ongoing.51

Accommodation for people seeking asylum is often of a poor standard and

unsuitable for particular groups, such as women with young children.52 This
includes the Manston migrant centre in Kent which has processed many people
seeking asylum who have crossed the English Channel.53 During the pandemic,
there have been concerns about the safety of accommodation for people seeking
asylum, including military barracks that were found to be impoverished
environments.54 Between January 2020 and August 2021, 69 people died in
Home Office asylum accommodation, an increase from four deaths in 2019 and
six in 2018.55

There remains a severe shortage of Gypsy and Traveller sites, due in part to
changes to planning policy in England.56 The UK Government launched a

49
Grenfell Tower Inquiry (2020), Submissions on behalf of the bereaved,
residents and survivors represented by Birnberg Peirce, Saunders Law, Duncan
Lewis and Deighton Pierce Glynn [accessed: 4 October 2022], annex A.
50
Equality and Human Rights Commission (2019), Summary of submissions
following Phase 1 of the Grenfell Tower Inquiry [accessed: 23 August 2022], p. 4.
51
Grenfell Tower Inquiry (2017), Terms of reference [accessed: 21 October
2022]; UK Government (2020), Grenfell Tower Inquiry Phase 1 Report:
government response [accessed: 21 October 2022].
52
Independent Chief Inspector of Borders and Immigration (2018), An inspection
of the Home Office’s management of asylum accommodation provision
[accessed: 22 August 2022], paras. 3.8 to 3.9; Home Affairs Committee (2018),
Asylum accommodation: replacing COMPASS [accessed: 22 August 2022].
53
Home Affairs Committee (2022), Oral evidence: Channel crossings, HC 822
[accessed: 30 November 2022], panel 2.
54
Independent Chief Inspector of Borders and Immigration (2021), An inspection
of the use of contingency asylum accommodation – key findings from site visits
to Penally Camp and Napier Barracks [accessed: 23 August 2022].
55
Liberty Investigates (2021), 95 died in asylum seeker accommodation in five
years amid fears Home Office downplayed toll [accessed: 23 August 2022].
56
Friends, Families and Travellers (2021), New research shows huge unmet
need for pitches on Traveller sites in England [accessed: 23 August 2022];
Cottle, S. and others (2019), Gypsy and Traveller sites: the revised planning
definition’s impact on assessing accommodation needs, Equality and Human
Rights Commission research report 128 [accessed: 23 August 2022].

13
 Economic, social and cultural rights in Great Britain

Traveller Site Fund for 2022–23, though it uses the limited definition of ‘Gypsies
and Travellers’ from the revised planning policy that applies to fewer people from
those groups.57 The relevant Welsh Government plan has not sufficiently
increased the number of pitches to meet demand.58

In 2022, UK Government legislation strengthened police powers to tackle

unauthorised encampments and criminalise trespass.59 We are concerned that
these measures do not address the shortage of authorised sites and may
constitute a disproportionate interference with the right to housing.

57
UK Government (2022), Traveller site fund [accessed: 4 October 2022].
58
Welsh Government (2018), Enabling Gypsies, Roma and Travellers [accessed:
23 August 2022]; Welsh Government (2021), Gypsy and Traveller caravan
count: January 2022 [accessed: 23 August 2022].
59
Police, Crime, Sentencing and Courts Act 2022.

14
 Economic, social and cultural rights in Great Britain

Social care (Articles 11 and 12)

See: UNCESCR Concluding Observations para 60, and UN Sustainable

Development Goals 3, 10 and 16.

Before the COVID-19 pandemic, adult social care was already under pressure in
England and Wales due to rising demand relating to demographic changes and
financial constraints.60 The pandemic led to additional concerns
regarding human rights breaches in social care settings. Routine
healthcare services were withdrawn from care homes as a result of the
reprioritisation of healthcare resources,61 potentially contributing to
‘excess’ deaths.62 Visits were restricted, and reports suggest
that ‘do not resuscitate’ notices were applied to people’s care
plans without consultation.63

We are concerned about the ‘closed culture’ of residential environments,64

particularly the inappropriate detention of people with learning disabilities and / or
autism. Too many are in institutions for long periods with little therapeutic benefit,

60
Equality and Human Rights Commission (2020), Adult social care and the right
to independent living [accessed: 23 August 2022], para. 6; The King’s Fund
(2022), Social care 360: access [accessed: 23 August 2022].
61
British Medical Association (2020), The hidden impact of COVID-19 on patient
care in the NHS in England [accessed: 23 August 2022]; Older People’s
Commissioner for Wales (2020), Care Home Voices: A snapshot of life in care
homes in Wales during Covid-19 [accessed: 23 August 2022].
62
Bell, D. and others (2020), COVID-19 mortality and long-term care: a UK
comparison, International Long Term Care Policy Network [accessed: 23 August
2022]; Office for National Statistics (2022), All data related to Deaths involving
COVID-19 in the care sector, England and Wales: deaths occuring up to 12 June
2020 and registered up to 20 June 2020 (provisional) [accessed: 23 August
2022].
63
Equality and Human Rights Commission (2020), Equality and human rights in
residential care in England during coronavirus and Equality and human rights in
residential care in Wales during coronavirus [accessed: 23 August 2022].
64
For a definition of ‘closed culture’, see Care Quality Commission (2022), How
CQC identifies and responds to closed cultures [accessed: 26 October 2022].

15
 Economic, social and cultural rights in Great Britain

often due to a lack of community services, and there have been indications of
potential breaches of human rights.65

A review in 2020 found that 71% of people with a learning disability and / or
autism, whose care they examined, had been segregated or secluded for three
months or longer, with some who had been in hospital for more than 25 years.66
They also found many examples of care that was ‘undignified, inhumane and
that potentially breached people’s basic human rights’.67 There have been recent
allegations of serious abuse, including physical and verbal mistreatment of
patients by staff, at Edenfield Centre mental health unit.68

The UK Government’s relevant action plan states that some progress has been
made in England,69 but we are concerned that the plan will not be effective and
that timescales for delivery are not urgent enough to achieve significant
reductions in the number of people inappropriately detained.

The Welsh Government’s Learning Disability Strategic Action Plan 2022 to 2026
includes actions on social care, including to increase community-based early
intervention to reduce hospitalisations. It is too early to assess the plan’s impact
on social care in Wales.70

We welcome the UK Government’s commitment to reform social care in

England.71 This must include the needs of unpaid carers and the issues facing
the paid workforce,72 and follow the principles in our response to the UK
Government’s proposals for health and care integration.73

65
Care Quality Commission (2020), Out of sight – who cares? [accessed: 9
September 2022], p. 46.
66
Care Quality Commission (2020), Out of sight – who cares? [accessed: 9
September 2022], p. 5.
67
Care Quality Commission (2020), Out of sight – who cares? [accessed: 9
September 2022], p. 46.
68
Equality and Human Rights Commission (2022), Our response to allegations
about mistreatment of people in Edenfield Centre Mental Health Unit [accessed:
24 November 2022].
69
Department of Health and Social Care (2022), Building the Right Support
Action Plan [accessed: 9 September 2022].
70
Welsh Government (2022), Learning Disability Strategic Action Plan 2022 to
2026 [accessed: 24 November 2022].
71
UK Government (2021), Build Back Better: Our Plan for Health and Social
Care [accessed: 23 August 2022]; Department of Health and Social Care (2021),
People at the Heart of Care: adult social care reform [accessed: 23 August
2022].

16
 Economic, social and cultural rights in Great Britain

There have been welcome commitments to reform the social care policy
framework in Wales, including to strengthen the integration of health and social
care,74 though the Welsh Government should also ensure that the social care
workforce is given sufficient support.75

In line with the right to independent living in the Convention on the Rights of
Persons with Disabilities, individuals should have choice and control over what
care they receive and how it is provided.76 However, the right to independent
living has not been fully incorporated into domestic law, meaning that disabled
people have no redress in the UK courts if it is breached.

72
Equality and Human Rights Commission (2022), Experiences from health and
social care: the treatment of lower-paid ethnic minority workers [accessed: 22
August 2022].
73
We recommend that the following key principles – based on the requirements
of relevant domestic and international legal instruments – should guide social
care reform: available, accessible, person-centred, choice and control,
community and connection, robust regulation and effective redress, support for
unpaid carers, and valuing the workforce. Equality and Human Rights
Commission (2022), Response to UK Government consultation: Joining up care
for people, places and populations [accessed: 17 November 2022], p. 9.
74
Welsh Government (2021), Health and Social Care in Wales – COVID-19:
Looking forward [accessed: 9 September 2022].
75
Carers UK (2021), State of caring 2021 report in Wales [accessed: 29
November 2022].
76
Equality and Human Rights Commission (2021), Strengthening the right to
independent living [accessed: 23 August 2022].

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 Economic, social and cultural rights in Great Britain

Access to healthcare (Article 12)

See: UNCESCR Concluding Observations paras 56 and 58, and UN

Sustainable Development Goals 3 and 10.

The National Health Service’s (NHS’s) pandemic response in England and

Wales included widespread COVID-19 vaccination coverage.77 There were
differences in vaccination rates across ethnic groups, with higher rates of
unvaccinated adults among Black Caribbean, White Other and Black African
ethnic groups in England.78 Barriers to vaccination uptake can include distrust in
vaccine safety and socio-demographic factors.79

In England and Wales, access to treatment for other conditions has been
restricted and waiting times for medical treatments were already increasing in the
decade before the pandemic.80 Though funding for mental health services has
increased,81 demand exceeds provision.82

77
UK Government (2021), Vaccinations in England and Vaccinations in Wales
[accessed: 22 August 2022].
78
Office for National Statistics (2022), Coronavirus (COVID-19) latest insights:
Vaccines [accessed: 4 October 2022]. For data on Wales, see Senedd Research
(2021), Which groups have lower rates of vaccine uptake? [accessed: 29
November 2022].
79
Scientific Advisory Group for Emergencies (2021), Factors influencing COVID-
19 vaccine uptake among minority ethnic groups [accessed: 4 October 2022], p.
6.
80
Health and Social Care Committee (2020), Delivering core NHS and care
services during the pandemic and beyond [accessed: 22 August 2022], p. 13;
Welsh Government (2021), Health and Social Care in Wales – COVID-19:
Looking forward [accessed: 22 August 2022], p. 25; Equality and Human Rights
Commission (2018), Is Britain Fairer? [accessed: 22 August 2022], p. 89.
81
NHS mental health dashboard [accessed: 22 August 2022]; Wales Fiscal
Analysis (2021), The NHS and the Welsh Budget: Outlook and challenges for the
next Welsh Government, Cardiff University [accessed: 22 August 2022], p. 25.
82
Care Quality Commission (2021), State of Care 2020/21: Rising demand for
mental health care [accessed: 22 August 2022]; Health, Social Care and Sports
Committee (2020), Inquiry into the impact of the COVID-19 outbreak, and its
management, on health and social care in Wales: Report 2 – Impact on mental
health and wellbeing [accessed: 22 August 2022].

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 Economic, social and cultural rights in Great Britain

The move to online and telephone healthcare services during the pandemic
made access easier for some but posed difficulties for digitally-excluded people,
including those in Gypsy, Roma and Traveller groups, older people and some
disabled people.83

Some protected characteristic groups face barriers to accessing healthcare. For

example:
̶ Some pregnant women report facing barriers to accessing treatment, such as
not feeling able to disclose sensitive health information over the phone.84
̶ There are extremely lengthy waiting times for gender identity services.85
̶ Ethnic minority women face inequalities in their experiences of maternity
services, including as a result of communication needs not being met or a
lack of cultural awareness.86
̶ Migrants, refugees and people seeking asylum face barriers to healthcare,
such as inconsistent or inaccurate information about services, or concerns
that their information will be shared for immigration enforcement purposes. 87

83
NHS Confederation Mental Health Network (2020), Digital inclusion in mental
health: a guide to help increase choice and improve access to digital mental
health services [accessed: 22 August 2022], p. 9; Doctors of the World (2020), A
Rapid Needs Assessment of Excluded People in England During the 2020
COVID-19 Pandemic [accessed: 22 August 2022], pp. 25-26; Centre for Ageing
Better (2021), COVID-19 and the digital divide [accessed: 31 August 2022], p. 9.
84
Karavadra, B. and others (2020), Women’s perceptions of COVID-19 and their
healthcare experiences: a qualitative thematic analysis of a national survey of
pregnant women in the United Kingdom, BMC Pregnancy Childbirth, vol. 20, no.
1, p. 600 [accessed: 24 November 2022].
85
For example, see NHS Cumbria, Northumberland, Tyne and Wear (2022),
Northern Region Gender Dysphoria Service, Waiting list/waiting times [accessed:
19 December 2022]; Tavistock and Portman Gender Identity Clinic (2022),
Waiting times [accessed: 22 August 2022]; Cass Review (2022), Interim report
[accessed: 22 August 2022], p. 32; Welsh Gender Service (2022), Home
[accessed: 24 November 2022].
86
Kapadia, D. and others (2022), Ethnic Inequalities in Healthcare: A Rapid
Evidence Review, NHS Race and Health Observatory [accessed: 4 October
2022], pp. 47-51.
87
Nellums, L.B. and others (2018), Access to healthcare for people seeking and
refused asylum in Great Britain, Equality and Human Rights Commission
Research report 121 [accessed: 22 August 2022].

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 Economic, social and cultural rights in Great Britain

The UK and Welsh governments have taken steps to improve access to

healthcare, including by publishing a Women’s Health Strategy for England and
updating the plan for ‘A Healthier Wales’.88 We welcome the UK Government’s
draft Mental Health Bill for England and Wales that strengthens the criteria for
compulsory detention.89 We consider that this Bill could be strengthened to
improve community-based services for people with learning disabilities and / or
autism, and address racial disproportionality in mental health detention.90

88
Minister for Health and Social Services (2021), A Healthier Wales action
review [accessed: 22 August 2022]; Department of Health and Social Care
(2022), Women’s Health Strategy for England [accessed: 22 August 2022].
89
Department of Health and Social Care (2022), Draft Mental Health Bill
[accessed: 21 August 2022].
90
NHS Digital (2021), Mental Health Act statistics, Annual Figures [accessed: 12
September 2022]; Equality and Human Rights Commission (2022), Written
evidence submitted by the Equality and Human Rights Commission [accessed:
10 October 2022].

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 Economic, social and cultural rights in Great Britain

Cultural life (Article 15)

See: UN Sustainable Development Goals 9 and 4.

Guidance from UNCESCR on the right to take part in cultural life notes that this
right is essential for the maintenance of ‘positive social interaction between
individuals and communities’. 91 ‘Culture’ is defined to include areas such as
sport, arts, technology, and religion and belief.

The right to take part in cultural life online is increasingly important. Digital
exclusion declined in the UK between 2011 and 2018.92 However, 10% of adults
did not use, or have access to, the internet at home in 2020, with factors such as
being aged 70 years or older, having a limiting or impacting condition, or living
alone, contributing to digital exclusion.93 This figure rose to 60% for people who
had all three of these characteristics.

There is geographic disparity in digital exclusion: the proportion of households in

Wales without internet access was 12% in 2019–20, decreasing to 8% in 2021–
22.94 People report a range of barriers to being online, including cost and a lack
of digital skills.95

The UK Government updated its Digital Strategy in 2022 and the Welsh
Government published its Digital Strategy in 2021.96 Both include commitments

91
United Nations Committee on Economic, Social and Cultural Rights (2009),
General comment no. 21: right of everyone to take part in cultural life [accessed:
23 August 2022], para 1.
92
Office for National Statistics (2019), Exploring the UK’s digital divide
[accessed: 9 September 2022], figures 1, 4, 8, 12 and 17.
93
Ofcom (2022), Digital exclusion: A review of Ofcom’s research on digital
exclusion among adults in the UK [accessed: 4 October 2022], pp. 9-10. The
source states that ‘limiting/impacting conditions’ include: ‘hearing, eyesight,
mobility, dexterity, breathing, mental abilities, social behaviour, mental health
and other illnesses’ (p. 9).
94
Welsh Government (2022), National Survey for Wales: results viewer
[accessed: 10 October 2022].
95
Ofcom (2022), Digital exclusion: A review of Ofcom’s research on digital
exclusion among adults in the UK [accessed: 4 October 2022], p. 11 and p. 14.

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 Economic, social and cultural rights in Great Britain

to increase digital inclusion. The Digital Strategy for Wales also indicates priority
groups for support, including older and disabled people.

Online safety is important to enable people, in particular children and young

people, to take part in cultural life digitally while being protected from harassment
and other unlawful behaviour. The UK Government introduced the Online Safety
Bill in March 2022, which seeks to establish a regulatory framework for a range
of online services, including social media.97 This Bill follows a ‘duty of care’
model, with services required to take action to minimise illegal content. This Bill’s
potential impact on human rights is unclear, but there are concerns that services
using automated systems to moderate content based on algorithms might risk
entrenching bias. This could result in unequal enjoyment of rights due to
disproportionate moderation of content posted by people with particular
protected characteristics.98

Barriers to physical participation in cultural activities remain. In sport, there is

evidence of racial discrimination as well as inequalities for sportswomen,99 which
can negatively affect mental health and future opportunities to participate in
sport.100 In this context, it is important that public services and community
activities promote understanding and respect for difference.

96
Department for Digital, Culture, Media and Sport (2022), UK Digital Strategy
and (2017), UK Digital Strategy [accessed: 9 September 2022]; Welsh
Government (2021), Digital Strategy for Wales [accessed: 9 September 2022].
97
Online Safety Bill [accessed: 9 September 2022].
98
Centre for Data Ethics and Innovation (2020), Review into bias in algorithmic
decision-making [accessed: 9 September 2022]; House of Lords
Communications and Digital Committee (2021), Free for all? Freedom of
expression in the digital age [accessed: 5 October 2022], para 43.
99
Sport Industry Research Centre (2021), Tackling Racism and Racial Inequality
in Sport review [accessed: 23 August 2022]; Bowes, A. (2021), A losing battle?
Women’s sport pre- and post-COVID-19, European Sport Management
Quarterly, vol. 21, no. 3, pp. 443-461.
100
AKD Solutions and others (2021), #Tellyourstory [accessed: 23 August 2022].

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 Economic, social and cultural rights in Great Britain

Recommendations

Equality and human rights legal framework

The UK and Welsh governments, as appropriate, should:
 Give legal effect to the International Covenant on Economic, Social and
Cultural Rights, and the six other ratified human rights treaties, in
domestic law to ensure access to enforceable rights.
 Ensure that any changes to the human rights legal framework are subject
to wide consultation and pre-legislative scrutiny.
 Review the unimplemented provisions of the Equality Act 2010 and
effectively fulfil their responsibilities under the Public Sector Equality Duty,
and Socio-economic Duty where applicable.
 Ensure that any changes to the legal framework following consideration of
retained European Union law are subject to parliamentary scrutiny and
ensure no reduction of rights.

Conditions at work
The UK and Welsh governments, as appropriate, should:
 Improve the transparency of recruitment, retention, progression and pay
reporting for ethnic minority and disabled workers, and ensure that
reporting is coherent with the existing reporting framework for gender pay
gaps to support employers.
 Improve the employment protections available to people in insecure work,
including by increasing access to statutory sick pay and establishing a
single enforcement body for employment rights.
 Bring forward measures to reduce the discrimination experienced by
pregnant women and new mothers, and remove barriers to their securing
redress.

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 Economic, social and cultural rights in Great Britain

Poverty
The UK and Welsh governments, as appropriate, should:
 Examine the factors causing higher poverty levels among certain groups,
develop accountability mechanisms to address them, and reintroduce
income poverty-related targets for the eradication of child poverty.
 Address the impact of labour market changes on workers with different
protected characteristics and ensure that public investment and
procurement target disparities in employment and training.
 Use the Socio-economic Duty to ensure Welsh public bodies prioritise
action to address the most significant inequalities, and bring forward plans
to update the Child Poverty Strategy for Wales.

Housing
The UK and Welsh governments, as appropriate, should:
 Reduce the number of people living in substandard and overcrowded
housing, including by ensuring that there are strong monitoring,
improvement and accountability frameworks for housing providers and by
addressing data gaps.
 Regularly publish information about the performance of asylum
accommodation providers and planned service improvements to ensure
sufficient provision of safe accommodation that meets the needs of people
seeking asylum, including access to healthcare and legal advice.
 Direct local authorities to increase Gypsy and Traveller site provision, and
regularly report on how and where funding for housing is used for sites.

Social care
The UK and Welsh governments, as appropriate, should:

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 Economic, social and cultural rights in Great Britain

 Ensure, and set out how, proposals for social care reform enhance
equality and human rights protections, including by supporting the
workforce, and meet the requirements of relevant domestic and
international legal instruments.
 Prioritise addressing the inappropriate detention of people with learning
disabilities and / or autism, and ensure that abuse and excessive use of
long-term segregation, seclusion and restraint are ended.
 Incorporate the right to independent living in domestic law to ensure
disabled people’s rights in, and to, care are protected and can be
enforced.

Access to healthcare
The UK and Welsh governments, as appropriate, should:
 Amend the Mental Health Act to improve access to mental health
services, including community-based services, to meet the needs of
protected characteristic groups and to address racial disproportionality in
the use of compulsory detention and community treatment orders.
 Address barriers that protected characteristic and other groups face in
accessing healthcare, including by improving providers’ knowledge of
patients’ rights and by increasing capacity at gender identity services to
tackle long waiting times.

Cultural life
The UK and Welsh governments, as appropriate, should:
 Establish a regulatory framework for online service providers that gives
effective protection from harm and for freedom of expression, ensuring all
groups can fully and safely participate in cultural life online.
 Publish regular updates on the impact of strategies to increase digital
inclusion and assist the digitally excluded, including the impact on
protected characteristic groups.
 Work with partners to increase understanding of human rights, such as
the right to take part in cultural life, among the public, policymakers, public
authorities and other relevant institutions, including in areas such as sport.

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 Economic, social and cultural rights in Great Britain

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© 2023 Equality and Human Rights Commission

Published January 2023

ISBN: 978-1-84206-871-7

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