With a legacy of grand Victorian hospitals and cramped GP practices, the NHS faces some of the biggest challenges in meeting the needs of the Disability Discrimination Act.
The NHS Executive estimates it will cost £500m to become entirely disability-friendly in all it does.
In wider terms, the DDA means asking the NHS to think hard about how it delivers its services.
If patient choice is the cornerstone of NHS reform, how is it applied to the needs and preferences of disabled patients?
According to the Disability Rights Commission, if the NHS is going to meet its targets, it not only has to provide the ramps, but hearing loop systems, sign language interpreters and literature in alternative formats. And that's just a start. These are not optional extras, but essential to the NHS's very aims, say campaigners.
But many changes are quite simple and it's thought the £500m bill could be halved if disability is taken into account at the planning stage of works and modernisation.
And in the long-run, disability-compliant doors or a booking system which notes a patient's requirements, could save the NHS both time and money.
TRAINING FOR NHS STAFF 2003
90% of Primary Care Trusts had no compulsory disability training
50% had no training plan at all
50% did not consult disabled patients
Source: Leonard Cheshire