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Equality: Discrimination and Health Sector

By Gragwar Jan 31, 2014 1996 Words
Critical Evaluation of Equal Opportunity Legislation and its impact within the Health Sector;

Promoting equality across the world is a constantly evolving process, and although complete social solidarity is all but impossible due to the nature of humankind, our increasingly multi-cultural societies demand fair and just laws for all people. “Men are born equal but they are also born different.” Because all people are different and have individual needs, to treat all people the same would be promoting inequality. The ‘Equality Act 2010’ is an Act introduced to “strengthen and streamline the legislation relating to equality” , hence improve equal opportunities for all groups of people in the UK, regardless of race, gender, age, disability, gender reassignment, sexual orientation, religion or belief. The Equality Act 2010 is enforced throughout the UK with any organisation in contact with the public, and has been since the 1st of October 2010. Therefore any person or group receiving healthcare should be protected under the Act, and will be entitled to the correct care to suit their needs. Because of the vast amount of legislation encapsulated within the Equality Act 2010, it is important to monitor service providers to ensure the laws are being upheld. As well as managers, staff, and service user feedback, we also have the Care Quality Commission (CQC). “We make sure hospitals, care homes, dental and GP surgeries, and all other care services in England provide people with safe, effective, compassionate and high-quality care, and we encourage them to make improvements.” It is also the CQCs responsibility to ensure that equality, diversity and the human rights of all service users are being promoted. So the Equality Act 2010 attempts to protect all people in the UK against discrimination, and Section 13 of the Equality Act defines direct discrimination as; “(1) A person (A) discriminates against another (B) if, because of a protected characteristic, A treats B less favourably than A treats or would treat others.” This legislation is of great importance to all groups of people, and is intended to help prevent discrimination within the health sector.

However this is not always the case, the Winterbourne View atrocities in 2011 for example, whereby T.V show Panorama uncovered people with learning disabilities being neglected and abused. The CQC were “heavily criticised” for their lack of action prior to the panorama T.V show, despite many reports and complaints of abuse. “We did not respond as we should have and we have offered our apologies to the patients and their families.”. Despite their apologies, the Disability Discrimination Act (DDA), and the Mental Health Act (MHA), both part of the Equality Act 2010, had been broken. This was a result of the CQC operating within the terms and requirements of the Health and Social Care Act 2008 (HSCA). The Department of Health requires the CQC to ensure that our services comply with the regulations of the HSCA, however these regulations did not uncover the extent of abuses at the Winterbourne View Care Home. So the CQC were operating within the law, and the Equality Act 2010 legislation had not prevented, or recognised this blatant discrimination. As a result, this meant that the disabled people at Winterbourne View Care Home suffered physical and irreversible psychological harm. Their families also suffered psychologically, “Viewing the footage shown in court this week has been distressing and extremely harrowing,” . This statement read by Beverley Dawkins, Mencap’s national policy manager for profound and multiple learning disabilities, was read on behalf of the parents of the victims. This demonstrates how damaging the experience must have been for them, and like any situation where a loved one is being harmed, we always consider what we could have done to stop it, perhaps blaming themselves for not stopping the abuse. One of the victim’s parents even tried to commit suicide.. This evidence demonstrates how influential discrimination can be, and the importance of equality. As a result of the Winterbourne case the CQC has made amendments to reduce the risk of this happening again within these environments; Follow-up on action plans when services aren’t meeting national standards. Build new ways to work with local safeguarding teams.

Develop the way we analyse safeguarding alerts so we can spot trends in care. By making these modifications to its code of practice the CQC are focusing on the recognition of problems as they are taking place. This is important as preventing problems before they occur is not always possible, especially when considering that the staff at the Winterbourne View establishment were said to be "poorly paid and untrained”. Another critical aspect when considering equality within the health sector, is that the service provider’s ‘protected characteristic’ sometimes has no protection from discrimination regarding the service user. For example a person can refuse treatment from a doctor based on skin colour, yet not state outright their prejudicial motives. A doctor on the other hand may not discriminate in this way, and any prejudices’ he/she may have must be confined if he/she are to adhere to the Race Relations Act 1976 (RRA), and failure to do so will result in prosecution in accordance with the Equality Act 2010. “If the protected characteristic is race, less favourable treatment include’s segregating B from others.”(Equality Act 2010) This type of prosecution could lead to a maximum civil penalty of £20,000 for each person who is discriminated against. Therefore in such a situation, surely the only way to provide equality for the ‘user’, and ‘provider’, would be to let the service provider pick and choose their patients depending on their own prejudices’? Of course this is a ridiculous proposition, but it does show how discrimination can sometimes be invisible within healthcare, and that even legislations such as the Equality Act 2010, can subsequently promote inequality. While considering ‘Race’ in the health sector, it must also be remembered that different Races’ also present different cultures’. These can be sometimes unsurpassable when trying to create equality within a society. A good example is the case concerning Shirley Chaplin, an NHS nurse who insisted that her ‘beliefs’ required her to wear a crucifix while working. However her employer, along with the European Court of Human Rights (ECHR), decided it was a health and safety issue. This resulted in Chaplin losing her job as a direct result of her beliefs, “NHS’ uniform policy was that, for health and safety reasons, no necklaces were to be worn when handling patients. This policy gave rise to a conflict between Ms Chaplin’s duties and her religious beliefs” This shows how legislations can conflict with each other, and how discrimination can sometimes be unavoidable when considering the ‘the greater good’. ‘The greater good’ however is not always clear, and may have shifted due to the ramifications following this case. Chaplin, after wearing her crucifix for 30 years without complaint, felt “she was forced to choose between her job and her faith” and claimed she felt “angry…..and personally discriminated against”. Also because the Muslim staff at the hospital were allowed to wear head scarves to represent their beliefs, she had felt singled out. Just by reading this article I could sense a bitterness within Chaplin, and I believe it is possible that her experience may have provoked her to adopt a prejudicial mind-set. This of course this would then mean that her family and friends would be told her opinion of the events, no doubt stories of how she was ill-treated, and how she felt that ‘Muslims have an advantage over Christians’. Basically ‘Labelling’ and ‘Stereotyping’ across the board of the NHS. Obviously I am speculating, but it doe’s demonstrate how easily people can feel hurt by legislative restrictions, and how quickly when somebody feels they have been done an injustice, can become hostile, hateful, and quite happy to start discriminating themselves. Another topic which occurs in the Health Sector as a result of cultural differences, is that of language barriers. This is a controversial problem, and in an increasingly multicultural society, a very difficult one solve. “The reality is that the migrant population is increasing, the non-English speaking population is increasing and extending down the generations. It is a huge problem in healthcare delivery and the NHS needs to deal with it.” This quote demonstrates the severity of the language barrier conundrum, and in certain establishments the NHS even use “Yes/No computer programs” as communication methods, along with hand gestures and broken English. Without doubt those who receive healthcare in the UK that do not speak English, will have a reduced quality of care. If a Diabetic needs immediate attention for example, and cannot inform anyone. Or if a patient is allergic to penicillin, yet they need an operation ASAP. These sorts of situation are potentially fatal, yet RRA does not cover this issue. The Equality Act 2010 however, states that all people must receive the same level of care, regardless of their ‘protected characteristics’. This to me sounds more like a wish than a fact, and fear it cannot be upheld. Another result of language barriers, is the detrimental effect they can have on a patient’s self-esteem. For example, if a woman is admitted to hospital regarding a personal problem which only occurs in females, and her only point of contact is through her son. She may be reluctant to tell her son due to the nature of the issue, and instead asks for a translator. Following this the hospital provide a male translator, unaware of her issue. Not only does this cross the lines of both Racial and Sexual Discrimination, but the woman will be crushed. Her dignity would have been taken, her relationship with her son would be damaged, and she will be terrified about ever stepping into a hospital again. Which of course could lead to any future health problems going untreated, ignored and left to deteriorate rather than experience her ordeal again. So I believe it is fair to conclude, given the evidence in this essay, that government legislation is widely implemented throughout the UK’s Health and Social Care sector. And that every attempt is being made to cater for all ‘protected characteristics’, supported by the CQC’s constant reviews, and changes codes of practice (Winterbourne) wherever necessary to promote equality. However it is also very clear, that despite our often successful attempts in promoting equality, it is a battle that can never be won. Referring back to my 1st quote, “…men are born equal but they are also born different”. I would say that it is possibly our greatest asset to be unique, yet also is the reason that equality, I believe, is impossible. With 63.23 million personalities in the UK, and 7.046 billion personalities potentially visiting the UK, it’s safe to say that someone somewhere will not be experiencing equality.

References
BBC. (2011). Retrieved from BBC News: http://www.bbc.co.uk/news/uk-england-bristol-20092894 Bevitt, A. (2013, April 5). Retrieved from Management Today: http://www.managementtoday.co.uk/features/1176622/mt-expert-religious-symbols-place-work/ CQC. (2012, August). Retrieved from Care Quality Commission: http://www.cqc.org.uk/public/news/our-role-winterbourne-view-and-changes-we-will-make-protect-people-abuse CQC. (2012, August 7). Care Quality Commission. Retrieved from http://www.cqc.org.uk/public/news/our-role-winterbourne-view-and-changes-we-will-make-protect-people-abuse CQC. (n.d.). Care Quality Commission. Retrieved from Care Quality Commission: http://www.cqc.org.uk/about-us Equality Act . (2010). Legislation.gov.uk.

Flynn, M. (n.d.).
Flynn, M. (2012). Winterbourne View Hospital.
Fromm, E. (1900-1980). Retrieved from infed.org:

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