Barriers to Accessing Health Care Services

In this essay I am going to critically analyse diversity at heart the National wellness Service (NHS. I will briefly sharpen on barriers to accessing wellness cargon return in relation to age, race, disability, gender and culture and intimate penchant. I will consider the barriers which have unintentionally been put into place within different health go for or so(prenominal) service users and members of staff, and the measures that have been taken in order to redress these pops by the government, NHS and De postment of Health (DOH).Diversity is the inclusion of all irrespective of an individuals age, race, capabilities, cultural background, gender or familiar orientation. The St. Helens and Knowsley NHS trust affirm this imagel describing diversity as, Different individuals valuing each other(a) regardless of skin, intellect, talents or grades. This is a quote the St. Helens and Knowsley trust have used from the Equality Act 2000 on their website to show their beliefs touch diversity.In alliance every individual is innate(p) other than, much(prenominal) as hair colour, skin colour, phallic or fe anthropoid, sexual orientation (depending on your belief that sexual orientation is genetic and non environmental), born into different religious and cultural backgrounds. As the U. K. has become ever more(prenominal) a multi-cultural society, issues such as diversity and anti- antiblack practices have become ever more signifi force turn upt within our society. An individual who has been treated differently or received an unequal quality of service based on a preconceived idea ascribable to a minority congregation they may mark themselves with have been discriminated against. deep down the NHS these minority groups argon kn have as characteristics, as in characteristics which help build an individuals idea of their own self-concept. Since the Equality Act was up-dated in 2010 the NHS have not besides embarrassd race, culture, gender, capabiliti es, religious beliefs and sexual orientation but overly now include, pregnancy/ maternity, marriage/civil partnerships and sustainmentrs as part of their protected characteristics policy. (http//www. nhs. uk). For the head start time the law also protects spate who argon at risk of unlikeness by sleeper or perception. This could include, for usage, a misgivingr who cares for a disabled person (http//www. nhs. uk) There are two forms which inconsistency gouge take place the first is called direct contrariety. Direct discrimination is when an individual is treated differently unremarkably negatively or unfairly compared to others based on the individual discloseing themself with one of the above protected characteristics.collateral discrimination is when a law, policy or mathematical function has been put into place, which applies to everyone, but this law, policy or procedure will disadvantage individuals who associate or identify themselves with the above protected cha racteristics. However delinquent to organisations commission too much on anti- anti-Semite(prenominal) practice a new controversial concept of positive discrimination has begun to emerge, this is also creation called positive/ affirmative go through. commanding discrimination is where minorities or individuals, who associate or identify themselves with the protected characteristics, are given preferential treatment to others. An example of this would be two candidates who are both equally qualified for a job, settle down one candidate is a white, heterosexual male and the other candidate is a black, homosexual female, by positive discrimination the second candidate would receive the position.Positive discrimination can be due to pressure felt by the organisation to employ a diverse work force, to fill a quota to ensure the organisation cannot be accused of being discriminatory or historical guilt for issues such slavery. The idea of positive discrimination came from the US whe re an affirmative action programme has been used to try and ensure the make-up of certain workplaces reflects that of society. (http//www. marklaw. co. uk) It has been suggested that the root cause of discrimination is due to prejudice.Prejudice is a stereotyped, pre-conceived idea of the way an individual or social group should portray themselves within society (Walsh et al, 2005). For example all Irish people drink alcohol excessively. Prejudices can be a result of your own beliefs and values, which can often come into conflict with work situations. (Pg. 194, Nolan et al, 2005). There are no laws in place against being actively prejudice, this is why the law concentrates against discriminatory practices. (Walsh et al, 2005. )Ageism is commonly purpose of as discrimination against the elderly many nursing and health and social care textbooks affirm this belief, Kydd et al (2009, Pg. 49) state that Ageism is the generalisation of old age as a social problem, this has contributed to the negative stereotyping and ageist practices in relation to older people. However this is a false perception. Ageism can affect individuals of all ages, for example in 2004 the upper age terminus ad quems of free breast screening were 69, (http//www. imsersomayores. sic) however due to a growth older population this age obstruction was raised to 73 in 2010 and the lower age limitation remained at 47. (http//www. cancerscreening. nhs. uk). Stu scares carried by the cancer research charity show The 5 Most Commonly Diagnosed Cancers in Females, Average Percentages and Numbers of New Cases, by Age, UK, 2007-2009 (http//www. cancerresearchuk. org). Breast cancer is highest in both categories of women aged 25-49 and 50-74, however in the group 25-49 breast cancer was more prevalent by 10% (43%) compare to the 34% in the group of women aged 50-74.These figures show there is a need for the lower age restriction to be reduced. This NHS policy for age restrictions on breast screenin g inescapably to be reviewed as it can be viewed to be discriminatory towards women in the UK under 47 who are proven to be in need of this health service. Racism is the belief that one race is superior to another (walsh et al, 2005) throughout account statement millions have faced discrimination and persecution due to this belief the most prevalent examples of this is in the Jewish lodge and the Black community.As the UK continues to become a more diverse, multi- cultural society racialism continues to plague Britain. Penketh (2000, Pg. 7) affirms this by stating, Black people are more likely to be stopped and searched, arrested, imprisoned and even to die in custody than whites. Studies carried out by Unison, the UKs largest healthcare trades union found that 70% of their non-Caucasian knobs employed by the NHS had endured racism or racial discrimination at work, some employees had experienced verbal abuse and visible abuse in relation to their race. (http//www. unison. org . uk).From this study the NHS have brought out an initiative to help eradicate racism within the NHS, part of this initiative is to have a smash complaints and redress system in place, as three quarters of the employees in this study who experienced racism or racial discrimination were unsatisfied with the outcome when the incident was reported to their management. Disablism refers to prejudices against individuals who have suffered mental, physical or sensory injurys. In the past speech such as lunatic, spastic and cripple were acceptable words used within health care settings as a way to describe an individual with item needs.These terms are still rife within society today. (Walsh et al, 2005). Goodley (2011, Pg. 24) states People with some form of impairment are likely to experience social disadvantage, a lack of opportunities and unfair discrimination. Barton (2002) agrees with this as Barton theorises that individuals with a sensory, physical or mental impairment will at s ome stage in their life experience oppression in both institutional and individual forms, this can be due to absence of choices, barriers to funding, unanticipated deterioration in their impairment or general ignorance. within the NHS discriminatory practices occurs on a mending basis despite programmes such as Valuing People Now being released by the DOH in 2009, this was a three year strategy to help improve the quality of life for individuals with learning difficulties. This year MENCAP have released a report called Death by Indifference 74 deaths and Counting. This report highlights the failings within the NHS to run an equal quality of care for those with specific needs and learning difficulties.The main areas of failing that subsequently genius to the needless deaths of many patient ofs with learning difficulties are failure to recognise pain, poor communication, diagnostic overshadowing, and delayed treatments, hostile DNRs and lack of basic care. Throughout the report it is emphasised the lack of compliance not only to the Equality Act but also the Mental Capacity Act, in relation to DNRs being allocated to patients without the consent or the knowledge of the patients family, friends or advocate. Again a major issue within the report is the NHS complaints and redress system in place. MENCAP,2012) In this report we deal with the inadequacies of the NHS complaints process.On middling it can take 18 months- 2 years to reach the Local stage, and between 2 years- 4 years to complete the ombudsman stage. (MENCAP,2012, Pg. 7). Sexism is the belief that one gender is superior compared to the opposite sex, it is generally felt that women work to be sexually discriminated against within society more so than men. (Walsh et al 2005). Within the health care profession a patient may express a preference in the gender of the health care practitioner (HCP) who provides their personal care (Smith t al, 2011). This is not to be seen as sexual discrimination aga inst the HCP, by noncompliance with the patients request this can be viewed as discrimination against the patients religious and cultural beliefs. However due to under funding and under staffing with the NHS the ability for HCP to work out these requests has been compromised. Modesty in dress and a requirement to be treated by a recompense/nurse of the same sex is also important in some religions. NHS staff should consider these requirements in order to preserve the dignity of the patient.However, it is not always possible or feasible to provide same-sex attendance, particularly without adequate notice that this might be an issue, and this should be made clear at the time of fashioning appointments (DOH, 2009) The Royal College recognise the need for a review within staffing levels within their 2011 report Mandatory nanny-goat Staffing levels, they also acknowledge the impact staffing levels have on a patient, they state, There is a growing soundbox of evidence which shows nur se staffing levels makes a difference to patient outcomes, patient experience, quality of care, and the efficiency of care delivered. (RCN, 2011). Within a female dominated profession such as nursing it is felt that males tend to be more so discriminated against sexually than females. A recent example of this on a national give-and-take level is the case of Andrew Moyhing, a male student nurse who won a sexual discrimination case against the NHS. He was told by a female staff nurse that he would need to be chaperone by a member of staff as he attached an electro-cardio machine to a female patient, due to intimate care required .Mr Moyhing felt this was unfair as female students on the same ward were unsupervised when carrying out personal hygiene and intimate care on male patients. The Equality Opportunities Commission supported Mr Moyhing releasing this statement, The Employment Appeal Tribunal was right to find that it was not acceptable to have a chaperoning policy based on lazy stereotyping, Male nurses are still seen as a bit of an oddity simply because there are so many more women in the profession than men despite the fact that so many doctors are male. (www. ews. bbc. co. uk/1/hi/health). The charity ManKind this year released a report presenting the Seven Challenges Male Victims Face, it highlights various forms of sexism specially within statutory service such as the NHS, Practically all training with in the police, NHS and topical anaesthetic authorities is aimed at women as the victims, men as the perpetrators. (See appendix 2). heathen discrimination is when a society does not accommodate or recognise the needs of an individual or group of people from a different religious or cultural background.As a society there will be expectations of what the social norms are, what is acceptable and what is not acceptable. When an individual or social group show beliefs or needs that do not fit in with our own social norms they can be met with hostility and intolerance. (Walsh et al, 2005). Cultural barriers can prevent, for example consideration of spiritual, relational or dietary needs that do not adapt to traditional expectations. (www. bridgingthegap. scot. nhs. uk).There are many areas of patient care which are can be jeopardised due to ignorance of cultural beliefs, examples of these which are emphasised in the NHS guidelines for cultural and religious beliefs are Diet- many religions are curb as to what types of food they can eat, and how the food was prepared, for example an orthodox Jew will not eat pork or any meal that has come into contact with a pork product, Muslims also have analogous beliefs surrounding food preparation.Personal Hygiene- as mentioned before patients often express preference to the gender of the HCP who wait on with their personal care. An orthodox Muslim will only wash in running water, therefore pass a basin of water to wash in may be seen as offensive. Palliative care and Dying- each religio n has different views are to how a clay should be laid out, when a patient dies the patient is given the Last Offices, if a patient is Christian a bible is also usually set in the room, however some religions find it offensive for anyone except the family to lay the body out. http//www. bfwh. nhs. uk). This is why more importance needs to be emphasised on patient admissions and selection in the ADL forms to the best of our ability, as it can prevent any future offence or discriminatory practices. As you can see in the Activities of Daily Living (ADL) (see appendix one) spiritual needs are mentioned, however the contents of the ADL will vary from trust to trust and all trusts do not include religion or spiritual needs.In the caring profession patients have shown signs of frustration, confusion and anger as their cultural beliefs are not met, over looked or ignored. (Leininger, 1991). Discrimination based on sexual orientation, Roper, Logan and Tierney identify sexuality as one of t he ADL (Mckenna et al, 2008), within each NHS trust it varies as to what is recognised as an ADL. As you can see (appendix one) the trust I work for have not included sexuality.Many people within society see sex as a taboo subject and therefore find it a difficult topic to approach and discuss openly, however sexual health is a part of holistic health and should be taken as seriously as any other scene of health such as mental, emotional or physical. The World Health Organisation defines health as, a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. (WHO, 1948). Studies have shown that the homosexual community are greatly disadvantaged and are the least likely group that identify with the protected characteristics to access health services.There are a variety of reasons due to this such as, a patient may not be openly gay, when they do access health services a majority of the time assumptions are made the reason for accessi ng that health service is related to the patients sexual health, also when homosexuals do access sexual health services they feel a stigma of promiscuity has been attached to the homosexual community. (Dunn et al, 2010). In conclusion from this essay I have realised barriers to health service access are a key factor in differential health outcomes among population groups within society. WHO, 2001) Although policies and procedures have been put in place by governing bodies to decrease the occurrence of discriminatory practice, these policies are not always effective they are only effective when they are enforced by the organisation. Within the health care profession we must always strive to respect an all aspects of an individuals identify and self-concept (Walsh et al, 2005). Simple measures such as filling in an ADL to the best of your ability can be a preventative method to causing future offence, or discrimination to a patient.