Asked by: Baroness Whitaker (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what steps have been taken to address concerns raised by the UN Committee on the Convention on the Elimination of all Forms of Racial Discrimination, the UN Committee on Economic, Social and Cultural Rights and the UN Committee on the Rights of the Child, that Gypsy, Traveller and Roma communities are frequently refused registration at GP practices.
Answered by Baroness Blackwood of North Oxford
Registering with and access to primary medical care services is the same for all patients, whether they are gypsies, travellers, homeless or vulnerable migrants. People do not need to provide proof of address to register with a general practice (GP). NHS England is working with a range of community groups to redesign the patient registration leaflet so that people are aware of this when registering. The free NHS 111 service can assist anyone who has faced difficulty finding a GP or accessing other services in their local area.
NHS England is aware of difficulties some individuals have faced when trying to register with a GP and is taking steps to address shortcomings with individual practices, working in partnership with the voluntary sector.
The Voluntary, Community and Social Enterprise Health and Wellbeing Alliance is a partnership arrangement with the aim to facilitate integrated working between the voluntary and statutory sectors, to promote equality and reduce health inequalities. It receives £1.2 million for core work from the Department, with each member receiving funding of up to £60,000. Friends, Families and Travellers is a member of the Alliance and has supported the Department on a range of work to date including the Inclusion Health Audit Tool, on maternal health, mental health, end of life care and dementia.
Asked by: Baroness Whitaker (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government which of the eight key recommendations they plan to implement from the final report by Leeds GATE, the University of Dundee and the University of York Enhancing Gypsy, Roma and Traveller peoples’ trust: using maternity and early years’ health services and dental health services as exemplars of mainstream service provision, published on 14 September 2018.
Answered by Baroness Blackwood of North Oxford
The Department is currently considering the recommendations set out in the report Enhancing Gypsy, Roma and Traveller peoples’ trust: using maternity and early years’ health services and dental health services as exemplars of mainstream service provision to improve uptake of services and reduce inequalities.
Asked by: Baroness Whitaker (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government, following the commitment to address health inequalities in the NHS Long Term Plan, published on 10 January, what steps they intend to take to tackle the health inequalities experienced by members of the Gypsy, Roma and Traveller communities.
Answered by Baroness Manzoor
During 2019 all local health systems will be expected to set out how they will reduce health inequalities by 2023/24 and 2028/29 including, where applicable, for Gypsy, Roma and Traveller (GRT) communities.
We are reviewing the collection of data within the National Health Service and working closely with NHS England to complete a scoping exercise to understand how information on protected characteristics is gathered in existing NHS datasets. The Department plans to complete an initial assessment later this year, which will form the basis for future decision-making on NHS data collection by ethnicity.
NHS England has produced guidance for general practices clarifying rights of patients and responsibilities of providers in registering with a general practitioner. It also co-produced a leaflet for members of the GRT communities on how to register. These will be kept under review.
The Department of Health and Social Care is also working closely with the Ministry for Housing, Communities and Local Government and the Department for Education on six community-led pilot projects, two of which are looking to improve health outcomes for GRT communities.
The Government commissioned research from the universities of Dundee and York examining how trust in healthcare services could be enhanced amongst Gypsy, Roma and Traveller communities. The report, Enhancing Gypsy, Roma and Traveller peoples’ trust: using maternity and early years’ health services and dental health services as exemplars of mainstream service provision, was published in September 2018. It has made eight key recommendations to the health sector and other key providers, which include increasing collaborative working with those that already have trusted relationships with GRT communities e.g. individuals from third sector organisations, individual health or other sector professionals; and suggested the introduction of literacy help-cards throughout the NHS. These are cards that can be presented to front line staff or receptionists to ask for discreet help with form-filling. A copy of the report is attached.
Asked by: Baroness Whitaker (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government, further to the Written Answer by Lord O'Shaughnessy on 9 April (HL6732), whether they are taking account of the finding in the report by the Social Exclusion Task Force and Department of Health, Inclusion Health, published in March 2010, that lack of ethnic monitoring in relation to Gypsy, Roma and Traveller communities “makes it difficult to ascertain which services are making a difference, to whom, and by how much”; and what progress they have made with NHS England to investigate whether data collection in the NHS could include more of the protected characteristics listed under the Equality Act 2010 to provide better information about Gypsy, Roma and Traveller communities’ access to healthcare.
Answered by Lord O'Shaughnessy
The Department is in the process of reviewing the collection of data within the National Health Service and has commissioned NHS England to complete a scoping exercise to understand how information on protected characteristics is gathered in existing NHS datasets, including the NHS Data Model and Dictionary which currently use the 2001 census ethnicity categories. Subject to the publication of the 2021 Census White Paper, we plan to complete an initial assessment by the end of 2018, which will form the basis for future decision-making on NHS data collection.
Asked by: Baroness Whitaker (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government whether the NHS Data Model and Dictionary will include entries for (1) Gypsies, (2) Travellers, and (3) Roma; and if so, when.
Answered by Lord O'Shaughnessy
The Department is in the process of reviewing the collection of data within the National Health Service and has commissioned NHS England to complete a scoping exercise to understand how information on protected characteristics is gathered in existing NHS datasets, including the NHS Data Model and Dictionary which currently use the 2001 census ethnicity categories. Subject to the publication of the 2021 Census White Paper, we plan to complete an initial assessment by the end of 2018, which will form the basis for future decision-making on NHS data collection.
Asked by: Baroness Whitaker (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what information about Gypsies, Travellers and Roma community is available from the NHS’s Improving Access to Psychological Therapies programme.
Answered by Lord O'Shaughnessy
This information is not available as Roma, Gypsies and Travellers are not separately identified in NHS Digital codes used when recording ethnicity of patients.
Asked by: Baroness Whitaker (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what training is provided to Clinical Commissioning Groups about Gypsy, Roma and Traveller issues in general, and with regard to dementia in particular.
Answered by Lord O'Shaughnessy
Information on training provided to clinical commissioning groups (CCGs) is not held centrally, as it is for CCGs to determine their specific needs.
Asked by: Baroness Whitaker (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what data, if any, they collect in relation to the diagnosed mental health status, and self-harm and suicide rates among self-identifying Gypsies and Travellers within the secure estate; and how such recorded data compares with that of other ethnic groups whose ethnicity is recorded on NOMIS or is otherwise monitored.
Answered by Lord O'Shaughnessy
Data on people detained in the secure estate, including secure mental health hospitals, prisons and immigration removal centres, are collected in different ways across Government. Across the secure estate, data on ethnicity is collected through self-reporting which impacts the ability to provide ethnic breakdowns with confidence.
The Mental Health Services Data Set (MHSDS) collects data on people in contact with National Health Service funded secondary mental health, autism and learning disability services, including secure mental health hospitals. The MHSDS uses ethnicity codes which align with the 2011 Census and NOMIS ethnic groups and includes a category for ‘White (Gypsy or Irish Traveller)’. It does not collect data on suicide and self-harm rates of people identifying as gypsies or travellers.
Prison recording systems such as the Prison National Offender Information System (p-NOMIS) do not hold clinical data, although individual prisoners’ records may refer to aspects of it where relevant. An example is that a vulnerable prisoner being supported through the Assessment, Care in Custody and Teamwork (ACCT) process may have mental health needs that are noted in their ACCT documents, so that non-clinical staff are aware of them and will respond appropriately.
p-NOMIS records incidents of self-harm and all deaths of prisoners, including suicide. For ethnic monitoring it uses the same classifications as the 2011 census. The specific option for Gypsies or Travellers is ‘White (Gypsy or Irish Traveller)’. Anyone not identifying themselves as such may use another, such as ‘White (other)’ or ‘Other’. It is not possible to calculate rates of self-harm or suicide by ethnicity with confidence.
Data on people detained in immigration removal centres is recorded by nationality. Data is not routinely recorded on people who may identify as gypsy or traveller. The Office for National Statistics, which is the official source of suicide data for the United Kingdom, does not collect data on suicide registrations by ethnicity.
Asked by: Baroness Whitaker (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what assessment they have made of the recent study by the University of Essex, The Cumulative Effect of Racial Discrimination on the Mental Health of Ethnic Minorities in the UK; and what monitoring they undertake or evidence they collect in relation to the impact of racism on the mental health and wellbeing of Gypsy, Traveller and Roma people.
Answered by Lord O'Shaughnessy
It is planned that The Cumulative Effect of Racial Discrimination on the Mental Health of Ethnic Minorities in the UK will be examined as part of a wider piece of work to be undertaken by the voluntary, community and social enterprise (VCSE) Health and Wellbeing Alliance programme. This is to examine effective strategies to reduce racial disparities in mental health. The programme is overseen by the Department, NHS England and Public Health England, who work together with VCSE organisations to drive transformation of health and care systems; promote equality; address health inequalities and help people, families and communities to achieve and maintain wellbeing. It is anticipated that work will begin later this summer.
The impact of racism on the mental health and wellbeing of Gypsy, Roma and Traveller people is not routinely monitored.
The Department has commissioned NHS England to scope out whether data collection within the National Health Service could be improved to include more of the protected characteristics listed under the Equality Act 2010. The Government is committed to improving NHS data collection to better understand the extent of inequalities, determine health outcomes and uptake of health services for these communities. The initial scoping exercise is due to be completed later this year.
The Government is committed to ensuring that attention is focussed on developing national and local services to reduce unfair gaps in outcomes between ethnic groups. The Government’s ethnicity facts and figures online resource brings together information from across Government about how ethnicity affects people's everyday lives.