NHS to act on unequal service to minorities

THE GOVERNMENT is acting to improve the service that people from ethnic minorities can expect from the National Health Service.

A scheme to monitor their needs has been coupled with a campaign to promote employees from ethnic minorities into influential jobs in the NHS.

The initiatives, headed by Virginia Bottomley, the Secretary of State for Health, follow official acknowledgment that their needs have been neglected, ignored or not understood.

The aim is to see reductions in the disproportionate levels of heart disease, strokes, and mental illness found in particular communities and to improve services for groups of people who suffer from race-related diseases such as sickle cell anaemia and thalassaemia.

Baroness Cumberlege, the health minister who has been given a special responsibility for ethnic health, said: 'We are finding that people with ethnic minority backgrounds do not get the full benefit of NHS services. We are not saying 'you have to conform'. We are saying 'please can you tell us how to help you to access the services'.'

From April, monitoring of all in-patients and day patients will begin. Hospital admission forms will invite them to state their ethnic group. 'The important point here is that patients will identify themselves, not have a member of staff do it for them,' Lady Cumberlege said.

Problems arise largely because of language and cultural barriers. For example, some Asian women take their husbands as interpreters to see male doctors, but are inhibited from raising concerns about problems they are not allowed to discuss in public.

'A major problem is that we do not have enough information at present,' Lady Cumberlege said. She is setting up a task force to look at existing 'good practice' and will be starting pilot schemes to promote the health of minority groups. She has arranged a first conference on the subject with ethnic group leaders for 6 January.

At the same time Mrs Bottomley, as chairman of a separate initiative, is promoting an increase in the numbers of men and women with black and ethnic minority backgrounds in senior managerial posts. She has already asked all regional health authority chairmen to provide her with names of those who have succeeded in climbing the NHS career ladders. There are also plans to monitor the professional status of nurses by ethnic group and later, of doctors.

In addition, as part of the NHS reforms, district health authorities are required under the NHS and Community Care Act 1990 to carry out 'needs assessments' of their areas. Ministers believe this will enable health planners to identify areas of need.

Lady Cumberlege said: 'There is enormous commitment from Mrs Bottomley, it is one of her top priorities. Our first task is to map the territory and to draw up a range of options. I am determined that our reports are not going to sit on shelves. I want to see dramatic changes in the way services are run. A very high political profile will be emerging on these issues.'

So far, however, the department has given only about pounds 500,000 towards these policies in the current year. Lady Cumberlege said that much of the early work would be with small local groups, but that the department had commissioned a number of research projects, including a study of the health of Vietnamese women.

The initiatives were heralded in September with the publication of a report by Dr Kenneth Calman, the Chief Medical Officer, in which, for the first time, official recognition was given to the neglect of special health needs of some ethnic minority groups.

At that time Mrs Bottomley promised to 'tune health services more precisely to their needs'.

Dr Calman said that information on the health of second and third generation ethnic groups was largely lacking.