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5th, March, 2013

  Abstract There is a disparity in the access of health care among the populations in the UK. The minority population is disadvantaged and does not access health care like the other native population. In this paper, I will address the case of quality health care access by the Blacks and the other ethnic minority population in the UK. Different literature review will be considered in highlighting this instance, and mainly research findings, linking poor access to health care with the minority populations. This will also include the context of the situation, which involves the factors behind poor health care access for the minority groups. In addition, this essay will address the role of the clinicians, policy makers, and managers in the UK, who are stakeholders in the health sector, in ensuring equitable access to health care by all the population in the United Kingdom. Nonetheless, their challenges in achieving this equal access to health care for all the population are also highlighted. Introduction             Gill et al note that the black and minority ethnic (BME) populations have suffered in most health care systems, as these are not given equal consideration as those individuals in the mainstream population (n.d). To this day, most of the BME populations have poor access to quality health care in their countries of residence. This is because of different factors, which act as barriers for these groups to access quality health care, including vital health services (Wikinson, Lane & Stoskl 2010). It is therefore, important that these health gaps in different populations be narrowed down and closed completely. This aspect should be prioritized by all the affected countries, since the BME populations are part of the country’s population and contribute equally to the national economy (Kingfund 2006). In the United Kingdom, the BME population accounts for a considerable part of the whole population in the country (Jones & Welhengama 2000). This is a country where there are different cases and evidence pointing to the fact that the BME populations do not receive quality health care (Gill n.d). However, this is blamed on a number of challenges by the health care providers and practitioners, experienced in dealing with the BME populations in health care provision (Owen n.d). The fact that the different BME groups have different cultural traits, different languages, as well as varying health profiles, poses a challenge to the United Kingdom’s policy makers and health practitioners, in developing a health care system that will cater for the needs of the different groups in the country (Ali & Atkin 2004). This paper therefore, focuses on the inequitable access of health care by the BME population in the United Kingdom, and ways through which this situation could be improved. Different evidence used in this essay point to the diversity of population in the United Kingdom, disparities in health care access between different populations, outcomes of health care, effective communication by patients, and participation in decision making, as far as the health issue is concerned. Context of the Issue             According to Meien (2007) and Tran (2010), the population of the minority ethnic populations in the United Kingdom is on the rise. In the year 1981, this population stood at 4.2% of the whole United Kingdom population. In the year 1991, the BME population in the United Kingdom was 5.5% of the total population of the United Kingdom. This population rose to 7.9% in the year 2001, which is approximately 4.6 Million people. Therefore, this trend shows that the BME population in the United Kingdom keeps growing. In the future, this number is still expected to grow, going by this trend, also considering the fact that this BME population comprises more youth and children, compared to the whites. The group with the highest population is the South Asian group, with close to a half of the BME total population. The Blacks both from Africa and from the Caribbean make up close to 1.15 million. Blacks from Africa account for half a million of this population, while the Caribbean blacks account for the remaining 0.6 million (Gill n.d). A large number of the BME population is located in England (Tran 2010). In the United Kingdom, different bodies concerned with health care, realize the need to create a health care system that provides equal health care to all the population in the United Kingdom. Such bodies in the UK include the Department of Health and Professional associations. In addition, various legislations have been implemented to address this issue of discrimination in provision of quality health care to different people. For instance, the Race Relations Amendment Act 2000 was implemented in the year 2001. This puts an emphasis on NHS and other bodies in the United Kingdom concerned with health care, to put a stop to the kind of discrimination in the health sector, which is considered unlawful. This legislation also requires these health care bodies to prioritize racial equality in their various acts involving health care (Butler 2001). One of the biggest letdowns in the health systems of the United Kingdom is failure to adopt an ethnic monitoring data recording. This case does not compare to the United States of America, as thy have implemented this fully. This has therefore, led to the lack of sufficient tracking of the disparities that are witnessed in the United Kingdom’s health sector, which mainly affect the BME population (Memon, Abbas, Khaonolakar, Dixon & Sign 2002). The census of 2001, and the show that e censuses of other previous years have evidently indicated the presence of vast disparities in the health care of the population in the United Kingdom. Evidence also shows that the blacks and other ethnic minority groups in the United Kingdom are most affected. The health disparities are mainly between the ethnic minority groups in the UK and the whites, who are the natives of the land. The blacks and other minority groups have poor access to quality health care, compared to the whites. The blacks also are also more affected by long-term illnesses, compared to the mainstream population. This is the case especially among the older black population. In addition, different surveys were conducted in the United Kingdom, with the purpose of determining the level of patient satisfaction with the health care services presented to them. The NHS in the UK initiated this exercise. The findings of these surveys showed that almost all the patients from the ethnic minority groups registered dissatisfaction with the health services. However, the UK has not taken the step of integrating the health disparities in the population, just like USA has done (Lee, Syed & Bellis n.d). Davidson et al (2012) argues that quality health care goes beyond the simple aspect of providing health care. Health care can be provided to everyone in the population. However, the way it is performed is what makes the difference, and differentiate it from low quality health care. All the population is entitled to access to quality health care. Therefore, provision of health care only to the population bars some people from accessing quality health care. The NHS in the United Kingdom, therefore, has identified this as a factor that increases health disparity in the UK. This case has prompted the NHS to think and develop different strategies, which will help deal with this situation in the UK. There have been concerns among the general population in the United Kingdom, about their perception of the terminology ‘diversity.’ The practitioners and providers of health care in the UK seem to not consider or embrace diversity while offering their health services. According to Bahl (2001), health services are provided to the black people, and other people of ethnic minority in the country. Therefore, the ethnic minorities, including the black people in the UK, are not denied health services. However, the issue that arises is the fact that, the health care providers and practitioners do not consider the quality of health care availed to these minority groups. To them, once the ethnic minority groups are provided with health care services, it does not matter the quality of the services. In addition, these did not follow up to ensure that these health care services reach the ethnic minority groups. Complaints launched by members of the ethnic minority groups about services not reaching them, do not get a positive redress from the concerned health care providers, as they emphasize that they have already played their role of providing the health services (Bahl 2001). Stakeholder Perspectives             The issue of health is important to any country as it affects the population, which is a prerequisite to the development of the country. There are various stakeholders involved in this issue. These can act collectively and responsibly to ensure that a lasting solution is obtained in order to address health disparities in the country. These include the ethnic minority groups themselves, the whites, the government, health providers, health practitioners/professionals, and different private or public bodies, which are concerned with health in the country (Bahl 2001). Different health bodies need to identify the major or specific areas in health where the disparity unfolds. For instance, in the year 1993, the Department of Health identified cancer screening as one area of the areas in health, which was not provided to the ethnic minority in the most appropriate manner (Memon, Abbas, Khaonolakar, Dixon & Sign 2002). This department identified this area as core to the country, since if it would be addressed, it could lead to the reduction of mortality and morbidity among the ethnic minority population in the country. Apart from cancer screening, the treatment programmes for the same were not availed to the ethnic minority populations in the right manner. The study performed by the department of health generally revealed that the individuals from blacks and other minority groups in need of cancer treatment were not provided with the right services to address their health needs concerning their cancer condition. Therefore, there was no sensitivity and accessibility of the cancer services to these groups (Bahl 2001). Today, if more professional bodies concerned with health issues in the UK would follow in the steps of the Department of Health, this would probably see a reduction in the level of health disparities sin the country (Ingleby, Chiarenza & Kotsioni 2012). Health care organizations in the United Kingdom should also consider training their native personnel on how to be competent both culturally and linguistically. Health care organizations ought to develop policies that are based on cultural and linguistic competencies to address health disparities in the country (Ingleby, Chiarenza & Kotsioni 2012). Since communication is considered a barrier to effective health care for the ethnic minority population, the health care practitioners should be trained to communicate effectively, in a way that is understood by those who are less competent in English, as well as the illiterate. The staff in the health care facilities could also be multi-lingual, or consider hiring interpreters for various foreign languages, which the ethnic minority groups ascribe to. The different groups of ethnic minorities have different cultures. Therefore, their beliefs and perceptions about health and healing vary. Health care organizations ought to as well consider cultural differences among the blacks and other ethnic minority groups, in relation to the mainstream culture and health and recovery beliefs. If the staff members in health care organizations are linguistically and culturally competent, they will be able to respond to the health needs of the blacks and other ethnic minority groups (Wikinson, Lane & Stoskl 2010). On the other hand, the government should develop and implement more legislation and policies that will effectively address the question of health disparity in the country. The government should act on this because they ought to realize that poor health among the blacks and other ethnic minorities is detrimental to the national economy as a whole. Therefore, it is the government’s responsibility to ensure equal access to quality health care for the whole population in the country (Davidson et al 2012). The public has a role to play in ensuring equal access to health care by everyone in the country. They can do this by changing their perception about the blacks and other ethnic minority groups. Specifically, racism should be eliminated from the public to allow for equality with the ethnic minority groups. The individuals comprising the ethnic minority groups should also be responsible enough to change their conservative beliefs about health and healing, and instead adhere to the health instructions from the professional health care providers. If all these stakeholders in health play a role, racism will be reduced, and the health disparity in UK might change for the better (Kingfund 2006). Policy, Theory and Contemporary Practice             The unequal access to quality health care by the whole population in the United Kingdom is an instance, which has been experienced over the years. This has had different effects on the public, the government, and health organizations. Access to quality health care by all lies on the theoretical foundation that this ensures a healthy population in a country (Potvin, Gendron, Bilodeau. & Chabot, 2005). This also lowers the mortality rate, as well as the rate of morbidity in the population. By ensuring equal access to health care for all the people regardless of their backgrounds, this eliminates different types of discrimination from the community, including racism. Additionally, access to quality health care for all ensures a healthy population, thus a stable economy in the country. The people are the main prerequisite for development in a country; therefore, if all are healthy, the country is able to develop without any constraints. One might define the concept of ‘equal access to health care’ in different ways. Nonetheless, this means that all the people in the society, regardless of their race, religion, education, culture, and economic status, among other differentiating factors, are entitled to health services, which are of the same quality, as the other people (Jones & Welhengama 2000). In the contemporary world, the United Kingdom has adopted a new contemporary practice, which is meant to ensure equal access to quality health care by all. For instance, different bodies of health care have come up with different strategies of emphasizing the need for equal access to health care by all the people in the United Kingdom (Randhawa 20007). The NHS since the late 1990’s has emphasized the importance of implementing ethnic monitoring data recording in hospitals, which is meant to integrate the health disparity in the country, among the blacks and other ethnic minority groups. This has the purpose of further finding strategies to fill the gaps in health within the population (Meien 2007). In addition, the Department of Health in the United Kingdom, together with NHS has worked to ensure that all the policies developed and implemented in the sector of health care must incorporate the aspect of equality in the provision of health care. These two bodies ensure that their decisions, as well as policies, contribute to the elimination of illegal discrimination based on race (Randhawa 20007). In the year 2001, the Race Relations Amendment Act 2000 was implemented in the United Kingdom. This requires different public authorities in the United Kingdom to eliminate any kind of discrimination that could be present in their procedures, as well as policies (Watt & McGauhey 2006). This emphasizes the importance of race equality in all spheres. This legislation came as an amendment to the 1976’s ‘Race Relations Act.’ In this legislation, equality was emphasized regardless of color, race, nationality, and citizenship. However, after being amended, the new legislation in 2001 puts more emphasis on the importance of racial equality. Here, authorities are encouraged to employ pro-active measures in ensuring there is racial equality in the population (Tran 2010). Today in the United Kingdom, people are expected to comply with this legislation. This includes both groups and individuals. Victims of racial discrimination with respect to health care therefore, have a right to take legal action through judicial review, which is then guaranteed to be addressed by the concerned body (Sheppers, Dongen, Dekker, Geertzen & Dekker 2006). Therefore, the United Kingdom has adopted the best practice in addressing the health disparity. However, for this to be effective, the public, as well as the authorities need to be committed to this practice and adhere to it. In addition, the victims should know their rights with regard to this, and follow the right channels in order for their concerns to be addressed (Lee, Syed, & Bellis n.d). Recommendations             The United Kingdom has already adopted laws to deal with the unequal access of the blacks and other ethnic minority groups from quality health care. This is in form of the Race Relations Amendment Act 2000, which was implemented in the year 2001. This law puts more emphasis on racial discrimination, since inequality to access to quality health care based on ethnicity is a form of racial discrimination. Although this legislation was first adopted in 1976 before its amendment, it has currently seen the levels of racial discrimination, with regard to access to quality health care decrease considerably. However, the United Kingdom today is still faced with incidences of unequal access to health care based on race. Health disparity is therefore, still existent, even though this law was implemented and is operational. However, the degree of this health disparity in the United Kingdom is reportedly narrowing down with each year. This therefore, points to the fact; more efforts are required in order to ensure that this health disparity is eliminated from the country. As observed, the government, health care organizations, and the public are responsible for seeing to it that the health disparity experienced in the country decreases. The government has tried to do its role through the creation of laws and policies, which will promote racial equality, even in health care. On the other hand, most health care organizations have aligned their policies with racial equality, such that every client has access to the same quality health care services. It is therefore, among the members of public to cultivate racial equality in their minds. The staff in health care facilities ought to adhere to the organization’s objectives, since these are influential in the rate of health disparity in the country. Therefore, taking individual responsibility and adhering to policies and laws, which address health disparity is important for the population of the United Kingdom, to avoid further marginalization of the ethnic minority population, with regard to access to quality health care. Works Cited Kingfund 2006, Access to Health Care and Minority Health Groups, Viewed 5 March 2013 <> Ali, S. & Atkin, K 2004, Primary Healthcare And South Asian Populations: Meeting the Challenges, Radcliffe Publishing, New York. Bahl V. ‘Improving access and quality for ethnic minority women,’ Women’s Health Issues2001; 11:348–54. Butler, P 22 February 2001, ‘Key Points of the Race Relations Amendment Act Report,’ The Guardian, Viewed 5 March 2013 <> Davidson, E., and Liu, J. Bhopal, R.S., White, M., Johnson, M., Netto, G., Deverill, M. &Sheikh, A 2012, ‘Adapting health promotion interventions to meet the needs of ethnic minority groups: mixed-methods evidence synthesis,’ Health Technological Analysis. Viewed 5 March 2013 <> Gill, P. Bhopal, R, Kai, J, & Wild, S n.d, Black and Minority Ethnic Groups, Viewed 5 March 2013<> Jones, R. & Welhengama, G 2000, Ethnic Minorities Eng. Law, Trentham Books, London. Ingleby, D., Chiarenza, A., & Kotsioni, I 2012, Inequalities in Health Care for Migrants and Ethnic Minorities, Maklu, New Jersey.Top of FormTop of Form Lee, B., Syed, Q. & Bellis, M n.d, Improving the Health of Black and Ethnic Minority Communities: A North West of England Perspectives, Viewed 5 March 2013 <> Meien, J 2007, The Multiculturalism vs. Integration Debate in Great Britain, GRIN Verlag, London. Memon, M., Abbas, F. Khaonolakar, M., Dixon, J., & Sign I 2002, ‘Health Issues in Ethnic Minorities,’ Journal of Royal Society of Medicine, Viewed 5 March 2013 <> Owen, D n.d, Profile of Black and Minority Groups in the UK, Viewed 5 March 2013 <> Potvin, L., Gendron, S., Bilodeau, A. & Chabot, P 2005, ‘Integrating Social Theory Into Public Health Practice.’ Am J Public Health, 95(4): 591-595 Randhawa, G 20007, ‘Tackiling Health for Minority Ethnic Groups: Challenges and Opportunities,’ Better Health Briefing, Viewed 5 March 2013 <> Sheppers, E., Dongen, E., Dekker, J. & Geertzen, J. & Dekker, J 2006, ‘Potential barriers to the use of health services among ethnic minorities: a review, Family Practice,’ The International Journal for Research in Primary Health Care, 23(3): 325-348, Viewed 5 March 2013 <> Tran, M 13 July 2010, ‘Ethnic minorities to make up 20% of UK population by 2051,’ The Guardian, Viewed 5 March 2013 <> Watt, P. & McGauhey, F 2006, Improving Government Service Delivery to Minority Ethnic Groups, Viewed 5 March 2013 <> Wikinson, S., Lane, K., & Stoskl, A 2010, A Survey of the Health Needs of Black and Minority Ethnic Groups in Norfolk, Viewed 5 March 2013 <>

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