Since taking up the post of Equality Lead at the end of October 2012, I’ve heard various comments such as “What does THAT involve?” and “Surely that’s a made up job?”. If only. If only it wasn’t the case in Scotland that only 0.3% of apprenticeships go to people with a disability or that women are paid 14% less than men in full time work. But possibly the worst comment I have heard so far is “people need to have a sense of humour about some things”. I’m sure those people that have suffered discrimination would be delighted to hear that all this could be resolved if they simply lightened up and learned to laugh about it….
With the ongoing work around person-centred care and patient experience, equality and diversity couldn’t be more relevant, after all, each and every one of us has at least one ‘protected characteristic’ and we are all at risk of being discriminated against at one point in our lives. Most of us will at some point have to engage with health services and I’m sure that none of us would like to be treated less favourably because of one of our protected characteristics.
After attending the Patient Experience event in September 2013, where I couldn’t help but think that equality and diversity is at the heart of so much of this work, I came across the following articles by columnist Ian Birrell who has a disabled daughter and writes passionately about discrimination. He cites an example of a patient with Downs Syndrome being made “not for resuscitation” without any discussion with loved ones as it was just assumed by medical staff that his life held no quality. He also quotes some frightening statistics about disabled patients being left to die as it was considered “the kind thing to do” by medical staff. Two of his articles can be read here and here.
It would be easy to think that we work in a place where discrimination like this doesn’t exist, and I often hear the words “I treat everyone the same” as if this excuses someone from needing any further training or development on equality issues. One thing which is clear though is that treating everyone the same or basing decisions on our personal assumptions is not equality and, as these articles highlight, can be dangerous. People (staff and services users) should be treated as individuals, with a range of different needs. Some of the complaints which I have been involved in since October 2012 could easily have been avoided if those involved had taken the time to consider the needs of the individual rather than a ‘one size fits all’ response.
At the recent Big Burns Supper event held in Dumfries, I had the wonderful opportunity to see a one man show called “If These Spasms Could Speak” which was about the way in which disabled people experience the world and how they feel about their bodies. The show is by Robert Gale, a disabled actor, and had rave reviews when it was shown at the Edinburgh festival (There are clips on You Tube for anyone that might be interested in finding out more, one of which can be viewed here). Despite the spasms which are probably the first thing people notice, and are so very aware of, the first thing that Robert sees when he looks in the mirror is a “cute face” despite the attitudes of others to his own physicality. However, one of the funniest, yet probably most worrying parts of the show is when he describes visiting his brother in hospital and a young doctor proceeds to ask him personal inappropriate questions, assuming that he “must be somebody’s patient”. This highlighted the way in which non-disabled people often view those with disabilities, in this case Robert’s own cerebral palsy and speech impediment.
Not only is it good practice to consider equality from a moral viewpoint, but by law we have had to become more pro-active about eliminating discrimination, advancing equality of opportunity and fostering good relations. One of the ways in which NHS Dumfries and Galloway have done this is to come up with a set of equality outcomes, which you can read more about here. We are also in the process of reviewing our equality impact assessment policy and toolkit, again something which is required to be completed by law but something which is often seen as something which is a bit of a nuisance. If the fear of being personally fined if there was ever a claim against us isn’t enough, then think of it this way. You have gone to all the bother of writing a policy/coming up with a strategy/started the process of service change (delete as appropriate). Surely it makes sense to ensure that you have considered and consulted as many different people and groups of people as possible. This can only improve your service or your policy and make it better than it already is, and may save you having to go back and make changes at a later date.
This is not to say that there isn’t already lot of good work being done out there. For example, we have several areas within our Board currently undertaking the LGBT Charter Mark. As an employer we are signed up to the disability two ticks symbol and each of our directorates have developed their own action plans on how equality and diversity can be mainstreamed into day to day business. There is a lot of good work being done out there and a lot of our staff willing to consider people as individuals with a range of needs and requirements which they are more than willing to try and accommodate.
But, for the time being anyway, it looks like I do have a ‘real’ job as equality and diversity is no laughing matter….
Lynsey Fitzpatrick is Equality and Diversity Lead for NHS Dumfries and Galloway