Diversity, Rights, and Equality in Health and Social Care - Essay Example

Assignment extract: This assignment requires you to demonstrate your understanding of how the health needs of a diverse population are related to social and political issues within contemporary society. You are required to identify a ‘group’ within British society who have specific health vulnerabilities and discuss how social, cultural and political issues may affect the health and social needs of its members. “Diversity, Rights and Equality in Health & Social Care” 1. Introduction In the introduction to the assignment you will need to identify a specific group within British society who have health vulnerabilities, and outline the health and social needs of that group. You will need to clearly define the parameters and membership of your chosen group. – 15% 2. In the main section students will be required to: i. outline the health and social needs of their chosen group, from which a single health issue specific to the group should be identified. A rationale for your chosen health issue should be included. – 20% ii. Describe how social, cultural and political issues may affect the experience of group members in relation to the chosen health issue. Where appropriate this experience should be compared and contrasted with the experience of other groups and society as a whole. – 20% 3. In closing students should: i. considers how diversity, rights, and equality are interrelated and -20% ii. Identify how health and social care professionals can acknowledge the health and social care needs of diverse groups. – 20% 4. Presentation – 5% The essay should be accurately referenced and include a full reference list using the Harvard System, with a bibliography and appendices as appropriate. The essay may be either word-processed using font size 12 or clearly hand written, preferably using only one side of the paper, double-spaced and neatly presented. Students are advised to proof read their work prior to submission as poor spelling and punctuation will cost marks. Students should support their work throughout with the appropriate literaturepolicieslegislation. In recent years the provision of healthcare within Britain, like the provision of other public and welfare services was supposed to be provided on a non-discriminatory basis. The founding principle of the NHS following its establishment in 1948 was that all medical treatment was free to all at the point of delivery and was provided solely on the basis of need. As much the basis of service provision within the NHS is egalitarian, nobody is supposed to receive better or worse treatment than anybody else. Reality has however never matched that ideal (Richards, 2003, p.207). Of course, in 1948 there was no concepts of diversity and rights although, in the provision of the NHS services were to be provided and used on a basis of equality. Diversity would not have been considered, there were fewer people from ethnic minorities in Britain, whilst the focus of service delivery was treating the medical needs of patients rather than protecting their rights. Almost from the start of the NHS treatment was rationed to the patients that were most likely to make a full recovery such as the young and the able-bodied. Doctors decided choices over which patients received the most effective treatment and those patients whose treatment was rationed or completely denied. The introduction of healthcare trusts has changed the way in which the NHS is funded and therefore treats its patients. Under New Labour the NHS is supposed to respect the diversity, rights and equality of its entire patient. Whether the diversity, rights, and equality of all are respected is debatable. The main group of patients to be examined in this study is epileptics. Epileptics have not always received the best treatment available from the NHS, whether that situation has changed will be discussed in detail. The reasons why epileptics were chosen as the main study will be discussed. When necessary the treatment that epileptics receive will be compared to the level of treatment that other groups receive to see if the level of diversity, rights and equality is equal, better or worse. Epileptics, unlike some groups such as those in wheelchairs or people form ethnic minorities are not obviously different from the majority of the population, yet that does not meant that they are able to leave lives free from discrimination. As well as actual discrimination, many epileptics have been reluctant to reveal that they suffer from epilepsy for fear of discrimination or stigma (Clarke, 2001, p.52). Epileptics suffer from two types of epilepsy, grand mal, and petit mal. Grand mal is the most serious form of epilepsy, sufferers of this form can have serious seizures and have no control over where they fall, which can have dangerous, even fatal consequences. It is the seizures suffered by people with grand mal epilepsy that have led to direct or indirect discrimination against epileptics as a whole group. That is because sufferers lose control of their limbs and can froth at the mouth. For other people that are unaware of grand mal epilepsy it would appear that the person suffering the seizure is either drunk or mentally ill, in some societies even possessed by evil spirits. Those who have petit mal epilepsy are less obviously afflicted with the condition. These attacks are milder and to those witnessing a seizure may believe that an epileptic is not paying attention for a short period. After all, there can be other reasons for losing concentration such as dyslexia. Epileptics as individuals are not mentally impaired because they have epilepsy, although the risk of attacks can place them in physical danger. Anti-epilepsy drugs can control epilepsy. The condition itself can be diagnosed through various tests and brain scans (Richards, 2003, p.124). The best means of identifying epileptics would be through medical records and figures by the NHS on the number of patients with epileptic symptoms that they treat. Knowing how many epileptics are working and where they are working could be more difficult as some epileptics may not inform their employers for fear of losing their jobs. The Disability Discrimination Act 1995 extended the rights of disabled people to gain employment. Employers are legally bound to maintain a register of their disabled employees and also allow them access to all parts of the workplace where they can work safely. However, disabled people can be denied employment or certain roles when their particular disabilities place themselves or others in danger. That is why epileptics are not allowed in front line positions with the emergency services or the armed forces (Richards, 2003, p.108). Whilst legislation such as the Disability Discrimination Act can demonstrate the political will of governments to tackle discrimination against groups or individuals it does not automatically end that discrimination. Like it or not it is natural for people to decide who or what they like or dislike. Subsequently, acting on that basis governments have found passing anti-discriminatory laws far easier than changing the attitudes of their general publics towards groups of individuals they discriminate against. At best governments have succeeded in overturning overt discrimination without being able to eliminate covert discrimination (Tomlinson & Trew, 2002, p.43). Educating people about groups or individuals that suffer from discrimination can be a means to reduce and perhaps eventually eliminate such discrimination. Closely linked to this is social stigma. Stigma is often suffered by groups or individuals to be abnormal or deviant. Unless they are suffering an actual attack, epileptics show no outward signs of their condition and hiding that condition is the best way of avoiding social stigma, although it is not the best way of maintaining their health. Stigma and discrimination or the threat of them has deterred epileptics from obtaining medical treatment or disclosing their condition to employers or work colleagues. For those that suffer from petit mal epilepsy, failure to disclose their condition could lead to them losing their jobs, as employers will have no plausible reasons for periods of poor performance or sudden stoppages in work. Given that epilepsy is controllable through the use of medication, epileptics can lead normal lives without the stigma if they hide their condition. However, sometimes seizures cannot be avoided and once an individual’ epileptic condition is known they will often face stigmatisation if not discrimination. However greater stigmatism can be placed on patients with other conditions such as sexually transmitted diseases, HIV / AIDS in particular. People with HIV / AIDS like epileptics are not easily identified as sufferers and also have strong incentives in hiding their condition. Epileptics however cannot give epilepsy to others (Clarke, 2001, p.46). The treatment available to epileptics from the NHS should be the same throughout the country if the concepts of diversity, rights, and equality were uniformly applied. However the levels of treatment can vary according to how individual healthcare trusts chose to spend their budgets. There are over 300 primary care trusts besides the numerous other forms of National Health Service trusts that nominally aiming to accept, implement and respect diversity, rights, and equality. The complexity of the NHS continues to increase as health services are being increasingly provided in conjunction with voluntary and private sector organisations from outside the NHS. Patient satisfaction questionnaires could in theory be extended to cover those external organisations. The Healthcare Commission already has to inspect some of those organisations to ensure they meet statutory requirements when they provide health services (Healthcare Commission, State of Healthcare, 2004 p. 16). Whilst legislation may compel trusts to take not of the diversity, rights and equality of all its actual or potential patients they have to ration out treatments to provide the most cost effective treatment possible. Perhaps, epileptics may have an advantage in that their treatments are not the most expensive and therefore the majority of healthcare trusts can provide those treatments. There is always intense competition as to which individuals or groups of patients should receive treatments and whether new treatments should be provided as soon as they are available. The NHS has always tried to balance efficiency with equality. Other parts of the NHS or Department of Health can inadvertently affect diversity, rights, and equality. A good example is the National Institute for Clinical Excellence which determines which drugs and treatments are safe enough to fully licensed for use within the National Health Service. Safety trials can be time consuming, whilst until treatments are fully licensed their increased cost and reduced availability deters health trusts from using them (Newman, 2001 p. 89). The NHS sacrificed the acceptance of diversity and did not take patients rights in to account when aiming to deliver its effective yet equitable services. As already mentioned legislation meant that the NHS had to accept and respect the diversity of all its patients. Diversity is to be respected whilst discrimination on the grounds of gender, race, ethnicity and disability is to be ended. Compliance to anti-discriminatory legislation can and is measured by various bodies established by that legislation. The Major government hoped to give NHS patient’s greater rights through the Citizens Charter, which gave patients greater means to complain if they had been treated unfairly (Hughes, 1998 p. 28). New Labour has monitored NHS performance against patient satisfaction as well as adapting the service to achieve targets on diversity rights and equality. Patient satisfaction questionnaires have arguably provided data that has helped to increase inspection and information gathering in certain areas of the NHS that did not usually receive as much funding or media coverage as other parts have done. More specifically patient satisfaction questionnaires helped to demonstrate problems with “maternity and mental health services, particularly mental health services for older people.” Data and information gained from patient satisfaction questionnaires have contributed to the Healthcare Commission annual health checks to cover the entire NHS, which only started in 2005. The advantage of these questionnaires is that they specifically targeted to find out particular groups such as epileptics are being treated in terms of diversity, rights and equality (Healthcare Commission, State of Healthcare, 2005 p. 36). Overall epileptics are probably not the worst treated patients within the NHS even though are certainly not the best treated. Their treatments are not the most expensive so the rationing of treatments does not affect them as much as it affects other groups. However other groups seem to be better at raising publicity about their treatments being rationed or their diversity, rights, and equality not being respected as fully as they should be. Patients awaiting organ transplants or suffering from cancer are more likely to be faced with the rationing of treatment either because there are no organs available or due to the higher cost of drugs and equipment. When it comes to promoting diversity, rights, and equality then the main focus within the NHS is on ending discrimination on the grounds of race, ethnicity, gender, and disability. The NHS and the Department of Health could monitor what treatment epileptics receive and how that treatment compares to other vulnerable groups such as cancer sufferers, those with AIDS and people from ethnic minorities. If treated properly epilepsy is more of a condition than a disability, a condition that need not prevent those that suffer from it leading a full and meaningful life. Epileptics can remain unknown to society at large unless they have a seizure in public whereas it is more difficult for others to hide their gender, race, ethnicity, or disability. Since New Labour came into office the NHS has had to complete patient satisfaction questionnaires that provide data not only performance but also on how well the NHS is working towards respecting diversity, rights, and equality. These questionnaires highlighted that is women and the elderly with mental health problems that received the most unequal treatment within the NHS and whose rights have been the least respected. However the NHS is restricted by its budgetary limits as much as its internal attitudes or policies in fully endorsing diversity, rights, and equality. As for the social stigma attached to being epileptic that will probably prove just as difficult to reduce or eliminate. Education and publicity are the best ways to reduce such stigmatisation yet unfortunately they do not seem to work on the entire population. Whilst the social stigma linked to epilepsy remains not all epileptics will want their condition to be known outside of their immediate family and friends, and not all epileptics will seek the medical treatments they need to stay in the best of health. Bibliography Clarke A, (2001) The Sociology of Healthcare, Prentice Hall, Harlow Healthcare Commission (2005) State of Healthcare 2005 Report, London Hughes G, (1998) Imaging welfare futures, Routledge, London and New York Leathard A, (2001) Health Care Provision – Past, present and into the 21st century, 2nd edition, Nelson Thornes, Cheltenham Newman, (2001) Modernising governance – New Labour, Policy and Society, Sage Publications, London Richards J (2003) Complete A – Z Health & Social Care Handbook, 2nd edition, Hodder & Stoughton, London Tomlinson D R & Trew W (2002) Equalising Opportunities, minimising oppression – A critical review of Anti-Discriminatory policies in Health and Social Welfare, Routledge, London and New York Read More