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Equality and Diversity within NHS Wales Ceri Harris Learning Objectives: Understand the importance of valuing difference as a fundamental principle of equality of opportunity and outcome, dignity and respect. Identify ways in which personal actions and collective strategies can challenge discrimination and promote equality. Explore the legislative framework that is currently in place within the UK. The Power of Language What is in a word? Knowledge Understanding Inspire Meaning Fear Prejudice Slander Definitions of Equality Equality Treating people according to their needs to ensure equality of outcome/opportunity. Diversity Valuing the differences that people bring with them Equality is a right, not a reward Equality is about difference, not sameness Believing in equality is about understanding Equality begins with ourselves not other people Equality is about everyone, not just specific groups Our perceptions of what is fair or unfair may change Freda Principles The concept of a human rights-based approach to clinical practice is relatively new. The Department of Health in 2008 stated that: ‘a human rights based approach is one where the realisation of human rights principles is a central aim in policy and planning, where staff and patients are empowered and involved in achieving these, where accountability is clear and the most vulnerable groups are prioritised.’ There are five core values that underpin the approach: Fairness Respect Equality Dignity Autonomy. Equality, Diversity & Dignity “Everyone should be treated with dignity and respect in the work place” Source: ACAS Equality Act 2010 Harmonises discrimination law Strengthens the law to progress on equality Most existing legislation has been repealed Protected Characteristics Race Gender Gender/ sex reassignment Marriage & civil partnership Maternity & pregnancy Disability Sexual orientation Religion belief & non belief Age Advancement of Equality – Public Sector Duty Public Sector to have Due regard to: eliminating conduct that is prohibited by the Act; advancing equality of opportunity between people who share a protected characteristic and people who do not share it; Fostering good relations between people who share a protected characteristic and people who do not share it. Specific Duties Current Specific Duties include: The need to develop Schemes, with evidence of involvement Training Monitoring Equality Impact Assessments Types of Discrimination Direct Discrimination When a person is treated less favourably than any other person in similar circumstances. Indirect Discrimination When a policy, provision or practice is used which has the effect of disadvantaging people of particular groups. Victimisation Occurs when a person or group of people are treated unfairly as a result of their involvement in a discrimination case. Harassment Unwanted conduct, affecting the dignity of that person By association Due to a relationship or connection to a person with a protected characteristic, e.g A carers relationship to the person they care for. By perception Discrimination due to a presumption that someone has a protected characteristic Equality Act 2010 New New Indirect Discrimination New New Age Partnership New Marriage & Civil Discrimination by Perception Sexual Orientation New New Sex New changes Religion or Belief Gender Reassignment New Characteristic covered in existing legislation – No Changes Characteristic covered in existing legislation – but some changes Characteristic covered in existing legislation – now covered Characteristic covered in existing legislation – still not covered Race Disability Key Pregnancy & Maternity What’s new & what’s changed: at a glance Direct Discrimination Associative Discrimination New Harassment Changes Changes Changes Changes Changes Changes Victimisation Changes Changes Changes Changes Changes Changes Changes Changes Changes Genuine Occupational Qualifications An exemption in equality law that allows an employer to advertise job vacancies to specific groups. E.g Female radiographer for breast screening program Positive Action Frequently confused with positive discrimination. …which generally means employing someone because they come from a disadvantaged group regardless of whether they have the relevant skills and qualifications, is unlawful. However targeted job training from under-represented areas in a particular area of work, or encouragement to apply for such work is legal & called positive action. Healthcare Examples A patient’s children believe it is their right to see their father’s GP to discuss the results of recent investigations for weight loss. They are adamant that if the diagnosis is Cancer their father should not be informed A woman tells her doctor that she cannot sign a consent form for treatment without her husband also agreeing A man with diabetes refuses to take insulin despite it being clinically necessary Understand behaviour by understanding Cultural Values Asian & Hispanic cultures value the group over the individual Males are thought to be dominant in many cultures Chinese families may be upset if a medic reveals a negative diagnosis to a patient without involving the wider family A Mexican or Arab woman may wait until her husband arrives to make key decisions for herself or her child People from cultures with a ‘past’ orientation (ie. Indian) may prefer traditional remedies over modern drugs Values, Stereotypes & Prejudice. Values These can be described as the morals or rules by which we all lead our lives. Stereotypes This is when you make a generalised opinion about someone or a group of people. A stereotype is usually based on incomplete information which leads to an assumption about the person or group. Prejudice This implies a negative feeling for another group, and usually involves stereotyping. It can be based on a perception of the group being seen as a threat, due to a lack of understanding. Remember! Values can lead to stereotypes Which can lead to prejudices Acting on prejudice leads to discrimination Political Correctness What is it? Change of language, services or policies due to concerns about offending or expressing bias regarding various groups of people. Often becomes exaggerated and makes fun of equality. Once upon a time… …there was a young person called Red Riding Hood who lived with her mother on the edge of a large wood. One day her mother asked her to take a basket of fresh fruit & mineral water to her grandmother’s house – not because this was womyn’s work, mind you, but because the deed was generous & helped engender a feeling of community. One the way to Grandma’s house, Red Riding Hood was accosted by a wolf, who asked her what was in her basket. She replied “Some healthful snacks for my grandmother, who is certainly capable of taking care of herself as a mature adult” The wolf said “You know, my dear, it isn’t safe for a little girl to walk through these woods alone”. Red Riding Hood said, “I find your sexist remark offensive in the extreme, but I will ignore it because of your traditional status as an outcast from society, the stress of which has caused you to develop your own, entirely valid, world view”. Red Riding Hood walked on along the main path, but, because his status outside society had freed him from slavish adherence to linear, western-style thought, the wolf knew a quicker route to Grandma’s house. He burst into the house and ate Grandma, an entirely valid course of action for a carnivore such as himself. Then, unhampered by rigid, traditionalist notions of what was masculine or feminine, he put on Grandma’s nightclothes & crawled into bed… Looking at protected characteristics – Race -Institutional Racism The collective failure of an organisation to provide an appropriate and professional service to people because of their colour, culture and ethnic origin. It can be seen or detected in their processes, attitudes, behaviour which amount to discrimination through unwitting prejudice, ignorance, thoughtlessness and racist stereotyping which disadvantage minority ethnic people. Isaac’s Story Looking at protected characteristics - Disability Unlawful to ask job applicant questions about disability or health before making a job offer, except in specified circumstances. Definition of Disability A physical, mental or sensory impairment which has a substantial and long-term adverse effect on a person’s ability to carry out normal day-to-day activities. Disability Continued Medical model problem Social model solution Painful hands, unable to open jars, doors Better designed lids, automatic doors Difficulty in standing for long periods More seats in public places “Housebound” or “Confined to a wheelchair” Badly designed buildings – need ramps and lifts in all buildings, also accessible transport/parking spaces Other people won’t give you a job because they think you couldn’t do it Educate people to look at disabled people’s knowledge and skills rather than looking for problems Can’t hear or see Recognition and use of sign language and Braille/raised letters Hidden Disability Looking at protected characteristics – Sexual Orientation What we had EU regulations in employment & Vocational Training 2003 Repeal of Section 28 - 2003 Civil partnership Act 2004. 1st Dec 2005 Equality Act 2006 – provision of goods and services 2010 Act introduces a duty to take account of the needs of Lesbian, gay and bisexual people when delivering and designing services. Running a promotional campaign to encourage more lesbians to attend cervical smears. Looking at protected characteristics – Religion Belief & non belief What we had EU regulations in employment & Vocational Training 2003 Equality Act 2006 – provision of goods and services Racial and Religious Hatred Act 2006 2010 Act introduces a duty to take account of the needs of people with different religious and philosophical beliefs when delivering and designing services Provision of prayer room Gives a definition of religion, belief or non belief in line with the freedom of thought, conscience and religion guaranteed by article 9 of the Human Rights Act. Stating that the religion must have clear structure and belief system. Denominations or sects within a religion can be considered to be a religion or belief. Looking at protected characteristics – Age What we had EU regulations in employment & Vocational Training 2006 2010 Act introduces a duty to take account of the needs of people of all ages when delivering and designing services Extends law to protect against UNJUSTIFIABLE age discrimination against people aged 18 and over where goods are bought and services provided, such as shops, hospitals and when buying financial products. Since October 1st 2012, it is unlawful for the NHS and social care providers and professionals to discriminate, victimise or harass a person because of their age. This includes previous policies on Do not resuscitate. Beneficial age-based products such as free bus passes for over 60’s and discounts for pensioners and age related holiday groups will still be allowed. Looking at protected characteristics – Gender Reassignment Extending public duty to require public bodies to advance equality of opportunity for transsexual people. Revises the definition of ‘gender reassignment’ to make it clear that a trans person does not have to be under medical supervision to be protected from discrimination and harassment. Protecting people who face discrimination due to their association with transsexual people Jenny-Anne Bishop Looking at protected characteristics – Marriage & Civil Partnership Replaces similar provisions set out in the Sex Discrimination Act 1975 Allows civil partnerships to be held in religious buildings Protection is not given if some one is engaged or divorced, civil partnership has been dissolved. On the 17th of July the Marriage (Same Sex Couples) Bill was granted Royal Assent. It is believed that the first same sex marriage will take place in Spring/summer 2014. Looking at protected characteristics – Maternity & pregnancy Defines what it means to discriminate because of a woman’s pregnancy or maternity, as distinct from her sex, in specified situations outside work. Protects from discrimination for current and previous pregnancy. Protects from maternity discrimination, including treating her unfavourably because she is breastfeeding, for 26 weeks after giving birth and provides that pregnancy or maternity discrimination as defined cannot be treated as sex discrimination Provides legal protection for breastfeeding mothers in public places. Human Rights Act 1998 (came into force 2000) Absolute rights. These rights cannot be limited in any way. They can not be reduced or amended. Article 3 – Prohibition of torture is a good example of an absolute right. Under no circumstances can torture, inhuman or degrading treatment or punishment be lawful under this article – it provides absolute protection. Limited Rights. These rights come with exceptions. Article 5 – Right to liberty and security is a limited right. This means that the circumstances in which this right can be limited are set out in the text of the article itself. . This means that it will be unlawful for the state to deprive you of your liberty unless this is in a way that is expressly permitted by Article 5.Lawful arrest is an example of a limited right. Qualified Rights. These are rights that the state can lawfully interfere with in certain circumstances. Generally in such articles, the right is set out at the start and then qualified by certain criteria, such as whether the interference is in accordance with the law; is in pursuit of a legitimate aim; and whether it is necessary in a democratic society. Examples of such rights include the right to respect for your private life, under Article 8,or the right to freedom of expression under Article 10, in order to calm a riot. Human Rights Act 1998 Absolute Limited Qualified Right to liberty and security Protection of Property Prohibition of discrimination Right to a fair trial Right to education Right to free elections Right to respect for private and family life Right to marry Freedom of thought(s), conscience and religion Freedom of expression Freedom of assembly and association Right to life Prohibition of torture Prohibition of slavery and forced labour No punishment without law Abolition of the death penalty- Restrictions on political activity of aliens Prohibition of abuse rights Limitation on use of restriction on rights Finally “Of all the forms of inequality, injustice in health care is the most shocking and inhumane.” Martin Luther King Jr Contact Details Ceri Harris Equality and Diversity manager – Velindre NHS Trust [email protected]