The first week in October is a landmark for the NHS.
This is the week when the new NHS commissioning board takes on its new responsibilities.
The board has a massive budget of £60bn, most of which will be given to clinical commissioning groups for them to plan and pay for their population’s health needs.
There are 212 CCGs across England made up of GPs, nurses and hospital doctors. Will they be any more successful than the primary care trusts they replace at meeting the needs of people with a learning disability, people with mental health problems and older people? Will they be able to gain the confidence of the gay community?
‘The NHS has been slow to recognise the equality opportunity agenda in relation to service delivery and community confidence’
Will they find better ways to improve access to healthcare for gypsies and travellers? Will they get the equality agenda or adopt a “we treat everyone the same” approach? And can this be achieved at the same time as delivering £20bn of efficiency savings?
The NHS has been slow to recognise the equality opportunity agenda in relation to service delivery and community confidence. This responsibility will now presumably be taken over by the CCGs.
These will need to more explicitly recognise that health equality and shorter live expectance amongst gypsies and travellers or other minority groups is an equal opportunities issue. The poor healthcare provided to people with a learning disability is a disability equality issue.
Accessibility of services
The reduced spend on mental health services when other service budgets have not been reduced is a disability equality issue. The fact that older patients have been receiving a poorer quality of hospital care is an equality issue.
The equality agenda includes gaining the confidence of all sections of the community that their needs can be met. The closure of hospitals to save money and centralise specialist services may have some professional support but is strongly opposed by communities and is hardly designed to gain their confidence.
Certain groups will feel that having to travel further to receive a service makes it less accessible to them. Accessibility of services is indeed an equal opportunity issue.
The new equal opportunity agenda for the NHS is about considering the impact of budget cuts, service reductions and new commissioning arrangements and ensuring that these do not disproportionately affect people already subject to discrimination and disadvantaged through race, faith, disability, gender, age or sexuality.
This starting point is willingness to acknowledge that if we are making staff redundant rather than recruiting new staff, reducing services rather than increasing them, narrowing who can receive help rather than broadening it out or privatising services, then there may be a negative impact on equality of opportunity.
Blair McPherson author of An Elephant in the Room, about delivering equality and diversity in the public sector published by Russell House
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