Women’s equality in the UK – A health check

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12.7 12.8 12.9 12.10 12.11 Women’s health sector Women face many barriers to accessing health and social care, which can delay treatment and make health worse. 18 Therefore services that do not build ‘relational security’ between workers and women may leave women isolated and unwilling to trust the service provider. This was acknowledged as important in the Department of Health (DoH) policy document, Women’s Mental Health: Into the mainstream, published in 2002. 19 Many women (in particular young, Black, minority ethnic and refugee (BMER) and/or women who are experiencing poverty) report being judged or having received inappropriate responses from healthcare professionals. Experiences of discrimination mean women do not receive the service they need and their health is put at risk. 20 The current model of health and social care does not meet the holistic needs of women. The gender-neutral policy coming out of central government masks the continued discrimination against women and undermines efforts to provide gender specific services that cater to women’s often complex health needs. The DoH needs to tap into the women’s voluntary sector to fulfil its obligations to women under the Equality Act 2010 by funding women’s organisations appropriately and ensuring their engagement in the commissioning process. However, women’s health and social care voluntary organisations are at risk of closure. 21 (See Appendix: 4) These closures increase the use of statutory health and social care services, as service users often have nowhere else to go or are forced to seek the services of hospitals because their (preventable) problems have escalated or become acute. This undermines the Government’s wider health reform strategy to invest in preventative care, make health services more responsive to local need, and provide tailored care closer to home. 22 Women’s organisations have specialist knowledge and expertise about women’s lives, experiences and needs. As such, their engagement in decision making, needs assessment and service delivery is integral to the Government’s aims to provide a patient-led NHS, improve public health and reform long-term and social care. 23 Health as a gender issue needs to be embedded in all DoH planning and policy work. In particular the DoH needs to recognise that the closure of violence against women and girls (VAWG) services has a direct impact on the numbers of women the State will eventually have to provide care for because of the serious health consequences of VAWG. (See Appendix: 21) Recommendation: Women’s health and social care needs must form an integral part of the Department of Health’s strategic framework and statutory guidance on how to proactively fund and ‘intelligently’ commission the women’s sector should be developed 18. Women’s Health and Equality Consortium (2011) Why women’s health? WHEC: London http://www.whec.org.uk/wordpress/wp-content/ uploads/downloads/2011/11/WhyWomensHealth11.pdf 19. Department of Health (2002) Women’s mental health: Into the mainstream, Strategic development of mental healthcare for women. DoH: London http://www.nmhdu.org.uk/silo/files/into-the-mainstream.pdf 20. Ng, P. (2010) Dispelling myths, speaking truths: Focus groups findings on the experiences, needs and aspirations of young BAMER women living in the UK. Imkaan: London https://www.dropbox.com/sh/4zq0jgk4xyez91i/OHBb9uELBr/Dispelling%20Myths%20Speaking%20 Truths%20-%20Focus%20Group%20Findings.pdf 21. Women’s Resource Centre (2009) Not Just Bread, But Roses, Too: Funding to the women’s voluntary and community sector in England 2004-07. WRC: London 22. Department of Health (2010) Healthy Lives, Healthy People: Our strategy for public health in England. DoH: London https://www.gov.uk/ government/publications/healthy-lives-healthy-people-our-strategy-for-public-health-in-england 23. Department of Health (2012) Department of Health Corporate Plan 2012 to 2013. DoH: London https://www.gov.uk/government/ publications/department-of-health-corporate-plan-2012-to-2013 112 Women’s equality in the UK: CEDAW shadow report 2013
12.12 12.13 12.14 12.15 Translators Women who are less proficient in English face language barriers and receive inadequate translation services that limit their ability to access care. 24 Little attention has been paid to gender needs in general guidance about language services but vulnerable migrant women, for example, are likely to require gender sensitive interpretation services, with continuity of the person providing interpretation wherever possible. It is not appropriate to use children or family members in medical consultations 25 yet this often is the practice for women accessing health services. Recommendation: Language services using professionally qualified interpreters need to be a key part of commissioning in primary care Tackling health inequalities Understanding the health inequalities women face demands an understanding of the ways in which different groups of women face specific barriers to good physical and mental health during their life course. Tackling health inequalities requires a focus on the disparities between men and women, boys and girls, but also amongst different groups of women, some of whom face significant disadvantage and marginalisation. 26 For example, Black women over 65 face higher risk of cervical cancer than white women. Additionally, women with ‘no recourse to public funds’ are doubly disadvantaged and are at particular risk of poor maternal and infant health. 27 Women from some South Asian communities face higher rates of cardiovascular disease 28 and significantly higher rates of cervical and mouth cancer 29 as well as disproportionate rates of suicide and self-harm linked to VAWG. 30 We have seen little evidence that the 2008 recommendations from the CEDAW Committee regarding intersectional discrimination against ethnic minority women, data collection and culturally-appropriate strategies and programmes 31 have been carried out. Women have been facing difficulties in accessing services, with some women facing triple discrimination in accessing healthcare, for example, being unable to access their GP as a result of their immigration status; being unable to have instant access to interpreters or being in poverty which causes barriers to them travelling to appointments. In addition, many women who have been in the care of social services do not have a GP at the age of 18; women in poverty 24. Bharj, K et al. (2008) Addressing ethnic inequalities in maternity service experiences and outcomes: Responding to women’s needs and preferences. Race Equality Foundation: London http://www.raceequalityfoundation.org.uk/publications/downloads/addressing-ethnicinequalities-maternity-service-experiences-and-outcomes-res 25. Maternity Action (2012) Guidance for Commissioning Health Services for Vulnerable Migrant Women. WHEC: London http://www. maternityaction.org.uk/sitebuildercontent/sitebuilderfiles/guidancecommissioninghealthservvulnmigrantwomen2012.pdf 26. Women’s Health and Equality Consortium (2011) Why women’s health? WHEC: London http://www.whec.org.uk/wordpress/wp-content/ uploads/downloads/2011/11/WhyWomensHealth11.pdf 27. Lewis, G. (2007) Saving mothers lives: Reviewing maternal deaths to make motherhood safer 2003-2005. The seventh report on confidential enquires into maternal deaths in the UK. The Confidential Enquiry into maternal and child health (CEMACH): London http:// www.publichealth.hscni.net/sites/default/files/Saving%20Mothers%27%20Lives%202003-05%20.pdf 28. British Heart Foundation (2010) Factfile for GPs about Women and Heart Disease http://www.bhf.org.uk/publications/view-publication. aspx?ps=1001365 29. Cancer Research UK (2009) Cancer incidence and survival by major ethnic group, England, 2002 – 2006. Cancer Research UK and NCIN http://info.cancerresearchuk.org/prod_consump/groups/cr_common/@nre/@sta/documents/generalcontent/crukmig_1000ast-2749. pdf 30. Southall Black Sisters (2011) Safe and Sane: A Model of Intervention on Domestic Violence and Mental Health, Suicide and Self-harm Amongst Black and Minority Ethnic Women. SBS: London http://www.southallblacksisters.org.uk/reports/safe-and-sane-report/ 31. CEDAW Committee (2008) Concluding observations of the Committee on the Elimination of Discrimination Against Women: United Kingdom of Great Britain and Northern Ireland. Forty-first session http://daccess-dds-ny.un.org/doc/UNDOC/GEN/N09/555/92/PDF/ N0955592.pdf?OpenElement Para 46 Women’s equality in the UK: CEDAW shadow report 2013 113
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Women’s equality in the UK - A he
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Women’s equality in the UK - A he
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Appendices (online only) Appendix 1
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• the continued discrimination ag
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• Develop a common model of analy
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Article 9 - Nationality: One third
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investment in social infrastructure
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and increase the marginalisation of
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have been no prosecutions in Englan
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1 2 3 4 5 Introduction This is a Un
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10 11 12 13 housing crisis, a ‘lo
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1.1 1.2 1.3 Article 1 - Overarching
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1.7 1.8 1.9 1.10 1.11 1.12 Women’
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1.17 1.18 1.19 Young women We are a
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2.4 2.5 2.6 2.7 consult to “remov
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2.12 2.13 discrimination”. Howeve
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2.17 2.18 2.19 2.20 2.21 worsen gen
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2.26 2.27 2.28 2.29 CEDAW and the l
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3.7 3.8 3.9 3.10 would “increase
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3.15 3.16 3.17 and accountable EHRC
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3.22 3.23 3.24 report is was partic
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classes, migrants, and Gypsy, Trave
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the institutional discrimination an
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5.5 5.6 5.7 Case study: 8 Sandra li
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5.12 5.13 5.14 issue. A more approp
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6.1 6.2 6.3 6.4 Article 6 - Exploit
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6.9 6.10 6.11 to the protection and
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6.15 6.16 6.17 6.18 Office’s own
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6.24 6.25 6.26 women and increase t
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6.31 6.32 6.33 6.34 infrequent lap
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Page 63 and 64: 7.7 7.8 7.9 7.10 The House of Lords
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Page 75 and 76: 9.21 9.22 9.23 9.24 women. 47 (See
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Page 105 and 106: 11.31 11.32 11.33 Introducing more
Page 107 and 108: 11.37 11.38 Case study: 83 Jasmine
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16.5 16.6 people being forced into
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16.10 16.11 16.12 16.13 16.14 16.15
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16.21 16.22 frequently women’s ac
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Recommendations: • Parents with c
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19.6 19.7 19.8 as well as for our c
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19.13 19.14 19.15 19.16 The Governm
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19.22 19.23 19.24 19.25 VAWG is a c
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19.30 19.31 19.32 19.33 DV is still
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19.38 19.39 19.40 perpetrators thro
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19.43 19.44 19.45 Support for victi
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19.49 19.50 19.51 19.52 Recommendat
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19.57 19.58 19.59 19.60 BMER VAWG p
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19.62 19.63 19.64 19.65 VAWG in hea
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19.70 19.71 19.72 Invisibility of s
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19.77 19.78 19.79 A number of repor
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19.85 19.86 means more provision. T
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Annex 1: The Devolved Administratio
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to 41.8% of rural men. 16 Rural are
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Annex 2: The UK’s relationship wi
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Annex 3: UK reservations and declar
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ESA - Employment and Support Allowa
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Annex 5: Acknowledgements Many than
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Women’s Resource Centre is suppor
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