Annex 1: Inventory of indicators from surveys and registries

medical personnel
� Cultural interpreters offer language
services and can tackle other potential
barriers to patient satisfaction
� Advocacy services are a means of
support and advice to those who are
excluded from service provision due to
range of obstructions (language, cultural,
financial)
� Increased coverage can be achieved
through the initiation of telephone help
lines offering interpretation services
Improving financial access to services affords
greater levels of protection to disadvantaged
groups and reduces the financial burden on
service providers.
By reducing financial pressures on those needing
treatment, they are more likely to present to
appropriate primary services rather than wait
and/or needlessly burden secondary services.
� Greater levels of access achieved through
legislation provide ‘safety nets’ to those
who would otherwise have been excluded
from participating in health insurance
schemes.
� Local agreements between primary care
services and insurance companies initiate
fixed payment schemes which offer
greater levels of access to low-income
people
Report on the role of Health Promotion in Tackling Inequalities in Health
and language barriers have been
identified
� Encourage the development of
curricula, codes of ethical practice and
qualifications within this field to
ensure appropriate quality standards
� Support and encourage the
development of legislation and
schemes which provide greater access
or afford greater levels of protection to
those who are prevented from
accessing services due to their lack of
financial means
Improving access to healthcare services was a subject that received a great deal of attention
within national reports. Co-ordinators provided examples of innovative approaches that were
designed to extend the boundaries of existing service provision. Generally this activity was
related to groups of people with special needs with respect to services, or to those who were
prevented from accessing services because of barriers (legal, cultural, financial) that had been
identified. The consideration of this subject covered a number of approaches including:
outreach work amongst difficult-to-target populations (migrant workers, rural-to-urban
migrants, ethnic minorities, sex workers); providing services within specific geographical
areas characterised by multiple deprivation; modifying the access points of traditional services
to make them more responsive to the needs of certain groups; and providing improved
financial access to care to those lacking sufficient funds or insurance 9 .
The links between health inequality and health services has long been an issue considered by
many writers. It was not considered necessary to reproduce here the entire debate. A brief
look at some of the issues is included for completeness.
9 Some of the examples that illustrated the extension of existing healthcare boundaries were part of
wider moves towards the integration of services and the creation of new working partnerships. This
closely related issue receives fuller attention within the section on cross-sectoral partnerships
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