Wednesday, August 04, 2010


This is a tough one because the ground around it is covered in egg shells coated with thin ice, but bear me out.
I have been looking into the parlous state of health care amongst UK gypsies. And frankly it is all pretty scary. According to one recent study the life expectancy of a Gypsy is up to 25 years less than it is for a non gypsy. At the very least we are talking about a discrepancy of 10 years.

Why is this the case? Well on this website there a number of reasons stated,

    1. Centuries of discrimination and fear of ‘authority’ means that some people will put up with enormous pain or emotional distress rather than seek help.
    2. Communities experience stress caused by loss of traditional livelihoods and being constantly moved on. There is evidence to suggest that they may also experience a deterioration in physical and mental health after moving into houses.
    3. Some Gypsies and Travellers won’t freely admit to health needs. Fatalistic attitudes and acceptance of pain and discomfort are prevalent among some Gypsy and Travelling Communities.
    4. Gypsy and Travellers may miss appointments because of being evicted, inability to read letters or because they don’t have rigid attitudes to time
    5. Gypsy and Travellers may not be aware of existing services or that certain services are free. A lot of health information and ‘choices’ are not accessible to people with low literacy levels.
    6. It is often inappropriate for a female Gypsies or Travellers to see a male GP, so a choice should be available. Men are less likely to go and see a GP at all and will often leave health problems until they are at ‘crisis’ stage’.
    7. GP boundaries are often drawn to exclude Gypsy and Traveller sites. This may be intentional because Gypsies and Travellers, who do not generally take up screenings and vaccinations, won’t be regarded as generating income for practices.
    8. Where outreach services exist these are usually only targeted at authorised sites. Reception staff may lack awareness of Traveller’s behaviour – for example, that they often turn up for appointments in threes and women may be chaperoned.
    9. Having experienced so much discrimination, Gypsies and Travellers are more likely to anticipate discrimination and to read it into other people’s words and actions.
Now take a look at this list and work out how much is the responsibility of society at large and how much within the community itself.

1. Is it fear of authority - or is it contempt for authority? If there is one sector of society that is not prone to discrimination I would say it is the health care crowd.
2. It is true that much of what is called traditional work has vanished. But that is as true of the miners and other workers in heavy industry and for that matter other agricultural workers as it is with the gypsies. Also, to alleviate the problems mentioned here about moving house. Well surely that is part and parcel of being a traveller. A cross that must be borne if that is the lifestyle that you choose?
3. Again this attitude is prevalent amongst men of all sectors of society, particularly amongst working class males. With the rest of society we cajole and inform, but we don't blame ourselves.
4. I thoroughly take the point about evictions, but the literacy and timekeeping must surely be their own responsibility. I find it outrageous that if I miss a dentist appointment for example I will be fined, but leeway should be made for others because they are supposedly culturally unsuited to timekeeping. How condescending is that?
5. Again, the literacy level must be in part their own responsibility. Yes access to education is more difficult for travellers, but that again is a consequence of a chosen lifestyle. Society can expect that as free education is offered, then it is our responsibility to take it up. (There again looking at the latest reports into literacy in the general population and standards of children coming out of primary schools I am not sure how the Gypsies can be helped here).
6. Cultural issues again. First I ask why? If Gypsy women have a cultural problem with seeing a male doctor then whilst I am sure all reasonable efforts will be made to find a female doctor in the end that may not be possible, especially in rural areas where choice is limited. In the case of Muslim women thee are similar problems, but normally solved by the fact that most of the Muslims in the UK live in cities. However if it is not possible, with the best will in the world, then maybe, just maybe the Gypsy women might have to swallow some cultural pride. The reference to men is just a repeat of point 3.
7. This I know nothing about and cannot comment upon, GP boundaries and the like. If that is the case then that is something that should be dealt with by the authorities. However when it comes the screenings and vaccinations, again this is the responsibility of the gypsies themselves. The service is offered, whether they take it up is a matter for them.
8. I cannot see why NHS services should be going to unauthorised sites except in extremis. Surely another word for unauthorised sites is 'illegal'? As to travellers behaviour. I cannot see the problem here. Other than the normal problems of people turning up to what is often a very private meeting mob handed. The time taken, and the general difficulties of dealing with more than one person at a time will make consultations difficult. Equally a chaperone could easily make the honesty required by the patient more difficult, thus hampering the health professional in the performance of their job. Again - the Gypsies responsibility.
9. This may well be true. But that does not make it any less the Gypsy's responsibility. Good manners would require the general public - or in this case the health care professional to be sensitive to this.

But but, this sensitivity looks like an excuse to scream discrimination where there is none.

Look at the comments of the organisation Friends, Families and Travellers (FFT),
Chris Whitwell, Director of FFT says:
“Racism against Gypsies and Travellers is deeply embedded and goes beyond individuals and institutions. There is structural racism which runs throughout society. Even people who would never dream of being racist normally will unthinkingly do or say things that exclude Gypsies and Travellers.”

Now as we know racism is now defined by the perception of racism by the so called victim. Intention is irrelevant. If as point 9 suggests Gypsies are shall we say, quick to take offence, then this becomes a minefield.
Now I am not for a moment suggesting that there is a deep and ingrained discriminatory attitude towards the Gypsies in the UK, as there is anywhere Gypsies are to be found. But surely in the case of healthcare as I hope I have shown there is a great deal that can be done by the gypsies themselves that could overcome this, with society at large being ordered to find itself guilty?



Racism is better than being mugged.

Fortune Articles said...

The role of cultural education in reducing racism in Aboriginal health care situations in Australia.