Equality, Discrimination and Human Rights: what they mean for older people using health services.
The last 50 years have seen a dramatic change in the structure of the population. First seen in economically developed countries but now evident across all continents and countries the proportion of older people has grown. Despite abundant evidence of this change the process of adaptation has been slow and patchy. Many governments have focused on demographic change as a burden and challenge to society rather than celebrating longer lives and generating creative responses to an ageing society. The burdens are described as: extra demands on health services,;the impact on pension provision; over-occupation of housing, the need for community support; having excessive wealth and damaging the life chances of younger people. This negative perception of older people in an ageing society is fertile ground for discrimination and unfair treatment of older people. That is why it is vital to draw on Equalities legislation and human rights principles to ensure that older people have full and fair access to health services.
Equalities Act 2010: This Act protects individuals from unfair treatment and promotes a fair and more equal society. The “protected “ characteristics are:
Marriage and Civil Partnership
Religion or belief
Prohibited Conduct can take the form of:
Direct Discrimination: Treating one person worse than another because of a protected characteristic e.g. an employer does not tell an older person about a job opportunity because he thinks older people’s memories are worse. An employer does not offer an interview to a person with a disability because of their disability.
Indirect Discrimination: This occurs when a rule or policy or way of doing things has a worse impact on someone with a protected characteristic than on someone without one e.g. holding meetings in the evening which may discriminate against women with childcare responsibilities or carers of an older person or a person with a disability.
Harassment or victimisation of people with a protected characteristic.
Human Rights: The UK signed up to the European Convention on Human Rights in 1951 and passed its own Human Rights Act which became law in October 2000. Also the United nations adopted 18 principles for the advancement and protection of older people’s human rights. The principles are grouped under the headings of:
All public bodies in the UK are bound to operate in accordance with Human Rights legislation.
Key rights under the European Convention relating to older people are:
Article 2- Right to life
Article 3- Prohibition of inhuman and degrading treatment
Article 5- Right to liberty
Article 6- Right to a fair hearing
Article8(1)- Right to respect for private and family life and home
Article 8(2)- Permitted restrictions on 8(1) rights to protect other people’s rights or the needs of the wider community
Article 9- Freedom of thought, conscience and religion
Article 11- Freedom of association
Protocol 1,Article 1- Right to peaceful enjoyment of possessions
Protocol 1,Article 2- Right to education.
In the health field the Equalities and Human Rights legislation is important to older people for the following reasons:
Older people use a wide variety of services– GPs; Dentists; Pharmacists; Opticians; Hospitals;
Emergency Treatment centres; Nursing Homes.
Health interventions have the potential to harm as well as benefit older people.
Older people may be overly deferential to health providers and not ask for relevant
information or question decisions; they may be reluctant to complain.
Some older people may be frail, have difficulties in communication, or need assistance
with personal needs (washing;eating; using the toilet). This makes them vulnerable.
Some older people may be disoriented by the hospital environment or very anxious.
Some staff may lack adequate training/education in the physiological, social and
psychological processes of ageing and operate with stereotypes of older people
present in the community and the media.
Older people may be ignorant of how to complain or sources of independent help.
Some professionals may make judgements/assessments on the basis of the older person’s
chronological rather than their biological age.
Some health staff may not allow enough time to explain the benefits/risks of treatments.
Who needs to be aware of these issues?
All staff involved in the treatment and care of older people
Managers and administrators
How do we know when provisions of the Equality Act or Human Rights legislation are being breached?
Complaints by patients, relatives , carers
Data collection and analysis/research
Analysis of routines/procedures/staff culture
Whistle-blowing by staff
Internal Audit-Dignity in Care/Fundamentals of Care
For support in making a complaint contact: South Glamorgan Community Health Council, Tel, 02920 750112. Email: [email protected].
For further materials on human rights go to website of British Institute of Human Rights.