In the diverse tapestry of the United Kingdom's cultural landscape, health and well-being are universal aspirations that transcend ethnicity, origin, and background. Yet, beneath the veneer of universal healthcare accessibility, a narrative of disparity emerges, shedding light on the challenges encountered by the Global Majority, who are the Non-white UK residents, when seeking to access healthcare services in the UK.
This article explores seven of these challenges, and suggests possible solutions on how the challenges can be resolved. Through this exploration, we aim to shed light on the urgency of addressing these challenges, not only for the betterment of individual health but also for the cultivation of a more inclusive, compassionate, and equitable healthcare system that truly serves every strand of the UK's diverse tapestry.
To this effect, some of the barriers faced by members of the UK’s Non-white community (THE COMMUNITY) in accessing healthcare in the UK are briefly discussed below.
1. Language Barrier: Although the 2019 General Medical Council guidance provides that “you must make sure, wherever practical, that arrangements are made to meet the patients’ language and communication needs”, research has shown that patients with limited English language skills face difficulties with communicating with hospital staff, especially the administrative staff. This is significantly improper and uncomfortable because the administrative staff members are the primary point of contact for new patients and their carers/loved ones.
Due to the language barrier, consultations between doctors and patients require more than the standard allocated time, yet no additional is added regardless of the complexities doctors face when speaking with patients who are not proficient in English language. There is also the inability of members of the community who are highly proficient in English to understand the hospital staff members due to differences in the accent and local terminology, which are oftentimes only understood either by the British citizens or non-British citizens who have spent a good number of years in the UK.
This has hindered many of the community members from reaching out to the hospitals when they need to. A 2021 research paper suggested that the Primary Care Network (PCN) manages its own budget in order to employ more staff members from diverse ethnic groups who can assume roles such as Interpreters and Administrative staff. The NHS can be applauded for the diversity it is trying to infuse in hospitals, but when compared to the proportion of Black, Asian & Minority ethnic individuals, the room for improvement remains a very wide one.
2. Lack of Representation: The underrepresentation of healthcare professionals who mirror the diversity in society, can lead to discomfort and mistrust among some sections of the population, who may relate better to professionals who understand their cultural nuances. A healthcare practitioner reported the issue of members of the community being hesitant to seek medical care, fearing that their concerns would not be understood or taken seriously, and this was simply because every healthcare practitioner they encountered was White.
Some healthcare practitioners who are also members of the community have reported cases of racism which they experienced at the hands of their colleagues and British patients, and this increased the misrepresentation rate as some of these practitioners chose to resign. This issue provoked the words of an African GP, Oluwatosin Ajayi “To improve access for ethnic minority patients, eliminating institutional racism should be a priority”
3. Stigma Surrounding Mental Health: Some individuals have stigmatised mental health issues, making it challenging for individuals to seek therapy or counseling, even when needed. Seeking therapy is sometimes seen as a sign of weakness or shame, which can prevent individuals from seeking the help they need. This stigma can exacerbate mental health issues and deter members of the community from engaging in therapy sessions.
4. Inability to relate with therapy sessions: Although some individuals already have their ascribed stigma to therapy and mental health care, those who decided to seek therapy regardless of the stigma still faced a challenge. Some of the therapists in the UK lack the necessary cultural competence to treat members of the minority ethnic groups. Due to the gap in knowledge on cultural background, understanding, and sensitivity projected by the therapists, the members of the community often feel misunderstood and therefore feel unsupported.
5. Mistrust and Historical Trauma: Historical experiences of discrimination and maltreatment which have been passed down to generations, some of which still occur in the 21st century, have led to mistrust in the UK healthcare and mental health system. Some individuals have explained their fear and concern- that therapy may not genuinely address their needs or may perpetuate harm. For some of them, this fear was borne out of the historical treatment of members of their ethnic groups. The majority of them had never experienced these treatments, but yet assumed that it would be their fate to endure. Examples of which are the fear of being used for social experiments, and unauthorised acquisition of organs from infants.
6. Cultural Barrier: Differences in cultural norms, values, and beliefs can affect the way some of the individuals perceive and engage with healthcare. Traditional practices and beliefs might clash with Western medical approaches, leading to mistrust or reluctance to seek treatment. Healthcare services that don't consider cultural differences may fail to address the unique needs and preferences of the patients. Religious practices and beliefs can impact medical decisions and therapeutic approaches, potentially creating barriers to effective care.
7. Limited Awareness: Some of the members of the community are not always fully aware of the available healthcare and therapy options due to a lack of information or outreach efforts tailored to their communities. In addition, some of them do not know how to reach their GP, all they do is depend on medication from their home countries, and medications from pharmacies they can get without a prescription.
It's clear that addressing these challenges requires a multi-faceted approach. As we move forward, here are a few suggestions that could be considered.
1. Cultural Competency Training: Healthcare professionals should receive training to better understand the cultural nuances of every patient, enabling more effective communication and care.
2. Increased Representation: Encouraging diversity within the healthcare workforce can enhance relatability and trust, helping to bridge the gap between patients and healthcare providers.
3. Language Support Services: Providing language interpretation services can ensure that language barrier does not hinder patients' ability to access and understand medical care.
4. Community Engagement: Building partnerships with leaders and organisations representing the community can help healthcare systems tailor services to specific needs and preferences.
5. Mental Health Outreach: Developing targeted campaigns to address mental health stigma can encourage individuals to seek the support they need.
6. Culturally Sensitive Resources: Offering informational materials and resources that resonate with diverse backgrounds can empower patients to make informed decisions about their health.
By embracing these suggestions and continuing the conversation, we can work towards a healthcare system that truly serves the needs of all individuals, regardless of their ethnicity or background. Through our collective effort, we can dismantle these barriers and pave the way for a more inclusive and equitable healthcare experience for everyone in the UK.
Ajayi, O., 2021. A perspective on health inequalities in BamE communities and how to improve access to primary care. Future healthcare journal, 8(1), p.37.
Fenton, K., Pawson, E. and de Souza-Thomas, L., 2020. Beyond the data: Understanding the impact of COVID-19 on BAME groups. Public Health England, pp.2020-11.
Kewe Ndakara
Disclaimer: These views are mine and do not represent those of OBV.
