EQUALITY AND DIVERSITY. Eric Bater Intending Trainers ‘ course Phase 4i 26 th September 2012. Why are we doing this?. Equality and diversity is a section of the GP curriculum Relevant to clinical care, relationships with patients, working with colleagues
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Intending Trainers ‘ course Phase 4i
26th September 2012
Equality and diversity is a section of the GP curriculum
Relevant to clinical care, relationships with patients, working with colleagues
And to you as an individual and society as a whole
And it makes routine everyday work more interesting
By the end of the session to have developed an understanding of:-
Equality is the principle by which all persons or things under consideration are treated in the same way
It is about creating a fairer society in which everyone has the opportunity to fulfil their potential
All of the characteristics that make individuals different from each. A term used to describe the relative uniqueness of the individual in the population- including characteristics or factors such as personality, work style, religion, race, ethnicity, gender or sexual orientation, having a disability, socioeconomic level, educational attainment, and general work experience.
de Mello, Awareness
Ascribing a general characteristic of a group to everyone irrespective of the individual’s characteristics
To make a judgement without having the facts
Having a negative attitude towards another based solely on membership of a group
A man and his son were out driving one afternoon and were involved in a serious car crash. The father was killed at the scene, but the son survived and was rushed to hospital and prepared for surgery for his life threatening injuries.
As the son was wheeled from the anaesthetic room the surgeon walked out of the theatre exclaiming “I can’t operate on this man, he is my son”
‘less favourable treatment on the grounds of sex, race, disability, sexual orientation and religion or belief’
Seven types of discrimination
Disability (including mental health and obesity)
Religion or belief
Marriage and civil partnership
Pregnancy & maternity
Harassment by a third party
Discrimination by perception
Burden of proof is on employer to prove that discrimination did not occur
Discrimination because of a protected characteristic
Direct discrimination against someone because they are associated with another person with a protected characteristic (including carers of disabled people and elderly relatives)
Where a rule or policy applies to everyone, but disadvantages a person with a protected characteristic, and is not justified by the requirements of the job (e.g possession of a UK degree)
Behaviour deemed offensive by the recipient .
(Employees can claim they find something offensive even when it is not directed at them)
‘engaging in unwanted conduct which has the purpose or effect of violating another person’s dignity, or is creating an intimidating, hostile, degrading, humiliating or offensive environment…… having regard to all the circumstances, including, in particular, the perception of the victim’
Employers are potentially liable for the harassment of staff or customers by people they do not employ
‘ a particular form of harassment involving a misuse of power to criticise, condemn, abuse , humiliate or otherwise undermine a person (or group’s) ability to the extent that they cannot perform their job properly of suffer stress as a result’
Discrimination against someone because they made or supported a complaint under Equality Act legislation
When someone thinks a person has a particular protected characteristic, even if they do not. (e.g. rejecting a job application from a women with an African sounding name, whom an employer infers must be black even though she is white).
‘the collective failure of an organisation to provide an appropriate and professional service to people because of their colour, culture, or ethnic origin.
‘a person who has a physical or mental impairment which has a substantial and long term adverse effect on his/her ability to carry out normal day to day activities’ (i.e. longer than 12 months)
‘Service providers should make reasonable adjustments to remove physical barriers ‘ (e.g steps, stairways, entrances and exits)
Ability to lift, carry or move objects
Speech, hearing or eyesight
Memory, ability to concentrate, learn or understand
Understanding of the risk of physical danger
Examples of disabilities:-
Physical impairments (ME)
Sensory impairments (visual/hearing)
Medical conditions (Cancer, HIV/AIDS)
Mental Health conditions (Depression/schizophrenia)
Learning difficulties (Dyslexia)
Choosing to hire a candidate from an under-represented group, providing they are as qualified for the role as other candidates.
For reasons of modesty
For reasons of authenticity
Genuine occupational requirement (the service being best provided by a person from that group)
Right to life
Right to a fair trial
No punishment without law
Right to respect for private and family life
Freedom of thought, conscience and religion
Right to marry
Right to education
Rehabilitation of offenders act (1974)
Human Rights Act 1998
EU Part-time work directive 2002
Flexible Working Regulations 2002.
NHS is one organisation
Deliberate discrimination illegal
Accidental organisational discrimination illegal
Onus of proof is on us, not claimant
Therefore keep records
NHS Litigation Authority standards
DH recruitment guidance
Care Quality Commission standard 7e
DH Human Rights in Healthcare
Northeast SHA Single Equality Scheme
Your new GPR turns up for work on their first day, having arrived by bus. “Didn’t you know I have epilepsy, so can’t drive at the moment?” she asks.What are your options?
A patient at your practice is seeking to make an appointment. When offered an consultation with your Irish GPR he comments “No, I don’t want to see no ‘Mick’”. The GPR is within earshot.How would you handle the situation?
Having seen your Nigerian GPR walk through the waiting room, a patient comments to another patient ‘you don’t see many chocolate Niggers round these parts do you?’What should you do?
Your GPR informs you they suffer from migraine which is provoked by sleep deprivation. They request that they not be allocated any night OOH shifts during their attachment. How would you respond?
You are a partner working in a practice with a large Bangladeshi population. You wish to employ a new nurse, primarily to work with the Bangladeshi girls and young women. Both your existing nurses are elderly. You would ideally like a young nurse who is bilingual, and who is not likely to go off on maternity leave.Compose a job advert.
At a practice party one evening you overhear a member of your employed staff making racist remarks about another member of your staff. The other person ignores the remark.What should you do?
Diversity and Culture
The recognition and valuing of difference between people
Creating a working culture and practices that recognise, respect, value and harness difference for the benefit of the organisation and individual patients.
Class (wealth, family background, education)
Country/region of origin
Country/region of residence
Culture (beliefs, expectations, behaviours)
Identification with a social group on grounds of culture, common origin, and shared history
Ethnic Population 0.7% (8.7% UK)
Even spread across county (no concentration in one area)
Immigration significant - especially from Poland
Tourist sector in lakes, seafood industry main factor
No stats available on health inequalities in Black and Minority Ethnic Groups - stats too small!
The sum of one’s beliefs, rituals, customs and practices that guide thinking, decisions and actions in a patterned way. They are learned throughout a lifetime, and passed on through generations.
Complex social phenomenon
Shared beliefs, values and attitudes that guide behaviour of members
Dynamic concept - keeps changing
We are all multicultural, but often don’t recognise it
What 10 features would best describe you to someone you had never met?
Disability and health
Cultural beliefs, expectations
Which cultural groups would others say you belong to (top of iceberg)?
Which other cultural groups do you feel you belong to (bottom of iceberg)?
Tendency to stereotype
A survey of over 100,000 employees of IBM in forty different countries (1980) looking at different cultural dimensions
Five cultural dimensions which chart the general characteristics of a society (though not necessarily each individual member of that society)
Power and distance
Individualism v Collectivism
Masculinity v Femininity
Long-term v short-term orientation / Confucian work dynamism
The extent to which less powerful members of a culture expect and accept unequal power distribution
People integrated into a cohesive group that provides protection, or everyone looking after themselves?
In masculine cultures traditional distinctions between the gender roles are maintained. In Feminine cultures the distinctions are blurred.
Differences in the avoidance of uncertainty or unknown matters, tolerance of ambiguity.
Observing status distinctions (older people having more authority)
Valuing thrift, frugality
Universalist vsparticularist (values vs relationships) (UK/Arab countries)
Individualist vs communitarian (individual vs group) (UK/Germany)
Neutral vs affective (range of expressed emotion) (UK/Italy)
Specific vs diffuse (range of involvement) (UK/Asian countries)
Ascription vs achievement (how status accorded) (Asian countries/UK)
Rules more important than relationships
A deal is a deal
Fairness is treating everyone the same
Consistency is valued
Relationships more important than rules
So deals can be modified
Treating cases on special merits is valued
Don’t show feelings
Little physical contact, strong facial expressions and gestures
Subconscious verbal/paraverbal signals important
Reveal thoughts and feelings
Touching and use of large gestures is common
Heated, animated expression admired
Direct and purposeful
Precise and transparent
Do not mix business with pleasure
Indirect, aim of communication not obvious
Tactful, maybe ambiguous or opaque
Personal trust important
Mix business with pleasure
Respect for what you do
Use of titles only when relevant
Age and gender (etc) don’t determine level of responsibility
‘What have you studied?’
Respect for position
Extensive use of titles
Older males in positions of responsibility
‘Where did you study?’
To make a judgement without having the facts
‘Thinking Fast and Slow’
Which aspects of your identity would you refuse to give up?Which aspects do you feel could not be changed even if you developed impairments?
A physical or mental impairment which has a substantial and long term adverse effect on the ability to carry out normal day to day activities
Disability Discrimination Act 1995
Which do you feel least able to cope with?
Which do you feel best able to cope with?
Impairment (Symptoms and signs)
Disability (Activities of daily living)
Handicap (social roles)
Kvalsvig A. 2003:362(9401): 2079-2080