Ethnic minorities: policy context
The Race Equality Framework for Scotland (2016-2030) sets out the Scottish Government’s approach to promoting race equality and tackling racism and inequality between 2016 and 2030.
Recently, the Equality Act 2010 has consolidated the previous legislation around preventing discrimination and improving equality of opportunity and good relations. The Act applies to both the private and public sectors, however there are additional provisions for the public sector and guidance has been published by the UK Home Office Equalities Unit. The previous legislation on ethnicity included the Race Relations (Amendment) Act (2000) , which amended the earlier Race Relations Act 1976.
Equally Well and Fair for All
In June 2008 the Scottish Government published Equally Well, the report of the ministerial task force on health inequalities. The report recommended a review of data needs in relation to diversity (recommendation 74) and recommended that NHS targets should be set to support work on patient monitoring and collection of equalities data (recommendation 75). The supporting papers include (chapter 10) a useful review of inequalities related to ethnicity.
The Scottish Government set up the Equalities Directorate in 2008 as a unit of NHS Health Scotland and as a centre of expert advice and support to NHS Scotland on delivering equality and diversity, eliminating discrimination and reducing health inequalities. The Scottish Government then published the Equally Well Implementation Plan in December 2008.
To support policy implementation, NHS Scotland launched an Equality and Diversity Impact Assessment Toolkit in 2005.
In Scotland, the response to the murder of Stephen Lawrence and the subsequent Macpherson report (1999) included the 'Fair for All' policy initiative outlined in the Scottish Executive Health Department Letter 2002/51(111Kb). This required Scottish NHS organisations to:
- make a clear commitment to address the challenge of ethnic minority health,
- develop a local demographic profile,
- ensure equitable access to services by all ethnic groups,
- include ethnicity in human resource strategies,
- involve ethnic minority communities in service development.
All Scottish NHSboards have Fair for All and Race Equality schemes, which should set out how they intend to ensure that they are delivering culturally competent services. Requirements for the NHS in Scotland to provide appropriate religious and spiritual care for minority ethnic groups are set out in the Scottish Executive Health Department Letter 2002/76(97Kb).
Addressing the needs of ethnic minorities is increasingly being set in the context of a broader equality and diversity agenda. This examines six "diversity strands": in addition to ethnicity these include age, gender, disability, religion and sexual orientation. These wider issues are summarised in a leaflet published in 2004 and entitled Fair for All, 2001(100Kb).
The Review of Equality Health Data Needs in Scotland arose from Equally Well recommendation 74 as mentioned above, and was published in 2012. A helpful overview of the role of data improvement through linkage techniques, in the context of the wider problem of improving the cultural sensitivity of health care systems in Scotland (Bhopal 2012b) is given in Key references. The Scottish Health and Ethnicity Research Strategy Steering group(SHERSS) was set up in December 2010 as recommended by the Health in Our Multi-ethnic Scotland report . SHERSS revised its strategy in 2014, and changed its name to the Scottish Migrant and Ethnic Health Research Strategy group (SMEHRS) to reflect a new strategic focus to include migrant health research.
The Scottish Government has developed harmonised survey questions which include the new ethnicity classification as used in Scotland's 2011 census and recommended for use in all relevant Scottish Official Statistics. The new ethnicity categories for use in Scottish Morbidity Record (SMR) returns which collect hospital discharge data can be found in ISD's data dictionary.
SHERSS made its first annual report in December 2011, and its second annual report for 2012 was published in in 2013. As the renamed 'SMEHRS', the group released its combined Report (2013) and Strategy 2014-19 in 2014. The 2015 report has now been published also, it and subsequent reports are available through the SMEHRS website. The 2015 report has also now been published, through the SMEHRS website.
In November 2009 NHS Health Scotland published Health in our Multi-ethnic Scotland. This report set out a proposed strategy for research on the health of ethnic minorities in Scotland.