Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. The Equality Act 2010 is a new piece of legislation that recently replaced the 100+ laws, regulations and statutory instruments that made up previous anti-discrimination legislation. The Equality Act, and the previous legislation it replaced, were written to protect individuals and groups of individuals from discrimination. Harassment is another form of prohibited conduct in the Equality Act, and it is closely linked to discrimination. That’s the legal background, but what does discrimination or inequality actually look like?
Person-centredness or client-centeredness are key values in health care, social work and social care. People often ask – well, what happens when we don’t have good data or research about particular issues. It has largely harmonised, and in some cases extended, protection from discrimination and harassment.
After all, there are other reasons why people might experience discrimination, or why they experience inequality. Being equality and diversity aware is an essential part of delivering a client-centred service.
Tackling inequality, improving access, experience and outcomes for all Scotland’s people is a task which requires all of us. We’ll do this by talking about a few scenarios, which illustrate the types of issues that come up in health and social care. In the UK, anti-discrimination law dates from the 1970s, starting with the Sex Discrimination Act and the Race Relations Act.
In addition, there is another specific type of harassment: Sexual harassment -- Refers to situations where the behaviour is of a sexual nature. So it’s not enough to know the basic concepts – we need to think about how to apply them in our work. You will be caring for a person, not an appendix, a set of teeth, a broken hip or a substance abuse problem.
In that report, the police were criticised for being ‘race-blind’- that is, for not thinking about the relevance that race or ethnicity may have for their ‘clients’ and for the way they deliver services. Engaging with service users is a great way to deal with that, and it’s something that you’re likely to do in design of services. We’ll also consider your role in delivering a service which promotes equality and is sensitive to diversity. The Equal Pay Act was also passed back in the 1970s, and if you’ve seen the film ‘Made in Dagenham’ you will have seen some of the conditions which led to the passage of that Act. Direct discrimination can be described as less favourable treatment on the grounds of a protected characteristic.
Or When someone is treated less favourably because they submit to or reject harassment related to sex or to gender reassignment. It takes will and focus, and at times you will have to challenge the behaviour, attitudes and assumptions of others. This is a key element of delivering a quality service, and is a fundamental aspect of client-centredness.
In the years since, protection from discrimination was extended to disabled people and then to people on grounds of sexual orientation, religion or belief, and, to a certain extent, age.
That’s why the NHS’s strategy on health inequalities, Equally Well, focuses so much on socioeconomic inequality.

Direct discrimination may also involve situations where reliance on a formally neutral criterion affects one group only, even if that was not the intention. Think about the relation between barriers to accessing services and experience of services are linked to outcomes. You may often find that people think that they are ‘equality neutral’ when they are actually being equality blind. Sometimes people assume that equality and diversity are only about legal issues and tribunals, or that it’s just a form of political correctness.
Discrimination legislation has focussed on both employment and on the delivery of services and access to premises. You might also want to look at the ‘Marmot review’, which is a major study of health inequalities and offers a vision for improving them. Indirect discrimination when a provision, criterion or practice is applied to an individual or group that would put persons of a particular characteristic at a particular disadvantage compared with other persons.
Hopefully by the end of today you’ll start to see that equality and diversity is so much more than that – and that it’s much more interesting and important. The Equality Act 2010 incorporates protection from discrimination, harassment and victimisation on the grounds of a series of protected characteristics, which are listed here. Have the services taken account of issues like gender, caring responsibilities, socioeconomic inequality, ethnicity and culture? After all, this is ultimately about people, and people are at the heart of the work that we do. This protect is pretty broad, because you are protected if you have a characteristic, are assumed to have it, are associated with someone who has it or is assumed to have it. Also, geographic location affects access to services, and sometimes the quality of service. When a disabled person is treated unfavourably because of something connected with their disability and this unfavourable treatment cannot be justified, this is unlawful and is described as ‘discrimination arising from disability’. The ‘equalities lens’ is a way of seeing the world which prompts us to ask ourselves – are we taking account of the inequalities people might face when we deliver the service. And I suspect that this is important to all of you – if not, you’d be preparing for another line of work. Plus, the geographic and social environment affects a range of things about your life experiences, social inclusion and your health.
Are we actually delivering or developing a service in a way which might perpetuate those inequalities, or even make them worse? So people might experience inequality because they live in a deprived area, or because they live in a remote area. She cannot afford child care for Amanda while taking Jack to the dentist, so she brings her along in the buggy.
If anyone tells you ‘this service is for everyone, or this policy applies to everyone, therefore it does not discriminate’, that’s often a sign that we are being equality and diversity blind. Hopefully we will equip you with some fundamental information, which will then help you start to ask the right kinds of questions.
You’ve probably noticed that there is a fourth type of discrimination listed – ‘institutional discrimination’. No one learns everything they need to know in a single lecture or even a single course, so I’ll point you in the direction of some useful sources of further information. So this means that, although equality law is important, there may be drivers of inequality that are not protected in law in the same way.
This is a very important concept which underpins the ‘promotion of equality aspect of the Equality Act.

She arrives 15 minutes late, and the receptionist curtly informs her that she has missed the appointment and will have to reschedule. Think back to the questions we asked ourselves earlier – that’s a good starting point for asking equality questions. In 1999, a landmark investigation into the Metropolitan police’s investigation of the murder of a young black man, Stephen Lawrence, argued that the police department was ‘institutionally racist’ because the organisation as a whole failed to take account of the impact of race, resulting in shortcomings in the organisation. Louise explains the circumstances but is told that the policy states that if a patient arrives late they must reschedule. It’s worth looking at a couple of quotes from that report: “ Unwitting racism can arise because of lack of understanding, ignorance or mistaken beliefs. Louise feels upset and humiliated because the receptionist chastised her in front of others in the waiting room.
It can arise from unfamiliarity with the behaviour or cultural traditions of people or families from minority ethnic communities.
It can arise from racist stereotyping of black people as potential criminals or troublemakers.
Imran aged 20, experiences major depression and has been re-referred to mental health outpatient services.
He can on occasions be medication non-compliant and is resistant to any suggestions from Consultants or CPN’s on what he could do to improve his mental health. Furthermore such attitudes can thrive in a tightly knit community, so that there can be a collective failure to detect and to outlaw this breed of racism. He only attends outpatient appointments on an ad-hoc basis (over the past 6 months he has missed 3 of his 5 out patient appointments) and can on occasions prove to be difficult to communicate with.
The failure of the first investigating team to recognise and accept racism and race relations as a central feature of their investigation of the murder of Stephen Lawrence played a part in the deficiencies in policing which we identify in this Report. At his latest appointment, Imran stated that he felt the service wasn’t really relevant and that he did not understand the purpose of the appointments.
Fiona (41) has been referred to the day hospital with severe depression following the sudden death of her daughter. This is Fiona’s first referral to this service The doctor has explained to Fiona what to expect and asked if she had any questions. Immediately after the murder Mr Brooks was side-lined, and his vital information was inadequately considered.
Fiona has been left feeling reassured that she is involved in her care and that staff have taken time to explain things to her.
They have asked if her partner Ruth is her next of kin and that if this can be recorded in her case notes.
What may be termed collective organisational failure of this kind has come to be labelled by academics and others as institutional racism.” This report, known as the ‘Macpherson report’, changed the approach to tackling discrimination in Britain. During a therapy session, another patient became verbally abusive by making loud derogatory remarks about Fiona’s partner being a woman. Now, public bodies, or organisations delivering public services, cannot merely ‘not discriminate’ against individuals. Rather, they need to proactively consider how to tackle discrimination more generally, and to promote equality of opportunity between different groups of people and good relations between communities.
This is known as the ‘equality duty’ and it is placed on NHS Boards, local authorities, Scottish Government, educational institutions, etc.

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