Background to the Research

• The Equality Unit of the Office of the First Minister and Deputy First Minister wanted to hear people's views and experiences regarding barriers to accessing essential services. In particular, views were sought from: people who are socially disadvantaged, people who are socially excluded, and members of groups under Section 75 of the NI Act (1998). The research allowed organisations and individuals to define essential services and to identify contexts in which problems about access occur.
  

Research Approach

• The research methods were desk research, focus groups and key informant interviews.
  

Main Findings

• A core set of essential services focusing on healthcare and the emergency services emerged and a general definition of essential services was proposed as: Essential services are basic services provided for the general public at large by key government departments and non-departmental public bodies.
• There was a prevalent view that accessing many essential services could be affected by financial circumstances, which was seen as creating different levels of access and as placing the less well off at a potential disadvantage from the outset.
• Three levels of difficulties in accessing information were suggested: finding where information about a particular service was available, and in what form; little useful or up-to-date information was available in some cases; and when documents, forms or posters were available, they were sometimes difficult to read, badly presented, and unclear.
• Information leaflets from government departments and agencies were often difficult to understand, with the perception that forms and processes were made difficult to put people off and that little thought went into the content, presentation or appropriateness of information, or where it was displayed.
• The times when many services were available were seen as limited or inappropriate, with healthcare reported most frequently as causing difficulties.
• Systems often appeared unnecessarily complex and inaccessible, particularly application procedures and payment systems.
• People often felt 'shunted around' where a service involved contacts with several departments. Delays and being 'put in a queue' were especially difficult for people using public pay phones.
• First contact was often at a counter or desk, with many finding this experience both important and deeply unsatisfying. Staff were often not fully aware of procedures; did not always have full accurate information; and, sometimes, did not deal with people appropriately.
• Some people experienced fear and anxiety about approaching 'people in authority', often from a perceived stigma.
• There was a concern that a lack of provision of alternative non-visual formats and/or large print formats was a barrier.
• The key barrier for people with hearing difficulties was the limited number of trained interpreters available. The increasing use of the telephone as a route to accessing services created particular problems.
• Transport and access problems were a central concern to people with physical disabilities. Improvements in public buildings were thought to be concentrated in Belfast, with small towns and rural areas still having problems related to access to essential services. Transport posed many difficulties, including problems with parking.
• Some felt there was still a stigma attached to 'mental health problems', meaning people could not always access the service they needed. Registering for healthcare/social security support could be problematic for homeless people and those in hostels/temporary accommodation.
• People with learning difficulties believed that their access to services was closely linked to the levels of support they received from statutory and voluntary agencies. Managing the practical aspects of everyday living, especially dealing with service providers, was difficult without a continuity of interaction with a known and trusted social worker.
• Older people were often discouraged by attitudes that suggested that their needs had a lower priority than those of younger people. Doctors were suggested to be less interested in the problems of older people and could be abrupt and dismissive. Electronic access to some services was also a worry to older people.
• The travel necessary to access services was a significant barrier to some, particularly those with disabilities and those living in rural areas. Poor public transport, poor maintenance and limited gritting of roads were all reported as increasing access difficulties in rural areas.
• Victims of domestic violence who move away from the home area to ensure their safety are often directed to their home area to access some services, thus limiting or preventing their access.
• For traveller's groups, sites posed dangers due to a lack of adequate drainage, water and lighting and limited access to telephones. The unwillingness of doctors to visit travellers was a concern.
• Homeless people may have problems registering with local doctors or dentists. Young homeless people have difficulties when referred back to their home area, but have no resources to meet the costs involved.
• Lengthy journeys and limited public transport may make travel costs in rural areas high. Those on low incomes who live in 'wealthy' areas face the problem that services may be geared to the affluent majority.
• For those with limited finances, access to the telephone or internet remains a problem and the increasing use of such technology may discriminate against such groups.
• Some felt that their background was a barrier, for example in a reluctance to claim benefits from the British government, or in their community (Unionist) not having a tradition of community involvement.
• The Chinese community were particularly concerned about language as a barrier. Getting language support, particularly out of hours, was difficult. The complex education system in NI was a further problem.
• Barriers for Lesbian, Gay, Bisexual and Transgendered people included areas such as housing and healthcare.
• Religion was a barrier in different case: working class Catholics felt stigmatised and labelled when they revealed where they came from; small Protestant minorities in rural areas in the West felt badly served when controlled schools were closed; and members of other faiths felt that little attention was paid to their religious needs.
• A number of agencies, such as Post Offices and local Libraries, and practices, were often praised for their support in accessing services.

Conclusions

• Certain services, such as the fire and ambulance services, require very little 'fine tuning' in relation to availability. Some thought may need to be given in relation to people with individual difficulties accessing these.
• Some health services are more available to those who can afford to pay for them, giving them an access advantage.
• There are barriers to some services that arise because of some characteristic of the person in need, for example English not being their first language; age; or belonging to a minority ethnic group. These barriers may be more difficult to counter, and regular, well-planned and structured systems of consultation will be necessary to overcome these difficulties.