Background to the Research

• Concerns over the provision for healthcare among the ethnic minority groups in NI has only recently been highlighted. Healthcare policy in the past has largely failed to tackle the difficulties faced by many ethnic groups, since central funding had been provided primarily for health research using Catholic and Protestant religions as a variable. Consequently, many have had to do without adequate healthcare.
• The provision for healthcare in NI is the responsibility of the NI Health Service. The service forms part of the United Kingdom NHS that consists of an internal market with purchasers and providers of healthcare. There are currently four geographically based health and social service boards in NI, each one designed to promote efficiency and quality. However, it is argued that competition between boards causes difficulties as each has different objectives and agendas. The commonality between them, however, is that their main focus is on tackling issues such as social class and poor health conditions. Consequently, this has diverted attention away from combating health issues associated with race and culture.
• Although estimates vary, it has been suggested that the size of the ethnic minority population in Northern Ireland is approximately 20,000. This accounts for about 1.5% of the total population.
• The main aim of this chapter is to focus on the health experiences of people from ethnic minorities. The issues that are addressed include difficulties in accessing healthcare, communication, and obtaining culturally appropriate services.
  

Research Approach

• Secondary data such as government reports, academic literature, and working group findings are used extensively. The evidence is utilised to create an overview of the problems facing ethnic minority groups, primarily in accessing public healthcare.
  

Main Findings

• There is a 'growing and impressive' range of policy initiatives in the Health Service designed to combat racism and promote equality in employment and service delivery, for example, the Patients Charter (1992), the NHS Ethnic Health Unit (1994), and PAFT (1994). However, the author strongly suggests that racism is still endemic in the Health Service and that rhetoric to combat discrimination has not been translated into action.
• One recent positive move by the EHSSB has been to form a creative link with representatives from the Chinese population in the Province. This move has created a set of quality standards for this particular group, for instance, accessing interpreter services and the provision of culturally sensitive care.
• In Northern Ireland, employment practices are closely monitored with respect to religion, but not race. Thus, it is impossible to assess the extent of job discrimination on racial grounds within the Province.
• Access to healthcare is problematic for many ethnic minority groups. For example Travellers, who reside in the markets area of Belfast, have difficulty in obtaining GP registration. Similarly, Indian, Pakistani, and Chinese people have problems with communication.
• Many studies have provided compelling evidence that shows the health status of black and minority groups in the United Kingdom is poorer than that of the majority.

Conclusion

• Ethnic minority healthcare should be incorporated into mainstream service provision, and the health service should provide the necessary flexibility to respond to the needs of people from a range of backgrounds. Given the fact that those most in need of healthcare are from the black and minority groups this seems an obvious request.