1. The Equality Act 2010 – What about the community? Harjinder Bahra

2. The Equality Act – will anything change for the community?
Historically implementing equality & diversity has focused inwards (employment practice) rather than outwards (services access/delivery)
My central argument is that the Equality Act 2010 must make the human rights principles of fairness, respect, equality, dignity and autonomy (the so-called FREDA principles) integral to service access/delivery
Secondly, that in a plural and multi-identity society, we must take a human rights based approach (HRBA) to equality and diversity
Taking a HRBA allows us to peel away or de-compartmentalise the protected characteristics (age, disability, gender reassignment, marriage and civil partnership, race, religion or belief, sex and sexual orientation) and treat the needs of the “human” first. 2

3. Equality – what’s in it for me, my family and friends?
Equality is not about being “politically correct” e.g. blackboard = chalkboard, black coffee = coffee w/o milk, Baa Baa Black Sheep = Baa Baa Green Sheep and no Xmas tree
Equality is about achieving social justice at home, work and for the communities we live in or belong to
For example: old age, frailty and living alone, patriarchal “imprisonment”, fear or stigma of coming “out”, race issues in mental health and being lost in disability.
Just as we must promote and protect equality and human right of our patients, someone else is making a decision on behalf of you, your children, parents, grandparents, friends and the people you love...are you prepared to put their equality and human rights at risk? 3

4. What are Human Rights?
They are Rights and Freedoms that belong to all of us all of the time (from cradle to grave)
Human rights cannot be “taken away” from us, but sometimes we need to “claim” them or ask for them to be “fulfilled”
In certain circumstances, however, they can be “limited” (e.g. depravation of liberty for committing a crime/mental illness)
Essential to understand that in a liberal society, the punishment for not obeying its rules is depravation of liberty, but not at the cost of personal security or other basic civil liberties 4

5. What are Human Rights?
They regulate the relationship between public authorities (the State, NHS, social services, police, courts, local authorities etc.) and ordinary citizens
First legally defined in the Universal Declaration of Human Rights 1948 in response to the Holocaust, and adapted in Europe as the European Convention on Human Rights
European Convention is enshrined in the UK by the Human Rights Act (HRA) came into force in 2000
Human rights set basic standards below which public authorities must not go.
Human rights protect us by placing public authorities under a duty of care to treat us with fairness, respect, equality, dignity and autonomy (the FREDA principles) 5

6. Who decides when we are no longer human?
Stephen Hawking. Has motor neurone disease. Gradually lost the use of his arms, legs, and voice - now almost completely paralyzed 6

7. Case study - disabled man denied support to attend gay pub
A physical disabilities team at a local authority had a policy of providing support to service users who wanted to participate in social activities.
Steve, who is gay, asked if a support worker could accompany him to a gay pub.
His request was denied even though other heterosexual service users were regularly supported to attend pubs and clubs of their choice. 7

8. Case study - disabled man denied support to attend gay pub
The issue here is whether the support workers have the right to deny Steve his human rights to participate in public life as a gay man
Human rights are about Fairness, Respect, Equality, Dignity and Autonomy (FREDA). Here Steve has been failed on all counts.
Right to respect for private life (Article 8) his right not to be discriminated against on grounds of sexual orientation (Article 14) and his right to participate in public life (Article 8) 8

9. Learning from Delivering Race Equality Programme
The 5-year Delivering Race Equality in Mental Health Care (DRE) programme has ended and the final review makes an interesting reading.
The review concludes that:
Black and minority ethnic (BME) communities are not homogeneous, but highly disparate with diverse needs and “varied perceptions about mental health services and want to access and use them in different ways’
Addressing factors such as poverty and social deprivation are the key to tackling overall health inequalities, and that use of ethnic data and statistics alone cannot be the basis for measuring change or the quality of services. 9

10. The Equality Act 2010
Important to remember that the Equality & Human Rights Commission has a duty under the Equality Act to monitor progress towards the development of a society in which:
people’s ability to achieve their potential is not limited by prejudice or discrimination;
there is respect for and protection of each individual’s human rights;
there is respect for the dignity and worth of each individual;
each individual has an equal opportunity to participate in society, and
there is mutual respect between groups based on understanding and valuing of diversity and on shared respect for equality and human rights. 10

11. The NHS Constitution
The NHS Constitution (came into force on 19 January 2010), puts equality and human rights outcomes at the heart of NHS access/delivery by placing a legal duty on NHS organisations to take account of the rights and pledges outlined in it, particularly the right to be treated with dignity and respect.
The first principle of the Constitution states:
‘The NHS provides a comprehensive service, available to all irrespective of gender, race, disability, age, sexual orientation, religion or belief. It has a duty to each and every individual that it serves and must respect their human rights. At the same time, it has a wider social duty to promote equality through the services it provides and to pay particular attention to groups or sections of society where improvements in health and life expectancy are not keeping pace with the rest of the population’. 11

12. What needs to be done
The Care Quality Commission (CQC) has made equality, diversity and human rights a mandatory and demonstrable outcome in service access/delivery from 1 April 2010
It is crucial that equality leads, commissioners and providers do not simply view people, groups/communities as homogenous, particularly as we head towards a single duty.
Taking a human rights based approach will enable practitioners to step back and develop more holistic and personalised approaches to care pathways.
The FREDA principles provide an excellent basis for ensuring high quality care services and outcomes that respect service users’ human rights
As equality leads we must develop a better understanding of multicultural policies that are shaping a highly complex and problematic multi-identity society 12