Description
The British Government has made the health of Black and
minority ethnic (BME) people a central part of its programme
to reduce current inequalities. There are no data on serious
neurological disorders among this group and the establishment
of a language support outreach project, provided the opportunity
to study users and carers experience of services. Review
of a small number of White people enabled a comparison with
their experiences.
BMEs were recruited from all referrals to the outreach project.
Whites were selected from all those with the specified diseases
who were receiving formal services during the final year of
the programme. Interviews were conducted in the clients preferred
language. Quantitative and qualitative data were collected.
Twenty-seven users (16 BMEs and 11 Whites) and 16 carers
(10 BMEs and 6 Whites) were recruited. BME users and carers
experienced inequalities in their disease experience, knowledge
and information and access to services. BMEs were more likely
to express dissatisfaction with services: institutional care
being of particular concern where there was a perception of
discriminatory treatment. Language and communication issues
were principal barriers to service access. Furthermore, there
was evidence of an access/quality paradigm in which ethnically
insensitive services combined with discriminatory practices
acted as a deterrent to their uptake. The findings have important
implications for practice in the primary and secondary care
setting. Addressing inequalities at local level is one of
the top agenda items for all Directors of Public Health across
the country. Can they rise to the challenge and address the
needs of this section of the population?

