Question to the Department of Health and Social Care:

To ask His Majesty's Government what progress they have made since the 2021 Friends, Families and Travellers mystery shopping exercise in ensuring that nomadic Gypsy and Traveller patients are not wrongfully refused access to GP services.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

We are very clear that a general practice (GP) cannot refuse registering a patient based on the race or ethnicity, gender, social class, age, religion, sexual orientation, appearance, disability, or medical conditions of the patient. This encompasses patients from gypsy, Roma, and traveller communities.

GPs have a responsibility to register people who are homeless, have no fixed abode, or are legitimately unable to provide documentation as proof of living within the catchment area. An individual should not be refused registration or appointments because they do not have a proof of address or personal identification. It is not considered a reasonable ground to refuse registration.

The General Medical Services Regulations were updated to require practices to use a standardised registration system that doesn't require identification or an address. Additionally, the regulations now require GPs to provide an online consultation tool, allowing patients to manage appointments, and view and request repeat prescriptions digitally. This service also simplifies electronic registration with GP surgeries. Digital registration is designed to accommodate diverse patient needs, enhancing accessibility, and making it easier for patients to register without visiting the practice in person.

However, to ensure that patients aren’t digitally excluded, the GP contract is clear that patients should always have the option of visiting their practice in person, and all online tools must always be provided in addition to, rather than as a replacement for, other channels for accessing a GP. Practice receptions should be open so that patients without access to telephone or online services are in no way disadvantaged.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what plans they have to improve access to digital primary healthcare services among Gypsy, Roma and Traveller people.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

We know that patients are struggling to access general practice (GP), and that these struggles can be particularly acute in inclusion health groups such as gypsy, Roma, and traveller communities.

We want to ensure that digital healthcare services are available to those who need them. The GP contract requires GPs to provide an online consultation tool, allowing patients to manage appointments, and view and request repeat prescriptions digitally. This service also simplifies electronic registration with GP surgeries. Digital registration is designed to accommodate diverse patient needs, enhancing accessibility, and making it easier for patients to register without visiting the practice in person.

However, to ensure that patients aren’t digitally excluded, the GP contract is clear that patients should always have the option of visiting their practice in person, and all online tools must always be provided in addition to, rather than as a replacement for, other channels for accessing GPs. Practice receptions should be open so that patients without access to a telephone or online services are in no way disadvantaged.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 25 October (HL1693), what assessment they have made of the June report, Enablers of digital inclusion in primary care for Gypsy, Roma and Traveller Communities, published by the Roma Support Group, and Friends, Families and Travellers, on access for Roma and Traveller people to digital services in primary care contexts such as GPs, opticians, pharmacies, and dentists.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

Enablers of digital inclusion in primary care for Gypsy, Roma and Traveller Communities recommends that primary care services offer flexibility and choice, including non-digital access routes, and that accessibility should be prioritised when designing digital services.

We will ensure patients have multiple routes of access to primary care by guaranteeing a face-to-face general practice appointment to anyone who wants one, and by implementing a modern booking system to end the 8:00am rush. Digital tools used in primary care settings must meet required minimum standards of functionality set by NHS England, ensuring a consistent quality of service for patients, and all organisations providing National Health Services, including primary care providers, must follow the Accessible Information Standard.

Question to the Ministry of Housing, Communities and Local Government:

To ask His Majesty's Government what steps they are taking to address the inequalities faced by Romani, Roma, and Irish Traveller communities; and which team within the Ministry of Housing, Communities and Local Government is responsible for leading that work.

Answered by Baroness Taylor of Stevenage - Baroness in Waiting (HM Household) (Whip)

The Government takes all forms of discrimination and inequality seriously. Efforts to reduce the challenges faced by any group or community – including those from Romani, Roma, and Irish Traveller communities - is at the heart of our mission to rebuild this country. Delivering opportunities for all is work that spans the roles and responsibilities of all parts of this government. We will continue to strive every day, across a range of policy areas and teams, to bring opportunity to people across our country.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the finding set out in the joint report by the Roma Support Group and Friends, Families and Travellers Enablers of digital inclusion in primary care for Gypsy, Roma and Traveller Communities, published in June, that 46 per cent of Gypsy, Roma and Traveller people surveyed reported they had no access to digital primary care services due to a lack of confidence in using technology, language barriers and a preference for in-person services, what steps they plan to take to improve those communities’ access to digital primary healthcare services.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

We know that some patients will struggle to access digital services. We will ensure patients have multiple routes of access to primary care by guaranteeing a face-to-face general practice appointment to anyone who wants one, and by implementing a modern booking system to end the 8:00am rush. Digital tools used in primary care settings must meet required minimum standards of functionality set by NHS England, ensuring a consistent quality of service for patients, and all organisations providing National Health Services, including primary care providers, must follow the Accessible Information Standard.

We are clear that all online tools must be provided as an additional option, not as a replacement for more accessible channels like telephone or reception services. This ensures that individuals without access to digital technology, including those from disadvantaged groups, are not excluded and can choose the method of communication that works best for them. All patients should be treated equitably no matter what route they access general practice with.

Question to the Cabinet Office:

To ask His Majesty's Government, further to the Written Answer by Lord Collins of Highbury on 4 November (HL1791), what plans they have to separate the categories of "Gypsy" and "Irish Traveller" in statistics in Government departments; and whether they plan to modify the Census to reflect this.

Answered by Baroness Twycross - Baroness in Waiting (HM Household) (Whip)

The information requested falls under the remit of the UK Statistics Authority.

Please see the letter attached from the National Statistician and Chief Executive of the UK Statistics Authority.

The Baroness Whitaker

House of Lords

London

SW1A 0PW

27 November 2024

Dear Baroness Whitaker,

As National Statistician and Chief Executive of the UK Statistics Authority, I am responding to your Parliamentary Question asking, further to the Written Answer by Lord Collins of Highbury on 4 November (HL1791), what plans we have to separate the categories of "Gypsy" and "Irish Traveller" in statistics in Government departments; and whether we plan to modify the Census to reflect this (HL2732).

1. What plans we have to separate the categories of “Gypsy” and “Irish Traveller” in statistics in Government departments:

A category for ‘Gypsy or Irish Traveller’ was added to the Census ethnic group question for the first time in 2011. Space constraints on the census questionnaire meant that separate categories for each group could not be included in the 2011 Census. Consultations with users of Census data revealed that although some users would prefer separate tick boxes, the majority of users of Census information considered the combined tick-box to be satisfactory. Other categories in the question also cover several ethnic groups, for example ‘African’ and ‘Indian’. Given the space constraints of the census questionnaire, the ethnic group question has always required a selection of categories that are few enough to be practical yet detailed enough to be useful for measuring real world racial inequalities.

The Census 2011 ethnicity questions were adjusted so they could be used in the 2021 censuses for England and Wales, and Northern Ireland; and the 2022 Census for Scotland. As part of this adjustment a Roma category was added in 2021. There was strong evidence of a different user need for population data on the Roma population when compared with data on the Gypsy or Irish Traveller population.

The ethnicity harmonised standard[1] we currently recommend to producers of official statistics is based on the 2011 Census questions across the UK. Development of this ethnicity standard is one of the priority topic areas for the Government Statistical Service (GSS) Harmonisation team. The broad aim of our ethnicity harmonisation workplan[2] is to improve the inclusivity of the question for minority ethnic groups. This will involve testing possible improvements and changes to the question design and response categories. To date we have undertaken a range of research including desk research, engagement with people who use or collect ethnicity survey and administrative data, and engagement with the public. We have published two reports exploring user needs for a new standard, in March 2023[3] and July 2023[4]. We are also gathering information to understand how ethnicity response options are used by participants, including reviewing data from the ‘write in’ responses collected across a range of data sources, and requests received for new proposed ethnic group response categories for Census 2021[5].

Qualitative research into the lived experiences of Gypsies and Travellers in England and Wales, published in 2022[6], highlighted the circumstances and needs of Gypsies and Travellers relating to a range of different areas including health, education, employment and accommodation. The findings provided insights into the culture and identity of Gypsies and Travellers, and how these are changing over time, including decision-making processes for individuals disclosing their ethnicity, for example to employers or service providers, and anticipated and experienced discrimination linked to this.

Our work to update the ethnicity harmonised standard will bring together information from all these sources to evaluate possible improvements and changes to the question design. This work will include further engagement with the public, community groups, people involved in collecting and publishing administrative data, civil society organisations and other interested parties both within and outside government.

2. Whether we plan to modify the Census to reflect this:

Decisions regarding the future of population and migration statistics, including the census, will be taken by the Government over the next two years with advice from the UK Statistics Authority. As such, it is too early to comment on specific approaches as part of a potential future census. The Future Population and Migration Statistics programme has an ongoing programme of user needs engagement and carried out a consultation in 2023, which acknowledged the importance of collecting data on a variety of topics, including ethnicity.

Yours sincerely,

Professor Sir Ian Diamond

[1]Ethnicity harmonised standard – Government Analysis Function

[2]Government Statistical Service (GSS) Harmonisation Team workplan 2024 – Government Analysis Function

[3]Review of ethnicity harmonised standard: findings from phase 1 of our research – Government Analysis Function

[4]Review of ethnicity harmonised standard: findings from phase 2 of our research – Government Analysis Function

[5]Ethnic group tick-box prioritisation report for Census 2021 in England and Wales - Office for National Statistics

[6]Gypsies’ and Travellers’ lived experiences, overview, England and Wales - Office for National Statistics

Found: Q10 Baroness Whitaker: Thank you. Good morning. I declare that I live in a national park.

Found: to 23 Title Schedule 2 [Amendments marked ★ are new or have been altered ] Clause 1 BARONESS WHITAKER

Found: to 23 Title Schedule 2 [Amendments marked ★ are new or have been altered ] Clause 1 BARONESS WHITAKER

Found: Letter dated 26/11/2024 from Baroness Smith of Malvern to Baroness Whitaker regarding questions raised