Gypsy, Traveller and Roma Communities

Baroness Bakewell of Hardington Mandeville Excerpts

Thursday 8th March 2018 Grand Committee

[Baroness Bakewell of Hardington Mandeville (LD)]

My Lords, I thank the noble Baroness for securing this important debate and setting out the issues so clearly. We all take healthcare for ourselves, our families and our children extremely seriously and want it to be available when we need it. This right has to be extended to the Gypsy, Roma and Traveller communities.

When elected to Somerset County Council, I was persuaded in 1995 by a colleague to chair a small working group looking into the needs of Gypsies, Roma and Travellers in the county. There was widespread support for the deliberations of this working group, including from the Traveller Education Service, social services and the various district and parish councils. We talked to many Gypsies and Travellers and found that it was all but impossible for them to access healthcare, due mainly to the need for a permanent address in order to register with a GP, as the noble Baroness said. There was also some suspiciousness on their part about having contact with officialdom and filling in forms. The county council at that time had a strong Gypsy and Traveller department, which looked after the six sites for Gypsies in the county’s ownership. Gypsies and Travellers arriving in the county from outside and camping in unregulated sites were provided with water bowsers and visited to ensure that their needs were met, especially if there were children present. We take the provision of water as a given, but many have recently realised just how difficult it is to live if their water supply is cut off.

Although the report of the working group was welcomed by some, this was not the case for everyone. I had the extremely unpleasant experience of attending a public meeting in part of the county where one vociferous gentleman stood up and said that the only thing to do with Gypsies was to stand them up against a wall and shoot them. Mercifully, his extreme and irrational hatred was not replicated by others in the room.

I wind the clock forward 13 years to 2008-09 when, as a member of the local district council, I took part in a piece of work run by the Centre for Public Scrutiny. A group of councils looked at health services available to communities on the margins. Two councils, of which mine was one, looked at the provision for Gypsies and Travellers, while two others looked at provision for sex workers and two others looked at provision for ethnic communities.

During our work in south Somerset, we visited two Gypsy sites. We talked to the teenagers, young women and mothers on the site. We found they had good access to maternity services, and midwives visited the site to do antenatal checks. They were all pleased with the level of support they got. As they lived on a permanent site, the young mothers and more mature women were registered with local GP practices and got good support, not only for themselves but for their children, although this did not seem to extend to dental care.

There was, however, little health support for Travellers who were often camping in woodland sites and on the corner of farmland, usually with the support of the local landowner or farmer. These were not permanent arrangements and, therefore, access to health care was very limited. Their children were unlikely to receive the usual inoculations that we take for granted for our children. Although Gypsies and Travellers need to access healthcare, they rarely, if ever, wish to access social services. It is part of their culture that they look after their own elderly relatives, while we in the settled community tend to call up services to help us with our infirm and elderly relatives.

The Equality and Human Rights Commission, in its report in March 2016, found that Gypsies and Travellers, compared with the general population, were more likely to suffer bad health, as has already been referred to. This includes lower life expectancy, high infant and maternal mortality rates, low child immunisation levels, chronic cough or bronchitis—even after smoking is taken into account—asthma, chest pains and diabetes. They also have higher rates of smoking. This is exacerbated by the fact that many Gypsies and Travellers remain, as I have indicated, unregistered with GPs.

Although variability in general health among different ethnic groups can sometimes be explained by an older age profile, this is not the case for Gypsies and Irish Travellers, of whom only 6% were aged 65 or above in 2011, and who had a low median age of 26. Improved life expectancy for Gypsy and Traveller communities appears to be associated with the availability of established site provision and access to medical care. Having a pitch on a permanent site is vital to accessing healthcare, to which every speaker has referred.

A recent report from the Department of Health noted that accommodation insecurity, the conditions of Gypsies’ and Travellers’ living environment, low community participation and discrimination all play key roles in exacerbating these poor health outcomes. It is suggested that these factors also hold the key to effectively addressing and improving health and well-being. The report calls for long-term, joined-up working at both local and national levels to address the wider social issues of Gypsies’ and Travellers’ ill health. Similarly, emerging evidence shows that the health inequalities of Roma people are close to those among Gypsies and Travellers. These include a high prevalence of diabetes, cardiovascular disease, premature heart attacks, obesity, asthma and mental health issues.

Poor familiarity with healthcare provisions and language barriers may make it difficult for this group of marginalised people to access services. Their culture may prevent some Roma people using support services for mental health issues, sexual health and drug and alcohol misuse. However, it is known that Gypsies and Irish Travellers have low rates of GP registration. While somewhat out of date, in 2004 16% were not registered, compared with 1% of comparators.

I have been looking at and involved in this subject for more than 20 years. We do not as a society appear to have moved forward in ensuring that this marginalised part of our nation has equal access to health care. What will the Minister do to allow these people to have access to the healthcare services the rest of us take for granted?