Baroness Wheeler
Main Page: Baroness Wheeler (Labour - Life peer)
Baroness Wheeler (Lab)
My Lords, I, too, congratulate my noble friend on securing this important debate. I pay tribute to her strong advocacy and campaigning work with the Gypsy, Traveller and Roma communities over the years, most recently as the president of the Friends, Families and Travellers organisation, which plays such a key role in the network of community organisations fighting hard against injustice, discrimination and poor health outcomes suffered by Gypsy and Traveller communities across the UK.
It is timely, one year on from its publication, to seek a clear and unequivocal response from the Government to the key recommendations and call for urgent long-term and joined-up working contained in the excellent work undertaken by Professor Greenfields and Matthew Brindley on the health impact of insecure accommodation and poor environmental conditions, so ably summarised by noble friend in her speech. As the foreword to that document states:
“This report makes it clear that the conditions in which members of this group are born, grow, live, work and age contribute significantly to their poor physical and mental health outcomes … Tackling these wider determinants is crucial to breaking this cycle of deprivation and health inequalities”.
Noble Lords have today painted a bleak picture of this cycle of deprivation and poor health. Gypsies and Travellers have poor access to healthcare generally, with difficulty in registering with GPs and poor access to services as a result, including health screening, home visits, dental services and access to secondary health care. We have heard about the life expectancy of over 10% less than the general population, with other health issues such as high infant mortality rates, high maternal mortality rates, low child immunisation take-up, mental health issues, substance misuse and diabetes, which are all prevalent in the Gypsy and Traveller communities.
The Care Quality Commission report in 2016 on end-of-life care came to the stark conclusion that, overall, health commissioners and services in most areas have done little to reach out to the Gypsy and Traveller community. Can the Minister tell the Committee what the Government are doing to address this? Should not each clinical commissioning group have a lead or champion, as we have heard, for all the four groups vulnerable to poor health that were identified by the National Inclusion Health Board, which includes this key group we are discussing today?
As the debate has clearly demonstrated, there is much for all of us to learn and understand about the history, values, traditions, culture and vibrancy of the Gypsy and Traveller community—for example, its strong family networks and relationships and their carer responsibilities and commitments. The Greenfields study showed that 42% of respondents were carers involved in helping to care for immediate household members or wider family onsite or in the immediate vicinity. That is significantly above the rate found in mainstream populations and, as the study underlines,
“reflects cultural values common to Gypsies and Travellers and significant cost-savings to local authority and health services who would otherwise need to engage with delivering care to vulnerable individuals”.
Like the wider communities, many of the adults and disabled being cared for within Gypsy communities will have comorbidities, particularly relating to high levels of respiratory disease and diabetes, as we have heard, resulting from poor care and accommodation, all of which make life more challenging and difficult for the carer and the cared-for. On International Women’s Day, as has been said, it is right that we underline the key role of carers, the majority of whom are women, as well as the importance of the role that women play in the communities that we are talking about.
Like other noble Lords, I am very grateful for the expert and comprehensive briefings that we have received from the Traveller movement and the FFT and for the thorough House of Lords Library research brief. They not only set out the problems and the challenges that individuals and communities face but address the myths and assumptions that lead to the health inequalities and widespread discrimination that we are discussing today. Most prominent among such misunderstandings is Gypsies’ and Travellers’ long-established roots in their local communities—yet they are so often wrongly labelled by the local community as newcomers.
I look forward to the Minister’s response on the issue of local authorities’ duty of care to Traveller communities and the Greenfields report’s call for the reinstatement of their responsibilities to provide Traveller sites where a need has been identified, an issue raised by my noble friend Lady Whitaker. Does the Minister agree that that would address one of the root causes of unauthorised sites and encampments, which not only have an adverse and negative impact on the health and well-being of Traveller communities but stoke up local community resentment and misunderstanding and deepen community risks? The Government are not usually very fond of giving praise to the Welsh Government on health and related issues, but the application of such a duty in Wales has had very positive effects, as speakers in the debate have pointed out. Indeed, the Welsh Government’s updated 2016 delivery plan for the Gypsy and Roma community, Travelling to a Better Future, is an excellent strategic and cross-service approach to raising awareness and providing the joined-up services across health and social care and accommodation that are being called for today.
I referred earlier to the CQC report on end-of-life care support, A Different Ending. I am currently undertaking a fellowship with the Industry and Parliament Trust on the hospice and end-of-life care movement, so I was particularly concerned at the CQC findings on the huge barriers to good end-of-life care faced by Gypsy and Traveller communities. The cultural misunderstandings that we have heard about throughout this debate are often at the heart of the poor care that they experience, such as the failure by hospital services and staff to recognise the importance of extended family being able to visit a dying person while they are still alive, and as a family or a group in large numbers, not just filing in one at a time in accordance with hospital single-visitor rules. There are also negative experiences around parking caravans in hospital car parks while visiting for long periods, often met with aggression and threats to call the police, and the failure to recognise the need for the quick release and burial of the body in Traveller culture.
Case studies under Professor Greenfields’ research work on the bereavement experience of the Gypsy and Traveller communities highlight the appalling lack of appropriate psychological follow-up care provided to families, particularly in relation to post-natal bereavement or stillbirth or following on from the suicides of close relatives. By contrast, good end-of-life care experiences cited by the CQC included both hospital and hospice support for the person being able to die at home in their trailer and the welcoming of the whole family into one room on hospital or hospice facility sites. The CQC cites a project in Suffolk where hospices and Gypsy and Traveller communities work together to raise awareness of Gypsy and Traveller culture. There is much to learn here. What plans do the Government have to help to raise awareness among health and community services of the end-of-life care needs of Gypsy and Traveller communities?
No debate on the health and well-being of the Gypsy, Roma and Traveller communities can pass without reference to Rodney Bickerstaffe, the former UNISON general secretary who sadly died last year. He was president of the Labour campaign for Travellers’ rights in the 1980s and 1990s, spearheading the adoption of some key policy initiatives that were subsequently taken forward by the Labour Government in office. The most important of these was supporting the drive for more Travellers’ sites through the inclusion of Gypsy and Traveller accommodation assessment needs in regional spatial strategies, sadly later abandoned by the coalition Government. As a former employee of UNISON, I can testify to Rodney’s heartfelt and indefatigable campaigning and commitment to working to improve the lives and health of the Gypsy, Traveller and Roma communities, which he carried on through into his presidency of the National Pensioners Convention after his retirement from UNISON.
This has been an excellent debate on a crucial issue that needs urgent attention, and I look forward to the Minister’s response.