Baroness Whitaker
Main Page: Baroness Whitaker (Labour - Life peer)
Baroness Whitaker
To ask Her Majesty’s Government what steps they are taking to address health issues in the Gypsy, Traveller and Roma communities.
Baroness Whitaker (Lab)
My Lords, I first want to give Her Majesty’s Government credit for commissioning the Traveller Movement to produce the report, Impact of Insecure Accommodation and the Living Environment on Gypsies’ and Travellers’ Health by Professor Margaret Greenfields and Mr Matthew Brindley. On International Women’s Day, it would be right to say that the report makes clear that it is the women who are most likely to report poor health, including mental health. My questions for the Minister are, now that it has been published for more than a year, what has been done to implement the recommendations, and how is progress being monitored?
The main findings were that the physical conditions of their environment were a key element of social determinants of health and thus had a measurable effect on the physical and mental health outcomes for Gypsies and Travellers. Sixty-six per cent of the sample reported bad, very bad or poor health, mental as well as physical, with those with the worst self-reported health living on unauthorised roadside sites, followed by those living on poor quality local authority sites. Thirty-nine per cent of the sample reported anxiety or depression, and the majority of those lived in conditions where they felt insecure because of planning status, threat of eviction or poor site conditions or had reluctantly accepted to live in bricks and mortar because there was no pitch available on a Traveller site. It is also notable that the majority of respondents rated their health as bad or very bad by their mid to late 30s and by their 40s a steep decline had begun.
Asthma and repeated chest infections, particularly among children, were noted in about half the interviews, but it was difficult for many at insecure sites to be registered with a GP. Chronic conditions, such as diabetes or kidney problems, were therefore inadequately treated and exacerbated. This was in contrast to those on secure sites, who were all able to access a local GP. Gypsies and Travellers who lived on private sites with planning permission felt that they had the best health. The experiences of racial harassment recounted to the interviewer are particularly heart-breaking, especially when the Gypsies and Travellers concerned had deep-rooted family connections to the area and had lived there for many generations.
The more secure a site, the fewer incidents there have been. It is not as if many Gypsies and Travellers did not engage in their local neighbourhoods when they did have stability through schools, councils and service providers. Respondents at two-thirds of the sites gave chapter and verse about this. Since they did much more caring for immediate household members or the wider family than the general population do, I think they did indeed have something valuable to contribute.
It is pretty well evidenced that improving the environmental health factors of existing sites and providing stability of tenure would improve health outcomes considerably. This would, of course, be cost effective in terms of reduced spend on ill-health and disability, as well as having a positive effect on children’s education, and it would deliver a measure of justice to those so heavily and unfairly penalised by the shortage of authorised sites.
Under the Health and Social Care Act 2012, commissioners of healthcare services have a duty to reduce health inequalities in access to services and outcomes. This, combined with the equality duty under the Equality Act 2010, should oblige local authorities responsible for accommodation to work with healthcare commissioners and health and well-being boards to sort out a fairer deal for Gypsies and Travellers. Will the Minister tell the committee how many local authorities have taken this role on board?
As local authorities have in the past been so slow to assume their responsibility for fair standards for their Gypsy and Traveller citizens, the report says, the duty once placed on local authorities to provide sites where a need has been identified should be reinstated. If the Welsh Government can do it—with a consequent drop in expensive disruption and protests—why cannot we?
At the very least, more robust data should be gathered by the MHCLG on the provision of new pitches on Gypsy and Traveller sites explicitly linked to health outcomes for people on insecure sites, monitored under Health and Social Care Act 2012 duties. Such monitoring should include the impact of the August 2015 Planning Policy for Traveller Sites’ change of definition, which can so damage the capacity of Gypsies and Travellers to obtain reasonable planning permission.
Non-governmental organisations, such as Friends, Families and Travellers, of which I have the honour to be president, also ask for the data to be disaggregated for Gypsies, Roma and Travellers. The amalgamation of data has skewed statistics for the different communities, who have different characteristics. There is no systematic monitoring because they are not yet included in the NHS data dictionary, so how can health outcomes be understood and resources properly targeted? Friends, Families and Travellers has asked Jeremy Hunt to include accommodation status in NHS data collection, so as to present a clearer picture of how homelessness impacts on health. Will the Minister tell me what is happening about this?
Time prevents me listing all the sensible recommendations of this report, but your Lordships’ Committee and the Gypsy and Traveller communities themselves are owed a progress report by the Government on what they are doing about them. I remind your Lordships that the inequalities of health among Gypsies and Travellers result in significantly decreased life expectancy—up to 12 years less for women and 10 years less for men—a miscarriage rate of 29% as opposed to 16% for the mainstream population, the highest maternal mortality rate of any single group and 17.6% of them having experienced the death of a child as opposed to 0.9% of their low-income peers, quite apart from increased chronic illness, a marked increase in incidence of mental ill-health and a lack of support in bereavement and suicide.
These are dark days for our cherished diversity. Gypsies and Travellers have never shared much in our much-vaunted tolerance, but now that the alarming increase in the racial harassment they experience is so clearly documented, what are Her Majesty’s Government doing to show that all our citizens are of equal worth?