LGBT people are being let down in health and social care, by
structures and services that are not inclusive or designed with
them in mind, and by a lack of leadership in Government, NHS and
social services. In a report published today, the Women and
Equalities Committee has found that too often LGBT people are
expected to fit into systems that assume they are straight and
cisgender. But the Committee has found that deep inequalities
exist in health outcomes for these communities and that treating
them “the same” as non-LGBT people will not address these poor
outcomes .
MP, Chair of the Committee,
said: “We found a lot of good will in health and social
care services to make them LGBT inclusive, and examples of good
practice that must be shared and embedded in our services. But
unfortunately, the best will in the world won’t change the
systemic failings in areas such as data-collection and training
that are leading to poorer experience when accessing services,
and to poorer health outcomes for LGBT people.
“This can never be acceptable. LGBT-specific services play an
essential role in the health and social care services for the
moment and must be maintained as long as that’s necessary, but
mainstream services must move now ensure that they are inclusive
and are effectively identifying and taking into account the needs
of the LGBT communities. We must eliminate the unacceptable
inequalities in health outcomes that glare out wherever you
look.”
While LGBT people do generally have the same health and social
care needs as the rest of the population for the majority of the
time, the evidence shows that they do not always receive
the same level of service as non-LGBT people and that they have
poorer health outcomes across many areas, for example, in levels
of smoking and smoking cessation, alcohol abuse, and even cancer
outcomes.
While some of the disparities have been uncovered, many of the
inequalities remain hidden, as data collection is poor and patchy
across health and social care services. This is not acceptable:
the NHS cannot formulate strategies to tackle inequalities
if it does not know where to find them. The Committee therefore
recommends that sexual orientation and gender identity monitoring
should be made mandatory by the NHS and social care sector within
the next 12 months.
The Committee also found that the NHS Long Term Plan is too
generic to work effectively for LGBT people, who should be
considered explicitly as part of health commissioning. The
Government admits this as part of the LGBT Action Plan published
in 2018, but the two plans are not working together and there is
no read-across. The Committee says the Equalities Office
and DHSC should formulate and publish a list of the key
inequalities in LGBT health that the NHS needs to be accountable
for. This should then be included in the LGBT Action Plan, and
both authorities should report back to the Committee annually on
progress they are making in eliminating the identified
inequalities.
The Committee found that, while there is a lot of good will in
health and social care services to make them LGBT-inclusive, the
work is driven by committed individuals in a piecemeal fashion
rather than by senior leaders in the NHS, councils or the
Government. There is little joined-up thinking and LGBT health is
tacked on to existing policies, rather than be integrated into
health and social care systems.
Witnesses to the Committee commented repeatedly on the importance
of training of frontline staff. Staff training varies
hugely between disciplines and the Committee is concerned that
staff may not receive any training on LGBT issues during any of
their professional training. Such training should be made
mandatory and an integral part of all core medical professional
training
