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Archive for the 'Health & Social Care' Category

I’ve covered a lot about crime in various forms over nearly three years of these Podcasts. A lot has been said about hatred directed towards Lesbian, Gay, Bisexual and Trans People. We’ve also covered domestic violence, which is mostly directed towards women.

None of these subjects are pleasant. Yet the hatred which seems the hardest to understand is that which is directed towards disabled people and those with Mental Health problems or Learning Difficulties.

The question why people behave so awfully in the first place tends to be brushed aside. And it’s clear that the unease that society as a whole has in this area is perhaps the elephant in the room.

In this episode I talk to Karen Machin, a campaigner in this field. She and her colleagues work to raise awareness about disability hate crime and how to report it.

She also works with the ‘Time to Change’ campaign, educating people about Mental Illness and she’s been involved in setting up the ‘ROLE Network’ - which is open to anyone who has experienced or supported someone through these kinds of distress or mental health issues.

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The first LGBT Health Summit took place at Guys Hospital in London in 2005 and, since then, this major annual conference has been hosted around the country. In this fifth year the hosts were Hertfordshire Partnership NHS Foundation Trust, and the venue was the excellent conference centre at the University of Hertfordshire in Hatfield.

In this programme you can hear the organisers, presenters and delegates describing the proceedings as they took place over the 6th and 7th of September 2010

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The question of whether gay or lesbian couples should conceive or adopt children has been with us for many years. Some people think it’s wrong.

There seems no justification for those reservations of course. We’re confronted all the time with examples of heterosexual men and women being bad parents and abusers. Yet the idea that less conventional couples pose some extra kind of threat is deeply ingrained.

And if there’s concern about gay and lesbian people adopting children, what must it be like for trans people?

In this interview I speak to a trans man who, with his wife, has successfully overcome the obstacles to adopt two young children. He also now advises other trans people on how to navigate the process too, and to deal with the general ignorance of social workers in this context.

We agreed we would keep his identity confidential for the sake of his children. In this interview he adopted the pseudonym "Nick". However if people would like to contact Nick for advice on adoption themselves then please ask for help by leaving a request via the comments facility below. If you supply an email address in the "mail" box on the comment form this won't be shown publicly; however we can use this to put you in touch.

Update: Since releasing this episode, 'Nick' has set up a special email address where people interested in adoption can contact him for advice: lgbtadoptionuk@gmail.com

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Why would a young Doctor choose to specialise in Psychiatry? Why would he choose to work in a field that's frowned upon by many of his peers? To cap it all, why would he work in a clinic that had (in the past) acquired a very negative reputation among patients?

Dr Stuart Lorimer works at Charing Cross Gender Identity Clinic in Hammersmith, London. It's a busy place. In 2008, 771 people were referred there with various degrees of gender dysphoria. At any time the clinic is treating well over 1500 people. Some (not all) are seeking support for one of the biggest challenges anyone can undertake: successfully changing the way they live and present to accord with their internal sense of being a man or a woman.

In Britain as a whole, over 300 people apply for legal recognition of permanent gender changes each year. Many others, with less intense dysphoria, take cross-gender hormones or simply find that their feelings can be expressed within their existing gender role.

Helping people make informed decisions about the steps they take is a tough challenge, which is made no easier by having to help them cope with the enormous levels of discrimination which many of those patients will face on the way. The clinicians face challenges too -- not just from fellow Doctors who can't or won't understand, but from patients who arrive with negative expectations about the institution.

Stuart was at pains to stress that he cannot speak on behalf of the clinic he works in. This interview focusses upon him as one of a wholly new generation of specialists in the field, and his own thoughts about some of the controversial issues that have raged for years in this field. In sharing his own thoughts, however, he paints a picture of a team still struggling with an inherited reputation, constantly learning and evolving -- and wanting to do their best in difficult circumstances.

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Happy New Year!

The biggest thing for Equality and Diversity in 2009 is probably going to be the new Equality Bill, which was announced in last month’s Queen’s Speech. Debate on that will begin soon in Parliament and then we’ll learn the precise details of what the Government intends.

During December I spoke to several audiences about the 40 year history that brought us to this point – you can hear a version that in an earlier episode. I plan to feature an update when the Bill has been published and there's been a chance to study the fine print.

In the meantime, here is a keynote speech about trans people in social care, which I delivered back in October 2007 for the Commission for Social Care Inspection. The audience included over 300 inspectors, social workers and service providers.

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Falling birthrates, increased life-expectancy and the approaching retirement of the so-called "baby boom" generation mean that the population balance is altering.

In 1998 just 32.4% of Britons were aged over fifty. By 2021 that proportion is expected to have burgeoned to over 40%. What effects will that have on the economy, public health strategy, the planning of housing and infrastructure?

I asked the public for their views and interviewed experts from a group called 50-50 Vision, who have the task of proposing strategies to anticipate and cope with the change.

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It is an occupational hazard of organising speaking events that now and then one of your speakers will be suddenly and unexpectedly indisposed. When that happens you can either leave a gap -- or try and fill the breach yourself.

This is a problem that arose in the third of our recent conference / workshops on the Gender Equality Duty in Health. At each event civil servants from the Department of Health had volunteered to come and deliver their version of a common presentation about their department's approach, and what it should mean. However, on our last day, one of them was prevented at the very last minute from attending.

Fortunately I'm familiar with what was going to be said -- in part because I contribute regularly to two community stakeholder engagement groups, including an advisory group on Gender Equality. This meant I was able to step in at short notice and fill the gap -- although the emphasis is inevitably my own as a result.

In the next episode we change tack again, with an in-depth interview with the Labour back bench MP Dr Lynne Jones. Lynne has lots to say about equality and diversity -- in and out of Parliament, so be sure you don't miss that episode, coming up soon.

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In the third of this series of episodes covering the recent NHS Northwest Gender Equality conferences we come now to the advice and guidance of the Equality and Human Rights Commission.

Several EHRC staff contributed to the three events that we ran, and I'd like to thank Sam Pryke, David Howard and Vivienne Stone who all made great contributions besides Merryn Wells, featured here.

Merryn gave the main EHRC presentation at our third event in Preston. She is the Commission’s “Transfer of Expertise Manager”. Among her many skills honed in a 25 year equalities career she managed a recent project looking at gender equality in the NHS and also worked with the Royal College of Nursing, advising HR managers in that sector on the gender equality duty. For those reasons she was ideally placed to connect with an audience of NHS managers.

Click here if you would like to view and follow a handout of Merryn's slides whilst listening. (PDF, 90Kb)

In the next episode hear how I ad-libbed my way through explaining the Department of Health's viewpoint when the civil servant booked to speak was unable to attend for very good reasons

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In the second of this series of episodes covering the recent NHS Northwest Gender Equality conferences it is the turn of the Men...

Peter Baker is the Chief Executive of the Men's Health Forum -- a charity which works to improve male health in England and Wales. His presentation to us in Preston was every bit as challenging as the women's message featured in the previous episode, though markedly different.

It was research by MHF that first highlighted how many NHS gender equality schemes in England appeared to have very little disaggregated evidential data, were focussed on processes rather than outcomes, or were lacking in effective consultation and involvement with service users.

Many speakers stressed that equality in this context does not mean providing the same service to everyone. That's not what the law requires, and stark differences in priorities were very clear in the different messages from the men and women presenters seeking the same equality of health outcomes.

Peter's presentation highlights a set of key areas where he says targetted action could be brought to bear on specific health inequalities for men; he also demonstrates how novel approaches can be used to get essential messages across to the men themselves.

Click here if you would like to view and follow a handout of Peter's slides whilst listening. (PDF, 1.2Mb)

In the next episode you can hear the EHRC's guidance for NHS organisations on what they expect when examining equality schemes for compliance.

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Attention has been focussed recently on whether NHS Trusts in England are responding properly to the Gender Equality Duty, since it came into force in April 2007. Research by the Men's Health Forum highlighted that many of the published gender equality schemes it had researched were poorly evidenced, focussed on processes rather than outcomes, and showed a lack of effective consultation and involvement with service users.

Plain Sense was recently commissioned to put together a series of conference workshops for senior NHS Trust managers in England's North West region, to discuss how to be more effective and compliant in this area. Presenters included figures from the Strategic Health Authority, the Department of Health and the Equality and Human Rights Commission to explain what was expected. Just as importantly, an array of stakeholder speakers were invited to explain their view of the real priorities for promoting equality.

Karen Moore is a policy officer with the Women's Resource Centre - a national umbrella organisation based in London. In her speech, presented here in full, she challenged NHS Trust managers to look strategically at issues like violence against women and support for rape crisis centres as a means of avoiding longer term and more intractable mental and physical health issues. Afterwards her colleague, Darlene Corry, provided an interview summing up the challenges and opportunities in thinking 'out of the box' on these kinds of issues.

If you would like to view a handout of Karen's slides whilst listening to her talk then click on this link. (PDF 141Kb; 4 pages)

In the next episode it's the men's turn.

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This week I'm presenting the third and final part in a series of episodes based on the recent Department of Health conference on LGBT Mental Health, which took place at the end of May in Nottingham. (For more details see part one)

I entitled my own presentation "Transgender Realities" and proceeded to pull very few punches about research-based evidence of trans people's experiences of health discrimination, in a factual approach aimed directly at the 130 healthcare professionals present. I regrettably had to publicly criticise Nottingham PCT itself, having adopted a commissioning policy which is clearly discriminatory and unlawful in my view.

If you wish to follow the presentation slides then you'll find these here.

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This week I'm presenting the second of three episodes in which you can hear the speakers at the recent Department of Health conference on LGBT Mental Health in Nottingham. (For more details see last week's part one).

Tim Franks is the Chief Executive of PACE, a leading London-based charity which promotes mental health and well-being within the lesbian, gay, bisexual and trans community there.

In his presentation Tim talks about the different reasons that LGBT people may have for connecting with Mental Health services. Like many of the day’s speakers he emphasises that whilst being different in these ways is not a mental illness, people have the experiences of discrimination to deal with and, of course, they can experience conditions such as depression or psychotic illnesses like anyone else.

Tim also raises interesting perspectives about the way therapeutic relationships can benefit when service users don’t need to explain aspects of their identity and simply feel that their sexual orientation or gender presentation is accepted. He says that in PACE the service providers ‘come out’ about their position so that the service user doesn’t need to.

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On 28th May the Department of Health organised a major conference on LGBT Mental Health in Nottingham. The event was attended by well over 100 health professionals and the day was led by Professor Clair Chilvers, who is the Chair of Nottingham Healthcare NHS Trust.

In this and the following two episodes the speeches of some of the main presenters will be featured in full. For this first programme we hear the introduction from Surinder Sharma, National Director of the Department of Health's Equality and Human Rights Group. Surinder is then followed by Professor Anne Rogers, who holds the chair in Sociology of Health Care at the University of Manchester. Both of these speakers paint a progressive picture of the understanding of the role of mental health, and how thinking is changing (or needs to change) to meet the true needs of people without unnecessarily pathologising their difference.

Copies of Powerpoint presentations and other materials from this conference are now online here.

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July 2008 sees the 60th anniversary of Britain's National Health Service. Much has changed in that time of course. It's a different world from the immediate post war era in which the idea of a universal public health service, free at the point of need, was born.

Britain is far more culturally diverse. Public health emphasis is shifting from treating illness to preventing it. Health and well-being are increasingly seen as integral to wider strategy for encouraging and maintaining a socially equitable and economically successful society.

As the Department of Health's programme director for equality policy, Barry Mussenden heads a team that's responsible for ensuring that health and social care services match everyone's needs equally and fairly.

It's not an easy brief. The NHS is a federation of independent public bodies whose priorities can only be influenced, not commanded. The health service is Europe's largest employer, staffed by ordinary people who have just  the same blind spots and prejudices as the rest of society.

In this short interview Barry explains how his team sees the challenge and takes it on.

Department of Health Equality and Human Rights Group

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