Gypsy and Traveller Healthcare
Sam Worrall, Friends Families and Travellers
Gypsies and Travellers experience some of the worst health inequalities of any group in the UK. Many of the issues and barriers travelling communities face are similar to those encountered by other vulnerable or marginalised groups. We often hear accounts from clients who have faced difficulties or discrimination whilst attending GP practices. However, there are steps that staff can follow to ensure practices can support patients to access primary healthcare and be sure they are delivering a fully inclusive service.
Some Facts and Figures
Gypsy and Traveller women are estimated to live 12 years less than women in the general population and men 10 years less, although recent research suggests the gap could be much higher
Irish Travellers are three times as likely to die by suicide than the general population.
Gypsies and Travellers are nearly three times more likely to be anxious than average and just over twice as likely to be depressed
39% of Gypsies and Travellers have a long-term illness compared with 29% of settled communities
There are higher rates of miscarriages, stillbirths and neonatal deaths in Gypsy and Traveller communities and high rates of maternal death during pregnancy and shortly after childbirth
What can I do?
Communication and engagement
Gypsy and Traveller communities have lower literacy rates compared to the national average, some estimate around 45% have low or no literacy. How does this affect how they can access your services, register, and receive information leaflets?
Levels of digital literacy, technology and internet use are also lower. It is really important that any changes in the delivery of healthcare that rely on technology don’t discriminate.
GP practices should offer support when needed with form filling, provide easy to read materials, and ensure patients with low literacy are supported throughout their health journey.
In the 2011 census, 24% of Gypsies and Travellers reported living in a caravan, other mobile, or temporary structure. This means many don’t have a permanent address.
Registration is often a flashpoint for difficulties. Not being able to provide an address or identification means some GP practices are unwilling to register patients.
But guidance from NHS England is clear: you don’t need proof of address or ID to register with a GP surgery. Of course, it is fine to ask for one, but surgeries should have procedures to register and offer services to patients who can’t prove their address
Gypsy and Traveller communities have cultural differences that may not initially be apparent. There are several distinct cultural groups within the umbrella term Gypsies and Travellers, with often widely differing traditions and practices. For example, within Gypsy and Traveller communities, women traditionally may not share or discuss their health issues with male members of their family. Women are often the main carers in the family and therefore can find it difficult to get appointments at convenient times or may have to take children with them to appointments. There are often strict rules around gender with some Gypsy and Traveller communities, meaning that women will only agree to see female doctors, and men only male doctors. Men can often be unwilling to seek help for health issues or attend GP practices. Mental health is usually not talked about and is felt to be an issue that family should deal with.
When communicating with members of Gypsy and Traveller communities, it may be useful to keep in mind that many will have experienced discrimination or stigmatisation from mainstream services. This may affect how they act or feel when accessing their GP practice. Therefore, it is important to ensure staff are welcoming, patient and understanding