Leeds GATE

Working to improve the quality of life for Gypsies and Travellers

0113 240 2444

Crown Point House,
167-169 Cross Green Lane,
Leeds LS9 0BD

What has co-production got to do with you? Yes, that means You!

Helen Jones's picture
By Helen Jones |  May 22, 2013 |

Improving Gypsy and Traveller health and wellbeing.

Next week our long awaited Leeds Gypsy and Traveller Community Health Needs Assessment (CNHA) will be released.  It has been a long process to reach the release date, not least because issues affecting the health and wellbeing of staff and community members at GATE. We’ll be blogging more about the findings of the CHNA over the next few weeks.

We all know that just about everything about how we interact with, and organise, health and social care is in a state of change.  Public Health (that’s everything to do with the broad health of the populations rather than individuals in their patient journey) is now part of the council.  Health and Social care services are going to become ‘integrated’; and even the way that we speak to our own doctors (ie by email, text, or even in groups) is going to change in the future.

So, how are all these changes going to impact on what we already know, that the health outcomes for Gypsy and Traveller people are poor?  Indeed, can these changes impact on the health of Gypsies and Travellers?  We certainly hope so.

In professional healthcare circles, people use the expression ‘wider determinants of health’. Sometimes they substitute ‘social’ for ‘wider’. What this catchphrase tries to describe are all the things that affect your health that no amount of medicine or clinical intervention can resolve.  It includes things like how adequate your home is, how good your education is, the security and status of your employment. Other social factors that affect health are things like whether you have good relationships with family and friends and whether you can make your own choices about how or where you live.  A critical factor for many people is about whether the communities they come from, or identify with, are highly regarded by wider society or not.

For Gypsy and Traveller people in UK society, these wider determinants have a critical role to play, and sadly are often areas of life in which the outcomes and available choices are far from ideal.  Homes are often obliged to be in unsuitable locations, or of a type which does not fit in well with the cultural inheritance we received from our parents and wish to share with our children.  Our address often affects our choices in education and employment.  Our pathways to health and social care are often difficult due to where we live, or whether we are literate, including IT literate, or not.  Our relationships with the wider communities around us are too often characterised as being conflicted, we are stereotyped and at times regarded with disdain, held up for public vilification even.

At Leeds GATE we have worked with colleagues from health for many years.  We have watched their trials and tribulations of endless reorganisation with compassion, and they have somehow maintained their support for us and continued to express desire for change and improvement for our communities.  Perhaps surprisingly, we even feel that there may be grounds for optimism about the future in this brave new world of NHS England and the integration agenda.  However fabulous as the health people are, they just cannot resolve the issues that Gypsies and Travellers face alone.  Without specific and lasting improvements in the housing, education, employment and social choices that Gypsy and Traveller people can make, their health will not improve.

Mind you, haven’t some local authorities and statutory bodies been trying to do this for years?  Many places have had some sort of specific education service for many years.  There are buses that visit sites for all sorts of reasons, youth buses, playbuses, health buses.  Many dedicated staff have done their best for years.  And yet....and yet.. the stats, where any are available, aren’t really improving.  NEET data, rates of roadside eviction, school exclusions, life expectancy, are all pretty much as bad as ever.  Why is this?

There isn’t one simple answer to the question, but we’d like to make a suggestion.  It can be summed up in a work that is becoming very popular in health circles, though less heard anywhere else.  That word is ‘co-production’.  It means that solutions to problems are not discussed, planned or implemented unless, from the outset, problems are identified and solutions are devised by community members themselves working in partnership with service providers and decision makers who can help them to make their solutions realistic and sustainable.

Clinicians and other healthcare workers seem increasingly to understand that solutions devised by professionals alone in consulting rooms, or even pathology labs, fail in the real world because humans are individuals with their own experiences, cultures, social influences and networks.  What they have realised is that you can’t ‘make’ people healthy unless they work with you, and they work with you if they feel ownership of a course of action that it makes sense to them, and is possible to implement, in their real life.  It is vital that all of us, and that must also include Leeds GATE in our efforts to achieve improvements in health and wellbeing, get this right.

Previous article: "Managing money and cards – another challenge of Universal Credit"

Next article: "Universal Credit - A report by Leeds GATE and Irish Traveller Movement in Britain"