El impacto de la centralización en el Perú

The 2011 Census identifies 5.3% of the combined English and Welsh populations self-define as British Pakistani. When considering more ethnically diverse areas such as the research area this percentage rises to 10.1%. Census data also records median age for each ethnic category and this data indicates that the Pakistani population have a significantly lower median age of 25 years, compared to the white British population which was recorded as 42 (Office for National Statistics 2011 [online]). This higher population of younger people from Pakistani heritage compared to the white population has an impact on the number of people from this population who require treatment or support via health and social care systems, as the majority of people using NHS and local authority services are older people.

The National Audit of Intermediate Care (NAIC), part of the NHS Benchmarking partnership was launched in November of 2011, the same year as the Census. This organisation annually records and publishes details of individuals admitted and discharged from various intermediate care units throughout England and Wales as part of its data collection. The NAIC is a voluntary audit and services are responsible for signing up and sending information to be processed, therefore its results are not necessarily as thorough as the

Census, however when observing the percentage of individuals using intermediate care services from the same ethnic groups identified above, there is a stark contrast in terms of representation. Only 0.56% Pakistani service users were identified as utilising Intermediate Care services. In real terms this equates to less than one person of Pakistani heritage accessing bed based intermediate care services out of 1537 individuals.

3.4 Table 1: Intermediate care access data* Population Pakistani % England/Wales population

(Census)

2.5

% research area population (Census)

10.1

% Accessing IMC 0.56 % Accessing Bed-Based 0.26 % Accessing Home-Based 0.86

*information sent as a response to a request to NAIC directly.

Although as described above, there are some discrepancies in the accuracy of this information, aside from more philosophical discussions around the usefulness of demographic indicators, there is an undeniable underrepresentation of service users from Pakistani heritage accessing intermediate care services. In relation to Section 2 (2b) of the Care Act (2014) this raises concern; as explored above, the new legislation obligates local authorities to ensure that individuals with care needs are identified and offered support. This support should (in keeping with Section 2 (1)) endeavour to prevent, reduce or delay the need for care. This purely quantitative information would indicate that there are a significant number of individuals of Pakistani heritage who require but are not in receipt of intermediate care support, under the duties designated by The Care Act (2014) this needs to be addressed.

Part 2

3.5 Introduction

In 1998 the Department of Health commissioned an inspection of social services departments (now local authorities) to evaluate the extent to which their ‘arrangements for planning and delivering community care services appropriately addressed the needs of ethnic minority older people’ (DoH 1998:3). The findings were published in the report; ‘They look after their own don’t they: Inspection of community care services for Black and

Ethnic Minority older people’ (1998). The report identified that in the eight boroughs

inspected, there was evidence of planning support and services for people from minority ethnicities, but in practice there was little variety. Provisions that were available were often ethnocentric, making it difficult for those from different ethnic backgrounds to establish appropriate support. Black and minority ethnic service providers, who had successfully developed ways to support their communities experienced difficulties securing local authority contracts, which exacerbated the problems service users were facing with longstanding ‘white’ services.

The report acknowledged that most authorities did provide translated leaflets about their services, but that these were not effective because of lack of other strategies to engage with communities. There was also inconsistent use of interpreters and lack of understanding of when it was inappropriate to recruit family members to step into this role. Once involved in care management, minority ethnic older people’s support was often dependent on the skill and confidence of the individual workers and there was a lack of cultural sensitivity. The title of the report; ‘they look after their own don’t they’ is a direct quotation from a worker interviewed as part of the inspection, indicating the level of institutional racism uncovered. Basic services were not always suitable, and the availability of appropriate support decreased as need increased, meaning that those with high support needs were often most likely to receive unsuitable support.

The report also identified that although authorities possessed generic safeguarding and adult protection policies, there was little information relating specifically to challenging racism. Additionally, employment of minority ethnicities in the authority workforces was not representative of their population.

Although positively framed, the report highlighted significant disadvantage and discrimination in the provision of services to minority ethnic older people, however it did not analyse the data it collated for patterns of discrimination within the broader group of ‘black and ethnic minority’. A more detailed intersectional analysis could have provided insight into the differential impact of disadvantage and oppression on the delivery of local authority support.

The research included in this review has been collected 20 years after the publication of this Department of Health document.