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NHS produces fairer primary healthcare system, study finds

28 Jul 2009

England’s ethnic minorities are just as likely to access GP services as their white counterparts and have similarly positive clinical outcomes, a study published this month has found.

The research found no differences for the clinical outcomes of care for patients from ethnic minority backgrounds with high blood pressure, raised cholesterol and - on the whole – diabetes: they were no more likely to have undiagnosed illness, and just as likely to have their condition well-managed. 

The findings are a surprising departure from widely held views that people from ethnic minorities have poorer care in the NHS. 

They also strongly suggest that poorer health of ethnic minority groups in England is not a consequence of limited access to healthcare, but poorer socioeconomic profile. 

However, the report did find inequalities in how patients from ethnic minorities access hospital services and a ‘marked’ difference in accessing dental care. 

It is published in the Journal of Epidemiology and Community Health. 

“While inequalities in the care received may exist for some conditions and other health care settings, particularly internationally, the implication of our research is that ethnic inequalities in healthcare are minimal within NHS primary care. 

“In other words, publicly funded primary care with universal access has resulted in greater equality of access to and outcomes of care across the main ethnic groups,” said Professor Nazroo– who led the study. 

“It’s a vindication of the NHS and the principles that underpin it.” 

One factor that might contribute towards poorer access to secondary care, according to the team, is that white people are far more likely to use private hospital care than patients from ethnic minorities. 

And the low use of dental services may reflect the difficulty ethnic minority patients experience in finding an NHS dentist, or paying dental fees. 

The study analysed thousands of respondents to four waves of the Health Survey for England, a representative population survey. 

Professor Nazroo said: “We found no evidence among respondents that ethnic minorities suffer disproportionately poorer care for hypertension and raised cholesterol. 

“In fact in some cases, there were indications that ethnic minority respondents received better care. 

“For diabetes there were also few differences, although there was some evidence of poorer outcomes for the Pakistani and Irish groups.

Notes for editors

Data used are drawn from the 1998, 1999, 2003 and 2004 sweeps of the Health Survey for England (HSE), a representative national survey. 

Method Respondents were asked if: they had visited a GP in the last two weeks; they visited a dentist for regular or occasional check-ups (1999 HSE only); and, in the last twelve months, they attended hospital as an outpatient, day patient, or at A&E, or had been in the hospital as an inpatient (overnight or longer). 

The paper - Ethnic inequalities in access to and outcomes of healthcare: Analysis of the Health Survey for England is published in Journal of Epidemiology and Community Health this week and is available. 

Doi 10.1136/jech.2009.089409 

It is authored by:

  • Professor James Nazroo, University of Manchester
  • Dr Emanuela Falaschetti, Department of Epidemiology and Public Health
  • Dr Mary Pierce, University College London
  • Dr Paola Primatesta, University College London
  • For media enquiries contact:

Mike Addelman
Media Relations Officer
Faculty of Humanities
The University of Manchester
0161 275 0790
07717 881 567
michael.addelman@manchester.ac.uk