Good quality medical care is the foundation of our health and social care service. Treatment that is respectful and inclusive is a cornerstone of these services. LGBT people have the same health and social care needs as the rest of the population of England for the majority of the time: clinical and care expertise, a listening ear, understanding, and health and social care structures that enable them to lead healthy and cared-for lives. However, it is not always the case that LGBT people receive the same level of service as non-LGBT people. Research has shown that, although LGBT people are often less healthy than the wider population, they also tend to receive lower levels of care than non-LGBT people. Too often medical professionals focus on sexual health rather than broader health needs and differences when supporting LGBT people. The reasons for this have become clear to us through this inquiry.
LGBT people need to be treated equally, but not identically to, other groups. Access to the same services as others is ineffective if that service is structured for a heterosexual and cisgender default and has limited flexibility. There is not enough understanding from service-providers of the different needs that LGBT people might have.
We have found that too few health and social care providers are actively thinking about LGBT people when they plan their services and that senior leaders are not doing enough to ensure that LGBT-inclusion is hardwired into commissioning strategies. This problem filters all the way down to training, where medics of the future are not taught how to provide LGBT-inclusive treatment. While few people set out to discriminate, training currently sends the message that sexual orientation and gender identity are not relevant to providing “person-centred care”. We have heard that for many witnesses that it is, in fact, essential. At the moment, there seems to be neither the leadership necessary to ensure services are designed to be LGBT-inclusive nor swift enough improvements among staff on the ground.
We have, however, heard many good ideas and lots of examples of good practice. These are not as widespread as they should be and so this report should be a clarion call to the health and social care sectors to take up the work that some very dedicated and inventive individuals have already begun.
Published: 22 October 2019