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Changed operating environment and purpose of the Guide
The increasing diversity in the Irish population is evident both among those who use the health services and the staff teams who provide those services. The changed operating environment has resulted in staff consistently reiterating a need to develop their capacity to respond appropriately to the health and personal needs of those from a culture other than their own.
The primary motivation in developing the Guide was to respond to this expressed need for intercultural knowledge, skills and awareness in the current working environment. This view is shared among Irish staff working in the services that are providing care to members of new communities, staff from other national backgrounds who were recruited to meet labour force shortages in the health services and staff from Minority Ethnic Communities living in Ireland who are working with cultures other than their own.
The purpose of the document is to provide information to healthcare staff so that they can deliver a sensitive, appropriate and quality service across cultural lines.
Policy and legislative framework
The Guide is supported by an extensive legislative and policy framework.
The Equal Status Acts 2000 to 2004 apply to those who provide a wide range of services, including health, and those who use the services. The Acts aim to promote equality of opportunity and prohibit particular forms of discrimination across nine grounds including gender, religion, race (identified as skin colour, nationality, ethnic and racial origin) and membership of the Traveller community.5
Discrimination has a specific meaning in the Acts and is defined as "the treatment of a person in a less favourable way than another person is, or has been or would be treated in a comparable situation on any of the nine grounds which exists, existed, may exist in the future or is imputed to the person concerned." 6
The various forms of discrimination prohibited are also clearly spelt out in the legislation. For a fuller explanation of the Equal Status Acts 2000 to 2004 and their provisions see Equal Status Acts 2004 to 2004 explanation bookletproduced by the Equality Authority or Equal Status Acts and the Provision of Health Services produced by the Equality Authority, the Department of Health and Children and the HSE.
Planning for Diversity: the National Action Plan Against Racism (2005)7 specifies actions that each public sector organisation should put in place to address the elimination of racism and positively promote interculturalism in service provision. The HSE National Intercultural Health Strategy, launched by the Minister for Health and Children in February 2008, was developed to respond to the increasing diversity in the population and the developing legislative and government policy context. The strategy provides a framework within which diverse healthcare and support needs may be addressed whilst recognising the need to support staff to deliver responsive, culturally competent services.
As phased implementation of the strategy takes place, a number of actions emerging from its recommendations are being progressed. These include actions aimed at enhancing access of service users from diverse backgrounds to health services, building of capacity among staff and managers in delivering culturally sensitive healthcare, development of a national model for interpretation and translation services, and promoting the collection of data on ethnic origin so that the design and planning of services is inclusive of all communities.
This legislative and policy framework, coupled with the duty of care that the health services work under, places a duty on all of us involved in the delivery of health and social care to respect the religion and culture of those who use health services where norms are not in conflict with the laws of the country, nationally agreed protocols and international agreements to which Ireland is a signatory.
Staff and settings that will benefit from the Guide
The Guide is primarily targeted at staff who care for the ill, particularly in in-patient settings, as well as those involved in care of the dying for both adults and children. As such, it is relevant for a wide range of staff including medics, nurses, midwives, health care assistants, allied health personnel, chaplains, mortuary and catering staff. Equally it is relevant for a range of healthcare settings including acute, paediatric, maternity, primary, continuing and community care.
The material will also be of benefit as an educational resource in training establishments for healthcare personnel and in continuing professional development courses.
The Guide can also provide information for staff management so that sensitivity can be shown for the diverse religious needs of healthcare staff in areas such as prayer needs, ablution needs and food provision including timing of food availability for those who ritually fast.
Scope of the content
The Guide is a diversity publication. The content is restricted to information that is directly relevant to dealing with the religion, philosophical belief and culture of the person being cared for. As such, it has been selective in sourcing and presenting information about any group and cannot be taken as a definitive description or explanation of any religion or culture.
The Guide provides information on general cultural features of the Chinese, Roma and Travellers in response to specific requests from healthcare staff for this information. The information selected and presented in these cases is also selective to intercultural interactions with these groups.
The content of the document is outlined in Overview of Care Themes.
5 The full nine grounds covered by the Equal Status Acts are gender; marital status, family status, sexual orientation, religion, age, disability, race and membership of the Travelling community.
6 Equality Authority (undated) Equal Status Acts 2004 to 2004 pg 6
7 Planning for Diversity: the National Action Plan Against Racism was developed by the Department of Justice, Equality and Law Reform.