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SWEDEN - Discriminatory practices in the health sector

August 8th 2014


Description

During 2010 and 2011 the Equality Ombudsman had a special focus on the health sector with the purpose of identifying and putting light on discrimination and discriminatory practices in the health sector. The Ombudsman cooperated closely with key stakeholders, including the National Board of Health and Welfare. A report describing the findings was published earlier this year by the Equality Ombudsman. The National Board of Health and Welfare during 2011 also produced a broader report on equality in health care where they identified similar problems with discriminatory treatment and inequality in the health care sector. One of the main problems identified was shortcomings in how individuals seeking health care were treated when contacting providers of health care.

Based on these reports the Swedish government tasked the National Board of Health and Welfare with developing training material and training-courses for duty bearers in the health sector and their staff. The government provided funds amounting to 4 million SEK for this purpose. In this effort the board is instructed to cooperate with the Equality Ombudsman in order that issues related to discrimination and equal rights and opportunities are taken into consideration when developing the material.

The training material should target personnel working in the health sector and should focus particularly on how individuals are treated and the information they receive when they seek and get medical treatment. The material will include information about the anti-discrimination legislation, about the problems of discrimination in the health sector and methods that health care providers can use to address problems and ensure equal rights and opportunities. The project should also develop a pilot project for testing and evaluating the training material and training-courses.

The work started in October 2012 and have been reported to the government by 30 September 2013. The next step is to test the effectiveness of the material in a small number local and regional hospitals and other types of health care wards, and this is going to take place during Spring and Autumn 2014.


Duty bearers targeted, and their specific obligations (if any)

The National Board of Health and Welfare is a government agency under the Ministry of Health and Social Affairs, with a wide range of activities and many different duties within the fields of health, medical services and social services. The agency has supervisory powers in these fields and develops standards based on legislation. Their activities focus on staff, managers and decision-makers in the abovementioned areas.

The National Board of Health and Welfare is not targeted as a duty bearer. The project is run jointly by two supervisory bodies to ensure that the output is of the highest quality. The duty bearers that are ultimately the target of the project – health care providers – have a duty under the Discrimination Act not to discriminate individuals because of their sex, transgender identity or expression, ethnicity, religion or other belief, disability, sexual orientation or age.

The Equality Ombudsman is engaged in a National Platform for Equal Access to Health and Healthcare. Within this network arena some duty bearers and some professional trade organisations (altogether 15-20 organisations) in the health care sector cooperates to arrange national public conferences about equal access to health care, and joint workshops to highlight and disseminate new methods and knowledge to the actors in the network. In this work the Equality Ombudsman has the possibility to use the lessons learned from the government project with the National Board of Health and Welfare.


Main objectives of the project

The long term objective is to improve how individuals are treated when seeking health care and to ensure that the medical needs of the individual is the focus in these contacts. The training material and the training courses should increase the awareness among health care providers and their staff of relevant legal requirements in the field and to provide concrete advice concerning working methods. The short term objective of the Equality Ombudsman is to ensure that the material produced in a correct way relates to the discrimination act and the protected discrimination grounds.


Tools

The Equality Ombudsman cooperates with a regulatory body (g) in order to provide advice and guidance to duty bearers in the health sector (e). In its report on health care the Equality Ombudsman identified a number of measures to be taken at different levels to address the problems in the health care sector. One of the proposals pointed to the need to increase awareness through trainings among health care providers and their staff about legal requirements and other matters related to discrimination and equality. Based on this proposal the government requested the National Board of Health and Welfare to carry out the project.


Key achievements

The project has raised the knowledge and understanding of the questions at stake both within the work of the National Board of Health and Welfare and the Equality Ombudsman. Some of the result is presented at the National Conference for Equal Access to Health Care 21 March 2014. After testing the written material will probably be disseminated in different ways into big parts of the health care system in Sweden.


Key challenges

By chance the Equality Ombudsman had a very good cooperation with the responsible staff at the National Board of Health and Welfare. Thus, the main challenge was the short amount of time (in reality) allocated to the project. The production, with the reference groups and all the meetings, had to be made in 7 months.