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The Gender Equality Duty - What does it mean for NHS Scotland?

In April 2007, the biggest change in sex equality legislation came into place since the 1970’s.  The Gender Equality Duty (GED) means that all public authorities, including the NHS in Scotland, have to consider the need to:

• eliminate sex discrimination and harassment
• promote equality of opportunity between women and men

The new Duty means that NHS boards now have to ensure the design, development and delivery of services takes into account the different needs of girls and boys and women and men.

The link between gender and health

Men, women, boys and girls have different needs and uses from health services, which in the past were based on a “one size fits all” model.  They may also experience different responses to illness, and this should be considered when developing services.  By doing this, the quality of health services will improve for everyone.

What does the NHS need to do?

To ensure that gender equality is embedded into services successfully, health boards need to ask some questions about the people using services. For example, “What are the different needs of women and men and how can we meet them?”  It needs to recognise that men and women are not homogenous groups and that there are huge variations in terms of need and expectations.

Developing specific services for men and women is one of the ways to provide gender sensitive services. In addition to this however, Boards need to embed “gender mainstreaming” into planning, shaping and delivery of services and have a robust base of gender evidence on which to base decisions.

As a legal condition of the GED, each health board has written a Gender Equality Scheme containing objectives and actions to ensure gender equality is built into services.  The objectives and actions must focus on real improvements for men and women and not just on process changes.  For example, Boards could remove barriers to accessing services by introducing flexible GP practice opening times or providing male-friendly weight management programmes. 

Gender Equality Duty and Employment

The Gender Equality Duty concerns both staff and service users.  For staff, gender equality consideration needs to be reflected in issues such as equal pay, caring responsibilities, flexible working, equal access to training and promotion, and ensuring part-time staff have the same opportunities as full-time staff.  The GED is also designed to generate employment practices that encourage more men into roles mainly occupied by women, such as nursing or administration and equally more women into roles traditionally dominated by men such as consultant posts or senior management.  The Duty applies equally to staff who identify as transsexual.

Clearly, most men want to be healthier.  Since men engage with health services less than women, the Gender Equality Duty will allow health boards to build on the opportunity to engage with men and boys on the edges of and outside the health care system.

Gender and Health equality is not just about writing a gender scheme and action plan and ticking the box.  It is about making meaningful changes and improvements for men and women and although a great deal has been done already, there is still a long way to go to deliver full gender equitable health services for all.

Marese O’Reilly

Equalities and Planning Directorate, NHS Health Scotland.