What are the health inequalities faced by Irish Travellers and how can we overcome them?

What are the health inequalities faced by Irish Travellers and how can we overcome them?

 

In the wake of the global Covid-19 pandemic, marginalised communities are at even greater risk than usual. These include groups like the Irish Travellers, which are so often ignored within policy, or openly discriminated against.

Given so little publicity has been given to this particular group, this blog sets out to explore why Irish Travellers tend to have poorer physical and mental health, and what we can do to change this.

Who are the Irish Travellers?

There are many different groups within the Traveller community. One of the largest is Irish Travellers.

Irish Travellers are recognised as an ethnic group in the Equality Act due to their distinct culture and identity.

Travellers are often characterised by a nomadic lifestyle where they move from one place to another. This is compared with the general population who usually follow a settled lifestyle and live in one place.

However, not all Travellers are nomadic. And even those who are sometimes have to adopt a settled lifestyle due to old age, health needs, or education needs.

So being part of the Traveller community is about more than being nomadic, as Traveller activist, Michael McDonagh, explained in Dr Colm Power’s report on England’s Irish Travellers:

“When Travellers speak of Travelling, we mean something different from what country people [sedentary people] usually understand by it […]. For Travellers, the physical fact of moving is just one aspect of a nomadic mind-set that permeates every aspect of our lives. Nomadism entails a way of looking at the world, a different way of perceiving things, a different attitude to accommodation, to work, to life in general.”

Irish travellers have poorer health outcomes than the general population

Irish Traveller life-expectancy estimates are shocking.

Data from the All-Ireland Traveller Health Study suggest that Traveller men have a life expectancy of only 63 years (vs 78 in the general population). For Traveller women, that figure is 71 years (vs 82 in the general population). This means Irish Travellers die about 11-15 years earlier than the general population.

The gap in healthy life expectancy is even more striking. Irish Travellers will experience 16-17 more years of poorer health than the general population, and they are more likely to be categorised as disabled.

Mental health is also worse among Travellers. 60% of Travellers said that their mental health was not good enough for one day or more in the last 30 days (vs 20% in the general population).

Suicide is a real issue, with a suicide rate for Travellers that is 6-7 times higher than in the general population.

Irish Traveller health is worse for three main reasons.

The underlying reasons for the inequalities we see in Irish Traveller health are multiple, complex and inter-related.

But put simply, Irish Travellers are more likely to develop certain conditions in the first place, have less access to health services, and have low uptake of health services when they are available.

First, social, environmental and economic factors mean Irish Travellers are more likely to develop health conditions.

The Irish Traveller community have many risk factors for developing chronic conditions, such as lower socioeconomic status. For example, unemployment rates amongst Travellers are as high as 80% (vs 13% in the general population).

It’s not only demographic differences at play however. Travellers still have worse health even when these are accounted for, so there are other reasons too.

Discrimination itself has been linked with poor health.

Compounding this, Travellers have many cultural, psychological and environmental factors that can make it harder to adopt healthy habits. For example, over-eating is encouraged through things like catering for a large extended family and chubbiness is seen as a sign of a healthy child.

Travellers often experience racism and social exclusion when they attempt to exercise, for example at gyms. Women in particular have little opportunity to exercise due to traditional gender roles that encourage family commitments.

Mental health can be impacted by the same factors as physical health. On top of this, reasons for poor mental health include poor physical health, bereavement and discrimination. This is impacted further by the stigma attached to mental illness within the Traveller community that can stop those who need help from getting it.

Second, Irish Travellers experience lower levels of access to healthcare.

Regularly moving location can make it hard to engage with health care, whether moves are by choice or enforced due to local regulations.

This is partly because of practical reasons. Most GPs need a permanent address to register patients. Health records aren’t easily and quickly accessible nationally so patient notes often can’t be accessed.

It’s also because constantly changing providers makes continuity of care difficult and it’s easy for people to fall through the gaps of services.

Some of these access issues could be deemed unconscious institutional racism. Pavee Point, an organisation that aims to improve the human rights of Irish Travellers, explains this as

“Processes that consciously or unconsciously result in the systematic exclusion of minority ethnic groups. It is most visible in the inequitable outcomes for minority ethnic groups from the policies and practices of organisations and institutions throughout society.”

Third, there’s usually low uptake of health services among Irish Travellers.

Irish Travellers often don’t want to engage with health care because of a fatalist attitude towards treatable health conditions, low expectations around good health, and a common belief that health care professionals cannot substantially improve health.

In a 2010 study, only 41% of Travellers “completely trusted the health care professional treating [them]” (vs 82% in general population).

There’s also a common attitude towards close-knit extended families taking care of health problems themselves.

Then when Travellers do want to engage with health services, it is made difficult for them by a system and professionals who don’t understand or cater for their needs.

This is often compounded and perpetuated by negative experiences and high levels of overt racism. For example, receptionists can be a barrier to get past and health professionals can have low expectations of the Traveller patient and their health.

Effort is needed from all sides to improve this

Policy is often integral to reducing inequality. Yet, like other itinerant groups, Irish Travellers are often forgotten about in health care policy.

Even though they are a recognised ethnic group, Travellers are not mentioned in most government initiatives. This reveals a woeful oversight.

Simplified Data believe that everybody should have access to evidence-based medical treatment. This mission ties in with Justice Studio’s understanding that health disparities like those witnessed in Traveller populations are issues of social injustice. We know that health outcomes are not necessary facts of biological makeup, but result from social, economic, and environmental drivers as well.

For groups who are at the margins of society, disproportionate health risks are embodied, lived experiences of broader social and political injustices. To really see improvements in health, it will be vital to break down some of the barriers between Irish Travellers and health professionals.

This will need to be written into health policy, and will require more education for health care professionals around the specific health needs of Travellers. There are examples of fantastic work being done to improve Traveller health that are mostly led by or operate in partnership with the Traveller community.

The complicated problem of Irish Traveller health will require complex solutions. But the gains that could be made by reducing the huge health inequalities experienced by Irish Travellers would be well worth the effort.


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Danielle Bodicoat is an independent medical statistics and writing consultant at Simplified Data and an Associate Consultant at Justice Studio. She specialises in health-related evidence reviews and meta-analysis. You can find out more about Danielle and her work on her website.

Featured image: An Irish Traveller in Dublin watches neighbouring children play from her trailer window. Photobymack 2011.

Justice Studio Research: The impact of Covid-19 measures on older adults in self-isolation

Justice Studio Research: The impact of Covid-19 measures on older adults in self-isolation

“It’s just behaviours”

Last week, Dr. Deborah Birx (who is leading the US response to combating the Covid-19 pandemic) appeared on stage in front of the press, flanked by illuminated images of bell curves. Pointing to the flatter of the curves, her message was clear: reducing the rate of new Covid-19 infections is key to reducing overall loss of life. This insight, informed by epidemiologists and experts on coronavirus transmission, has become part of the pubic lexicon as citizens around the world make efforts to #flattenthecurve.

Birx’s key point, however, was not medical advice in the classic sense. Rather, she reiterated, “It’s communities that will do this. There’s no magic bullet. There’s no magic vaccine or therapy—It’s just behaviours.”

Dr. Birx’s revelation comes as no surprise to social and behavioural scientists, who have long catalogued the behavioural and contextual markers of disease patterns within populations. Today more than ever, this attention to the role of human behaviour in the spread of novel coronavirus is a stark reminder that there is no such thing as a ‘natural’ catastrophe.

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Answering the call to better understand behaviours during the Covid-19 pandemic, Justice Studio have created a pioneering piece of action research, that we would like your help with.

Chronic loneliness isolation and health outcomes

Human behaviour—specifically, social networks and socialisation—has been at the center of many health-related studies in the past decade. In 2003, scientists at the University of Pittsburg isolated 304 adult volunteers in hotel rooms, then later exposed them to a virus. They discovered that those with a greater number of social contacts were less likely to develop symptoms. Similarly, another study at Brigham Young (2010) found that loneliness could equate to the health risks of smoking 15 cigarettes per day.

But what happens when loneliness is a shared experience? Whereas previously, loneliness defined an individual’s experience in contrast to a larger group, today we are all isolated together. Is simultaneous loneliness qualitatively different? Will novel coronavirus entail novel social impacts? As Jonathan Kanter, director of Center for the Science of Social Connection at the University of Washington, recently explained, “We’re in a massive social experiment and we don’t know what extent this earlier research applies.”

At Justice Studio we are determined to take a critical, socially conscious look at these issues and find ways to help in real time. Governments and key decision-makers are grappling with this crisis, looking for ways forward and are open to evidence; we need to provide it. After all, social conditions like isolation, inequality, and lack of access to resources aren’t inevitable.

So, in order to begin to understand these crucial behaviours, we have launched an action research project to investigate the impact of Covid-19 measures (self-isolation, social distancing) on adults aged 70+ with underlying health conditions. Our research has a number of elements including:

  • Literature and data review
  • Peer research by 60+ volunteers interviewing a cohort of older people
  • Interviews with organisations supporting older people

In addition to this, we are surveying a wider sample and will be opening local phone numbers with voicemail boxes to capture phone-in responses. We believe that it is crucial to think creatively and resourcefully when switching to virtual research methods, keeping in mind the different populations that we will be less able to reach in this way.

We see several potential key benefits from this research:

  • Providing evidence in real time (action research);
  • New expertise around gaps in medical/social knowledge;
  • Practical insights published and shared with key decision-makers and frontline workers;
  • Exploring virtual, or non-co-located research methodologies with harder-to-reach populations;
  • The act of interviewing as an aid or intervention itself.

Now we could really use your help. We are recruiting interview participants in the USA, UK, and in Spain who are 70+ and with an underlying health condition. Please spread the word to anyone you know who may be eligible and interested. Recruitment closes at midnight on April 13th.

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June

Why is health a social issue?

Why is health a social issue?

Nearly ten years ago I became passionate about health inequalities when I read Fair Society: Healthy Lives, Professor Sir Michael Marmot’s review of the most effective evidence-based strategies for reducing health inequalities in England.

Now, as the corona virus pandemic threatens to cause the worst health and societal outcomes for the most vulnerable in recent times, this seems especially pertinent.

The strategies of Marmot’s 2010 review were far-reaching and took a lifespan approach to health inequalities. The highest priority in the review were initiatives aimed at maternity services, child development and parenting to ensure that all children got the best start in life.  But older people were not forgotten and health services that promoted the independence of the elderly were also championed.

The ambitious recommendations considered every aspect of life that can impact on health. From establishing minimum incomes in order to reduce the social gradient. Right through to policies aimed at reducing the impact of climate change to sustain and create environments where people can flourish.

This approach is crucial now as we live through the pandemic.

What does it mean in the current crisis?

Statistics published in the recent ten year review of the original report – Health Equity in England: The Marmot Review 10 Years on make for a shocking read. In general, since 2010, improvements to life expectancy have stalled, and alarmingly even declined for the poorest 10% of women.

The ten year review provides little analysis of why poorer women may experience worse health inequalities. However, the British Medical Association already recognise that the healthcare system may not be responsive to biological and societal gender differences. Gender-based health inequalities may exist because of the impact of unmet needs relating to gender-based violence or problems with reproductive, gynaecological and maternal health services.

Women from deprived areas and communities are already at a significant disadvantage. This coupled with the burden of roles that women are traditionally expected to hold in society, may mean that they are disproportionally affected by the current crisis.

For example, a recent report published by Autonomy reported that three quarters of the people working in jobs most at risk of contracting Covid-19 are women – this includes nurses, carers and home-carers.

In general the health gap has grown between wealthy and deprived areas. One aspect of this is the link between deprivation and access to healthcare services.

Digital exclusion. is a significant barrier to accessing health and social care services, information and support is being highlighted during the COVID-19 pandemic. Digital exclusion particularly affects  economically inactive, disabled and older people.

In a recent blog for the Joseph Rowntree Foundation, the Addressing Poverty Through Lived Experience Collective call for, ‘the Government to find practical solutions to cross the digital divide and introduce free wifi for vulnerable low-income groups.’

Cancer care and inequalities

During the pandemic, those with existing conditions will face greater risks. In particular, people with cancer may have reduced access to important treatments.

Before the COVID-19 outbreak we knew that the social gap for lung cancer survival was widening. In other words, socioeconomic status is becoming a stronger predictor of whether or not a person survives lung cancer. This could be exacerbated by this crisis -survival is linked to earlier diagnosis, which requires access to screening and diagnostic services.

In general, people in underserved communities already face multiple barriers to accessing the health services they need – relating to practical, financial and geographic factors.

This also includes racial and cultural differences. For example, black and minority ethnic patients report more negative experiences of cancer care than white ethnic groups. Generally it’s likely that these barriers will increase and negative experiences may worsen – The Runnymede Trust predicts that the corona virus may increase race inequalities,

 What can be done about health inequalities?

The NHS long-term plan, published in January 2019, prioritised health inequalities and made further promises towards tackling the shocking gaps between health outcomes for different social groups. The plan particularly focused on the health behaviours underpinning ill-health – smoking, poor diet, high blood pressure, obesity, and alcohol and drug use.

However, it seems that it missed something by blaming individual behaviour and not addressing the structural inequalities we face in this country. During the pandemic, individual behaviour has been touted as a ‘cure’ for COVID-19 –  stay at home to save lives.

Whilst this is important it may again overlook inequities in society that may make spread of and recovery from the virus worse. For example, staying at home is not an option for everyone – what if your home is unsafe or at a very basic level you do not have a home?

In his 2020 review, Marmot called again for, ‘a national strategy for action on the social determinants of health with the aim of reducing inequalities in health. ‘ This has been supported by the Royal College of Physicians who have urged the prime minister to accept all of the report’s recommendations and to go even further with policies to address health inequalities across the country.

This is even more vital now.

 A first step is to highlight the experiences of underserved groups. Justice Studio and I work to ensure equal access to health by including groups of people who might otherwise be overlooked within health system research. For example, for Prostate Cancer UK, we highlighted the  needs of black and minority ethnic patients and their supporters as well as men who identify as gay and bisexual.

For Anthony Nolan we uncovered specific difficulties for patients from disadvantaged backgrounds in returning to work. Finding links between lower education levels and unemployment post-stem cell transplant.

Justice Studio is now conducting research into the experiences of older people with underlying health conditions during the pandemic.

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Health is a social justice issue      

Keeping social justice at the heart of health research and service development, will help work towards ending broader social injustices. To ensure everyone can lead as healthy lives as possible.

I hope that policy makers now more than ever heed Marmot’s call for social change to ensure health change. If so, then in another ten years’ time, not only will we be met with more positive statistics, but a -more socially and economically just world will be reflected in our very bodies and wellbeing.


Anneliese Levy is a Justice Studio Associate and health communications specialist. More on Anneliese and her work can be found on her website.

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Anneliese

Equality and Justice Alliance Forum February 2020

Equality and Justice Alliance Forum February 2020

Last week I was at an activist forum in the beautiful location of Seychelles. LGBT+ and women’s rights campaigners from the Pacific, the Caribbean, and Africa gathered together, under the umbrella of the Equality and Justice Alliance (EJA), to talk, share and laugh, in a very nice setting indeed.

The tropical island location has not gone unnoticed, with a sense of guilt, by the participants. There were many concerns that people might judge them for being in such a typical holiday destination, and particular worries of being judged too privileged by those from their home countries. They were worried that it might be seen as too nice for a bunch of human rights activists that, what, I guess feel they are meant to suffer.

It is sad that these tireless individuals, who face death threats, sexual harassment, and the anxiety that accompanies not being able to be with the one you love legally, feel that they somehow don’t deserve to work in a comfortable location. I’m pretty sure that the attendees of Davos do not have these sorts of conversations with each other. There is a certain entitlement in those circles that is clearly not present here.

This forum is work in any case, and arguably much more impactful than what goes on at the World Economic Forum. The EJA was set up as a two year alliance of partners: the Human Dignity Trust who fight for the decriminalisation of consensual same-sexual activity; the Kaleidoscope Trust who uphold the rights of lesbian, gay, bisexual and trans (LGBT) people;  Sisters for Change combatting violence against women and girls through legislative reform; and the Royal Commonwealth Society who champion human rights, equality, and democracy across the Commonwealth. These partners have been working across the globe countries to specifically target the laws that discriminate against LGBT+ people and women.

But let’s not forget that these gender discriminatory laws were instruments of British imperial patriarchy. So, the fact that the donor is the FCO seems fitting, but even potentially hypocritical. I think it’s the very least they can do. Whilst Britain has signalled some regret, no clear apology or unequivocal recognition of the damage of imperialism and the discriminatory gender laws and legal structures that it left behind, has been made. There is still a public un-knowing about where this legal discrimination came from, both in Britain and across the Commonwealth. The history needs to be better understood and acknowledged.

These activists are doing a brilliant job to work towards equality and legal reform. The Live and Let Live campaign just launched in Belize on TV, twitter and Instagram is a campaign promoting inclusion by raising the voices of those who support those who suffer discrimination. The #Reform53 campaign is a youth led movement to compel Commonwealth leaders at the 2020 Commonwealth Heads of Government Meeting (CHOGM) to reform laws that discriminate against women and LGBT+ people. Before EJA, amazing work was being carried out by the independent civil society groups, such as Equality Bahamas, and V-Pride in Vanuatu.

To spread activism knowledge a whole load of research has been produced thanks to the EJA. Good practice, guidance, research and mapping studies have been conducted, such as on creating compliant sexual offences laws, a review of anti-discrimination law and the series launched at the Forum that our own research was part of: Building Stronger Equality Movements, which encompassed research on managing backlash; promoting intersectionality; and increasing intergenerational solidarity.

For our research, which focused on intergenerational activism, we interviewed younger and older activists across ten commonwealth countries such as Fiji, the Bahamas, Botswana, Nigeria and Uganda. They told of the challenges and benefits of working across the generations. Clearly, there is a need to have the wisdom of the older activist generation; communicating the history of what has gone before can benefit younger activists who then know where they have come from, and what needs to be done next. Younger activists can then drive the movement into the future, standing on the shoulders of their forebearers, and creating more strength and sustainability.

Given how long women and LGBT+ people have suffered under discriminatory laws and structures imposed by Britain, how much work the activists do, and how little recognition they get, I don’t even think they should have to justify a meeting in a nice location. They deserve this, and so much more. I’m sure they would swap it to be able to walk down their own streets without abuse. If it wasn’t for these people constantly facing danger, getting up to challenge prejudice and battling in court and against Parliament, many of us would suffer so much more than we realise. Activists’ wellbeing should be a much higher priority to us and to themselves. Many of the participants are volunteers so it is hard for them to even get here or get time off. They deserve what little respite there is.

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Marianne

OECD – the ‘PISA’ of the Globalization Puzzle

OECD – the ‘PISA’ of the Globalization Puzzle

The Organisation for Economic Co-operation and Development (OECD) has come to dominate global education policy. Since 1991, education has increasingly come under the remit of the OECD, and its Programme for International Student Assessment (PISA) test has become the main export of the organisation. It tests 15-year-old students from 90+ countries or economies in three-year intervals. They are examined on natural language, mathematics and science, with a different ‘main’ subject of focus each time.

The OECD began in the post-world war II period of political and economic recovery. A United States invention to supersede the Organisation for European Economic Cooperation (OEEC), it was an intergovernmental institution of northern industrial economies cooperating to steer global economic development. It has a high-profile invitation-only membership, leading it to be commonly regarded as a ”rich boys club”. This elite group, which includes the US and UK, are now extending its invitation to developing economies such as Colombia and Lithuania in order to widen its influence.

This influence has meant that the OECD is a useful export of imperialist values. Since its inception, its member states have spearheaded the drive towards neoliberal globalisation in its promotion of industrial and technological advancement, free trade, and global market expansion whilst simultaneously privatising industries, retreating the state and dismantling social welfare.

The OECD has used the allure of its ‘objective, scientific, evidence-based data’ to translate national test results into global ‘best practice’. Presented in league tables, ranking nations performance, and published in reports, the results appear credible and objective. However, all is not as clear cut as it seems. The data has received much statistical criticism. These include: the usefulness of calculating a national ‘average’ in diverse education systems; low participation rates; the irrelevance of survey questions for the school’s curriculum; and the validity of tracking ‘progress’ when the survey questions are different each round due to the ever-changing subject focus. These issues mean the range of possible rankings in a league table for a given country can be very wide. So much so that the OECD has admitted to ranking countries based upon the cryptically vague  ‘’plausible values’’.

There are a number of issues with uncritically accepting this data. For example, OECD data presents numerical data as telling a story of ‘success’ or ‘failure’ but rarely draws upon the context of the nation’s schooling. The façade of ‘global’ best practice emphasises a northern neoliberal approach and dismisses culturally relevant and more meaningful local policy options. PISA results encourage the global race towards a unitary vision of what is ‘successful education’. The scientific data assumes rationality and neutrality in order to create an illusory ‘best practice’ that makes disputing these global education trends difficult in a world that privileges ‘the scientific method’. Yet we know the way data is explained is very much tied to the value systems of specific influencing countries like the US and UK.

Further, the use of whole nations as ‘benchmarks’ is causing a new global education rivalry. PISA results are now so important that they intensify competition between national education systems. For example, in 2002, Finland was pleasantly surprised that they came first in the results and were now positioned as the forerunners in education models. Germany, however, was shocked to come 20th amongst 32 countries. This led German politicians to reform their education system, ending in a significant decision to introduce a large-scale assessment at the end of primary and secondary schooling. The entry of ‘Asian tigers’ in PISA in 2009 knocked Finland off the top spot, and Shanghai became the new ‘poster boy’ for global education policy discourse. Michael Gove, former Education secretary for the UK, used the impassioned language of Britain’s ‘plummeting’ PISA scores for sweeping education reform to implement the ‘Shanghai-method’ which echoed an OECD sanctioned neoliberal privatisation of education through increasing the number of academies, free schools and intensifying exams for ‘performance-related pay’.

The OECD has fostered an audit culture that monitors education insofar as its ability to produce a ‘knowledge economy’. In the global neo-liberal framework, economic prosperity as a motivating factor for education provision has since overtaken ideals of social justice and egalitarianism. The privileging of efficiency has led to a standardisation of ‘quality education’ resembling a corporate governance model in a capitalist system that centres on competition, surveillance, and privatisation in schools. The ‘streetlight effect’ has meant governments focus on subjects where measures of educational performance are well lit (quantifiable and accessible) such as maths and sciences whilst the arts are being scaled back or dismissed.

Two new initiatives: PISA for Development (PISA D); and ‘PISA Global Competency’, embed this dangerous influence further. PISA-D was created to support the monitoring framework of the Sustainable Development Goals (SDG’s) which intended to tailor surveys for a broader set of countries, namely low and middle-income countries. Seemingly the OECD desires to absorb these countries into the prevailing system of quality assurance as opposed to altering its own vision of success in education. PISA Global Competency was forged to support SDG target 4.7. which aims to foster cultures that promote ‘sustainable development’ through ‘education of sustainable development and sustainable lifestyles’. ‘Global competence’ is defined by the OECD as ‘skills’ and ‘mind habits’ for ‘global interdependence’ to live with ‘meaning and direction in contexts where global interactions increase exponentially’, raising deep conceptual criticism of what constitutes the ‘global’ and who is determining the ‘meaning’ and ‘direction’.  It goes far beyond ‘sustainable development’ into something much deeper – changing cultural values. The compounding effect of PISA D and PISA Global Competency contributes to the widening and deepening of OECD’s governance to endorse neoliberal globalisation beyond the market, beyond the classroom and into selfhood.

Ignoring both the cultural context of education systems and down-grading less quantifiable, arts-based education endangers a generation of learners. We believe that in many ways it is these aspects of education that have much more to teach us all about resilience and creativity in a rapidly changing world. Justice Studio has assisted a number of clients such as the Wessex Dance Academy and Hampshire Cultural Trust who are proving that arts-based activities can be transformative both for the individual learner and their environments. It is crucial that we embrace all forms of education, and not reject the aspects that are harder to quantify within the terms the neo-liberal value system has imposed.

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Esra

Election 2019 Manifesto Analysis

Election 2019 Manifesto Analysis

The UK General Election, set for Thursday 12th December, presents an opportunity for all parties to improve social justice. Focusing on the manifesto commitments towards criminal justice, Justice Studio sets out the main parties’ approaches to young people, human rights law, policing, gender-based violence, legal aid, the courts, prisons and terrorism.

Young people

At the age of 10, children are legally responsible for crimes they commit, whilst being deemed too irresponsible to vote. None of the parties tackle our criminally low age of responsibility, however, both the Green Party and the Liberal Democrats want to extend the right to vote to 16 and 17 year olds.

In terms of disrupting the path of young people towards crime, Labour and the Conservatives focus on youth services, with Labour stating that they would ‘rebuild our youth services and guarantee young people’s access to youth workers.’ The Conservatives would invest £500m in new youth clubs and services and promote the National Citizen Service in schools to bring communities together. The Greens would also ‘invest in youth services and centres’, helping turn at-risk children away from crime. This is especially important for the Greens in ending knife crime. The Liberal Democrats’ ‘public health approach’ to youth violence would provide a £500m ringfenced youth services fund to local authorities to reinvest in youth services, as well as embedding ‘trauma-informed Youth Intervention Specialists in all Major Trauma Centres.’

With regards to school exclusions, the Conservatives take a punitive approach, wanting to expand the practice, backing heads to use exclusions and helping teachers to tackle bullying, whilst the Lib Dems pledge to reverse the damage of exclusions to young people, giving local authorities the responsibility for exclusions. The Greens promise to create ‘a fully inclusive education system’.

Labour commits to invest in a youth justice system where young people are diverted from crime through co-operation between schools, local, health and other authorities. They also commit to tackling the disproportionate levels of BAME children in custody. The Greens similarly pledge a cross-government strategy to tackle ethnic inequalities, ranging from school exclusions through to biased treatment in the criminal justice system. The Conservatives reiterate their plan for trialling Secure Schools for existing offenders. They also pledge to ‘establish Violence Reduction Units to prevent serious crime, requiring co-operation between schools, police, councils and health authorities. The Brexit party pledge to ‘abolish distortive targets’ and introduce sentence ‘ranges’ for young offenders to encourage rehabilitation.

County Lines is only addressed specifically by the Brexit party and the Conservatives. The Conservatives would strengthen the National Crime Agency to tackle county lines gangs, child sexual abuse and ‘eradicate human trafficking and modern slavery’. 

Sentencing and Human Rights

Many of the parties want to introduce new sentencing policies; either creating more sentences or less. Both the Liberal Democrats and the Conservatives promise to introduce stronger penalties for animal cruelty offences. For the Lib Dems, that means increasing maximum sentencing from six months to five years and properly funding the National Wildlife Crime Unit. In order to address homelessness, both Labour and the Liberal Democrats pledge to scrap the Vagrancy Act so that rough sleeping is no longer criminalised.

On drugs policy, the Greens stand out with a radical decriminalisation agenda, to ‘end the war on drugs’. They want to repeal the Misuse of Drugs Act 1971 and the Psychoactive Substances Act 2016, pardon and expunge the criminal records of those previously convicted for possession and small-scale supply of drugs, and create an ‘evidence-based, legalised, regulated system of drug control.’ They would have an Advisory Council for Drug Safety and promise that the production, import and supply of all drugs will be regulated according to the specific risks they pose to individuals, society and the environment.

The Human Rights Act is mentioned by most of the main parties, except the Brexit party. The Conservatives state that they will ‘update the Human Rights Act to ensure proper balance between individual rights, national security and effective government’. Labour will ‘retain and promote’ it, and the Lib Dems pledge to ‘defend the Human Rights Act, resist any attempt to withdraw from the European Convention on Human Rights and oppose any laws that unnecessarily erode civil liberties.’ The Greens will similarly retain the act as well as reaffirming the UK’s commitment to the European Convention on Human Rights. They also pledge to introduce a ‘Digital Bill of Rights’ and a new law on ‘Universal Jurisdiction’, to make it easier to prosecute genocide, crimes against humanity and war crimes.

Policing

Policing is a high profile topic and as such all national parties have addressed it to some degree in their manifestoes. The Conservatives have been headlining with an increase in uniformed officers by 20,000 since Boris Johnson was selected as leader, and this is included in the manifesto. Labour has committed to recruit 2,000 more officers than the Conservatives, bringing total police numbers to 1,000 above the level at which it stood in 2010. The Brexit party also promises an unspecified increase in police numbers. The Liberal Democrats’ manifesto sets out an investment of an extra £1billion in community policing and emphasises that stopping Brexit will mean continued transnational police and security co-operation via agencies like Europol and the European Arrest Warrant. The Greens would create a new role: ‘community liaison and equality officers’.

The Lib Dems, Labour and Conservative manifestoes all touch on cybercrime, technology and new threats. The Conservatives pledge to create a new cyber crime police force and to enable the police to make use of biometrics, artificial intelligence, and DNA. The Lib Dems promise a new Online Crime Agency and Labour say they will review the role of the National Cyber Security Centre to examine expanding its remit, and strengthen the ability of the NCA to deal with economic and cybercrime.

Mental health features prominently throughout the Liberal Democrat manifesto. They pledge to end the use of police cells in cases of mental health crises, and to establish mental health liaison teams in all hospitals. They also set a one hour target of handing over mental health crisis cases from the police to public health officials.

None of the manifestos are especially strong on police accountability. The Liberal Democrats even propose the abolition of democratically elected Police and Crime Commissioners. There is also a degree of different parties appealing to supposed core constituencies: the Conservatives mention rural crime, the Brexit Party talks about cracking down on illegal immigration and both Labour and the Liberal Democrats mention stop and search.

Gender Based Violence

All of the main parties, with the exception of the Brexit Party, make pledges to tackle gender based violence. The Greens are the most comprehensive on this. They would develop and implement ‘a UK-wide strategy to tackle gender-based violence, including domestic violence, rape and sexual abuse, Female Genital Mutilation (FGM), and trafficking’. The Conservatives and Labour take a more enforcement approach. The Conservatives pledge to ‘fight crimes against women’ and to increase ‘community support for victims of rape and sexual abuse’. Labour will ensure better police training on domestic abuse and offences arising from coercive control, as well as establishing an independent review ‘into shamefully low rape prosecution rates,’ and promise a Commissioner for Violence against Women and Girls.

The Liberal Democrats, Labour and the Greens want to roll back the effects of Conservative austerity cuts to survivor centres and support. The Lib Dems would expand the number of refugees and rape crisis centres ‘to meet demand’, giving local authorities the duty and funding to provide accommodation and support for survivors, and establish a national rape crisis helpline. Labour promises to reverse cuts to legal aid so survivors aren’t forced to represent themselves against their abusers in court. The Greens would similarly ‘roll back the cuts to support centres and refuges, and increase funding to provide more safe and secure accommodation for women and their children. They would ensure Rape Crisis Centre services receive ‘sustainable funding’ so that all survivors ‘receive proper support’. This would include increasing and ringfencing the Rape Support Fund and ensuring funds are provided via the Victim Surcharge.

Most of the parties had policies related to the Domestic Abuse Bill. The Conservatives pledge to pass the bill, Labour pledge to reintroduce it, whilst the Greens pledge to introduce a new bill, which ‘enables prosecution of economic abuse.’ The Liberal Democrats would ‘legislate for a statutory definition of domestic abuse that includes its effects on children.’

On other issues, only the Liberal Democrats set out their commitment towards ratifying and bringing in to law the Council of Europe Istanbul Convention on violence against women (2011). The Greens want to make misogyny a hate crime and ensure that this recognises the groups of women who are most at risk.’

Legal Aid

Eighty per cent of the population was eligible for legal aid when it was first introduced 70 years ago; only an estimated 20 per cent are today. The legal aid budget stood at £2.2bn before the coalition government introduced the Legal Aid, Sentencing and Punishment of Offenders (LASPO) act in 2012, intended to reduce spending by £350m while reducing the scope of civil legal aid cases.

Labour devotes the most attention to the issue of all the main national parties. It would reverse LASPO cuts, restoring all early legal aid advice for housing, social security, and family cases. The party would also restore legal aid to immigration cases, though in October the government brought legal aid back into scope for separated migrant children. Labour would also consult on the civil legal aid means-test levels and act on the criminal legal aid review. The manifesto commits to ensuring legal aid for inquests into deaths in state custody and the preparation of judicial review cases.

While not as far-reaching as Labour, the Liberal Democrats would establish a ‘new right’ to affordable, reasonable legal assistance, pumping £500m into the legal aid system. The legal aid budget currently stands at £1.6bn, roughly £950m less in real terms than its 2010 levels.

As mentioned, the Greens also commit to reversing cuts to legal aid to protect survivors of gender-based violence from having to represent themselves against their abusers in court. Some 18 per cent of all cases in 2016 were self-represented, compared to just two per cent in 2010.

The Conservatives make general pledges to look at ‘broader aspects’ of the constitution, which includes access to justice for ordinary people, though they fail to outline any formal commitments.

Courts & Judges

Attempts to legislate about the court system itself may be perceived as an effort to curb its independence and upset the democratic balance. In a democracy, an independent judiciary ensures that there are proper checks and balances and that the executive does not exceed its remit when implementing the law as set by the legislature. Nevertheless, all of the main parties, with the exception of the Green Party, make pledges on the courts system.

The Liberal Democrats say that they would like to improve diversity among judges as well as other professions within the justice system, such as police and prison officers, by adopting ambitious diversity targets with regular reporting to parliament. Labour, too, say they would like to see a more ‘representative’ judiciary, whilst upholding its independence.

In contrast to the other parties, the Brexit Party appears unconcerned about the principle of ensuring that judges remain independent of politicians. They propose ‘reforming’ the Supreme Court so that judges who play a role in politics (which is not well defined in the party’s manifesto) are subject to political scrutiny. They would like to ensure political balance among the justices by broadening participation in the Selection Commission or conducting interviews by Parliamentary Committee, essentially leading to a US-style system of party political judge appointments. The Conservatives, meanwhile, promise to make judicial review available to protect against an overbearing state, while ensuring it is not abused to conduct politics by other means.

On courts, Labour pledge to end the programme of court closures and to review the funding of the Crown Prosecution Service. They also promise to keep employment tribunals free, extend their powers, and to introduce new Labour Courts with a stronger role for people with industrial experience on panels. The Conservatives promise and provide costings for a pilot of integrated domestic abuse courts that address criminal and family matters as part of the same process.

Prisons

Prisons fluctuate between being a critical political issue and being largely ignored. The hyper-incarceration crisis set in motion during the Blair years is continuing, albeit to a lesser degree than when the incarceration rate reached its peak in 2012. Prison occupancy is currently running at 111%, with overcrowding significantly worse than that in some facilities. With this in mind, the Conservative pledge to create 10,000 more prison places may appear sensible, but this seems to be an admission of defeat with regard to ensuring that more people do not re-offend and continue to return to prison.

The Conservatives also propose to create a ‘prisoner education service’ focused on work-based training and skills and to improve employment opportunities for former offenders, including a job coach in each prison. In stark contrast they also pledge to maintain the ban on prisoners being able to vote: arguably preventing prisoners from engaging in civic life seems counterintuitive to encouraging them to participate in rehabilitative activities and taking civic duties such as voting seriously.

On prisons, the Lib Dems echo the focus on improving mental health seen elsewhere in their manifesto. They pledge to treat mental health problems with the same urgency as physical health and to ensure the continuity of treatment between prisons and the community. They, too, mention rehabilitation, pledge to recruit 2,000 more prison officers and to improve the provision of training, education and work opportunities.

Labour’s stance reflects the party’s current broader view of the workforce and the economy. Similarly to their police officer pledge, they plan to restore total prison officer numbers to 2010 levels and to phase out lone working which they view as being dangerous to staff. Furthermore, they pledge to bring PFI prisons back under state control and promise that there will be no new private prisons. They also promise to tackle the prison maintenance backlog and develop a long-term estate strategy, reflecting a degree of technical understanding of the challenges of outdated buildings and infrastructure.

The Greens plan to halve the prison population and to ‘expand’ restorative justice. They will enhance the rehabilitation services on offer to long-term prisoners and commission rehabilitation services that have a track record of success. They will furthermore support the development of specialist women’s centres in order to reduce the female prison population. The Brexit Party’s manifesto has nothing to say on the subject generally.

Extremism and Terrorism

The threat of extremism has gained renewed attention in the wake of the recent London Bridge attack, prompting the Conservatives to announce a new policy to enforce minimum sentences of 14 years for serious terror offences.

The government’s hallmark anti-radicalisation programme, Prevent, has come under intense criticism for its impacts on the Muslim community. Labour, which introduced the strategy in 2003, has said it would review and consider replacing Prevent with alternative safeguarding programmes to protect the most vulnerable. The Greens would replace Prevent with ‘community cohesive policing’ to engage BME communities.

There is a balance to be struck between security and civil liberties. Labour would ensure security powers are exercised proportionately. Both the Lib Dems and Conservatives would provide funding and protection to places of worship. The Conservatives would also improve safety at public venues, while the Lib Dems would limit the use of technology in intrusive domestic surveillance.

The Conservatives would invest in the security services to give them the necessary powers and tools to combat new threats. Immigration controls would prevent entry for serious foreign national offenders and ensure those already here are deported. The Brexit Party’s ‘clean-break-Brexit’ would allow the UK to control its own borders and national security.

Labour would ensure closer counter-terrorism coordination between the police and security services, combining international intelligence with ‘neighbourhood expertise.’ The party also promises to strengthen scrutiny and accountability, while constraining the Prime Minister’s power to suppress the publication of committee reports. The Greens would replace the Home Office with Ministries of Sanctuary and of the Interior to oversee domestic security and protect human rights.

The Conservative manifesto reiterates the party’s commitment to existing multilateral power bases in the UN and Five Eyes and would champion collective security by exceeding NATO spending targets. Labour would respect international law to counteract global threats and agree a new UK-EU Security Treaty. The Lib Dems would defend against nationalism and isolationism through the UN and NATO while strengthening existing EU crime-fighting tools.

 

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99 years by his name

99 years by his name

IMAGE USE:  Photo by Matthew Ansley on Unsplash

There is nothing so heartbreaking as interviewing a boy in prison with ‘99 years’ written by his name. I can still see him: hazy, and unsure of himself and the draconian sentence he had just received, as I interviewed him in a Youth Offending Institution, back in 2010.

I was undertaking a detailed study of young people in England and Wales who had been given long-term sentences for the Youth Justice Board. One of the things I had to establish was if the young people understood the ‘nature and implications of their sentence’. This boy sticks out because he most certainly did not understand the nature and implication of his sentence. He, like many young people who received that impossibly long punishment, believed his first date for parole in a couple of years was actually his release date.

At the time, in 2010, there were four long term sentences being given to children. Two of them had determined end dates (Section 91 and Section 228) and two of them had indeterminate end dates (Section 90 and Section 226). In these last two, the court specifies a minimum tariff that is required to be served before the child is eligible to apply for parole. It’s not when you leave, it’s when you get a chance to leave.

Detention at Her Majesty’s please, (Section 90), is the life sentence; it applies to those under 18 years convicted of murder. Brought in under the 1908 Children Act, it replaced the death penalty for children: ‘… in lieu thereof the court shall sentence the child or young person to be detained during His Majesty’s pleasure’. The current provision is within the Powers of Criminal Courts (Sentencing) Act (PCC(S)A) 2000, Section 90.

Section 226 was the DPP – Detention for Public Protection – the child version of the IPP: the Indeterminate Sentence for Public Protection. Brought in by the Criminal Justice Act of 2003, it was a draconian, hard-line sentence, designed for a few. For both children and adults, they were life sentences for serious offences excluding murder and they came with a blanket 99 year licence. The court set a minimum tariff to be served before the young person may apply for parole. This was 12 months for those sentenced before 14 June 2008, and 2 years for those sentenced on or after that date.

The judges went to town on this new sentencing power. Thousands of adults and children were given IPPs and DPPs in the preceding years. At their peak, in June 2012, there were 6,080 people serving indeterminate Section 226 sentences.

Civil society organisations warned of the dangers of IPPs. The Centre for Mental Health wrote that ‘levels of mental distress are higher among IPP prisoners than among either the general prison population or prisoners serving life sentences’. The Prison Reform Trust highlighted that IPP prisoners were emotionally distressed and that the sentence eroded of any sense of hope, damaged relationships and created Kafkaesque obstacles to discover when they have any prospect of release.

A joint review by Her Majesty’s Inspectorate for Prison and Probation in 2008 highlighted the case against child DPPs, showing that in addition to the problems above, many young people didn’t even understand the sentence that had been doled out to them. Whilst they knew they were considered a risk to the public, most young people initially thought that their tariff date was their release date, like my young man above. This was precisely why we found ourselves talking to child after child who had inconceivably long sentences by their names in that 2010 research and trying to establish if they actually realised what this meant.

During the research, we spoke to a number of staff members who were particularly worried about the implications for children on indeterminate sentences. Prison is damaging for a child in general, but the psychological distress associated with the uncertainty of having no idea when one will get out is even more traumatic. Mental health problems were exacerbated by the indeterminate nature of sentences, and that one might leave at some point via parole is no relief if you don’t understand this, you don’t have access to the courses necessary to secure your release, and if the parole board doesn’t understand you.

The outcry, the bulging prison population, and a sympathetic new Justice Secretary Kenneth Clark saw the Section 226 IPP and DPP sentence abolished in December 2012 by the Legal Aid, Sentencing, and Punishment of Offenders (LASPO) Act. However, because LASPO was not implemented retrospectively, the sentenced DPP and IPPs remained. There were 5,809 IPPs serving in 2013 with 3,570 serving beyond their tariff date.

In England and Wales, we can boast the highest number of people serving indefinite detention in Europe. Overall, in the prison estate, there were 9,342 (8,994 male; 348 female) indeterminate sentenced prisoners (including both IPPs and life sentences) at the end of June 2019. Within this statistic hides the 19 young people aged between 15 and 17 who are detained at Her Majesty’s pleasure, a sentence that remains alive and well.

By the end of June 2019, there were 2,315 people: 2,273 males and 42 females, serving that botched and awful sentence the IPP. A depressing 92% of these prisoners are now serving beyond their original tariff date.

Almost ten years on I wonder: is that uncertain boy, now a man, one amongst these statistics? If he is, he must grimly understand his sentence now.

 

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Marianne