Forum

AROUND THE WORLD WITHMEN’S HEALTH AND WOMEN’SHEALTH ORGANIZATIONSMEN’S HEALTH FORUM: ENGLAND AND WALES

The gender equality duty became law in the that contains essential information on the It would, of course, have been unrealistic

United Kingdom in April 2007. This legisla-

tion received relatively little media attention

but has the potential to transform the way

public services are delivered. It requires all

such services (including the National Health

Service (NHS)) to tailor their activities to

meet the particular needs of men and

women and to ensure equitable outcomes

between the sexes. The duty effectively

‘mainstreams’ gender in public policy and

service delivery and embodies the kind of

approach the Men’s Health Forum (MHF)

has advocated for several years. Its impact

on men’s health, as well as women’s, could

be significant.

The Equal Opportunities Commission

(until recently, the lead statutory agency

tackling sex discrimination in the UK) high-

lighted men’s under-use of General Practi-

tioner (GP) services as one significant health

issue that should be addressed through the

gender equality duty. Other issues include

men’s under-use of smoking cessation and

weight management programmes, the lack

of health information targeted at men and,

above all, their considerably lower life

expectancy.

Over the past 2 years, the MHF has been

working with the government and other

official bodies to try to ensure that the

new equality legislation really will make

an impact, and also that health policy-

makers and service providers understand

what is required of them.

In addition to organising a number of con-

ferences and seminars and publishing reports

and other information, we have established a

website (http://www.mhfgenderduty.org.uk)

! This section reports recent communications regarding

Mention in this section does not imply endorsement

474 Vol. 4, No. 4, pp. 474–475, December 20

gender equality duty and links to a range of

other sites.

The MHF has investigated the impact of

the new legislation in its first few months of

operation. We focused on the Gender

Equality Schemes (GESs) developed by all

152 primary care trusts (PCTs) in England.

PCTs are critically important NHS organisa-

tions: they assess local health needs, man-

age a wide range of primary care services

(GPs, dentists, optometrists, pharmacists),

commission secondary care services and

control 80% of the massive NHS budget.

Their GESs should have been published by

the end of April 2007 and they should set

out how the requirements of the gender

equality duty will be met.

Our research, completed in late July

2007, showed that compliance with the

new legislation was surprisingly and disap-

pointingly poor. Over one-third of the PCTs

had failed to publish a GES at all. Of those

that did, most failed to comply with the

majority of requirements for a GES, as spe-

cified in the official code of practice. More-

over, the emphasis of most schemes was

also skewed towards internal administra-

tion and process, not how to achieve equi-

table outcomes between men and women.

We have raised our concerns about the

performance of PCTs with the Department

of Health, the Commission of Equality and

Human Rights (the main regulatory body for

the legislation) as well as the PCTs them-

selves. We are demanding immediate

action to implement the legislation in the

way government ministers and parliament

intended.

pharmaceutical products of relevance to men’s health.

of the product by ISMH or Elsevier.

07

to expect that one piece of legislation

would, at a stroke, transform health policy

and services for men. New legislation gen-

erally does not work like that. Moreover,

the gender duty was introduced at a time

when PCTs were undergoing a major struc-

tural reorganisation, when many parts of

the NHS were in financial crisis, and when

staff morale was generally very low.

Furthermore, the NHS, for all its many

achievements, has had a generally poor

record on equality issues and tends to see

them primarily as a concern for internal

human resources (HR), not one for public

facing services. A few key individuals and

initiatives aside, the NHS has, historically,

not shown a significant interest in men’s

health or in a gender-based approach to

healthcare.

While progress might be slow, the new

legislation has at least forced NHS organiza-

tions to begin to consider gender and has

given the MHF and other men’s health and

gender equality activists an important new

weapon. The NHS must no longer address

men’s health because it is an ‘interesting’ or

‘ethical’ thing to do; it must now be

addressed because there is a legal require-

ment to do so. Ultimately, compliance can

be enforced by the courts and transgressors

face significant public embarrassment.

Our involvement as a key ‘stakeholder’ in

consultations organised by the government

and others on the implementation of the

gender equality duty also increased our

profile and credibility, and helped to spread

a greater awareness of men’s health across

several government departments and other

equality organisations. Moreover, the gen-

der equality duty has created an important

new opportunity to establish a new ‘cross-

Forum

cutting’ men’s organisation, provisionally

called the Men’s Coalition, which aims to

bring together organisations working on

health, education, crime, employment, par-

enting and other issues to speak with a single

voice on issues affecting men and boys. This

organization was launched in November

2007 with the MHF in a central role.

Alongside our work on the gender

equality duty, the MHF has been working

on a range of projects designed to improve

policy and practice. These include three

government-funded projects to increase

men’s participation in the national bowel

cancer screening programme, to improve

men’s use of community pharmacy services

and to develop resources to improve the

mental health of black and minority ethnic

men.

The MHF is developing a range of male-

friendly health information booklets – there

are already some 40 titles in stock – and

continuing to develop our http://www.

malehealth.co.uk ‘consumer’ website, which

currently has over 125,000 ‘unique visitors’ a

month. We are now seeking support for

Men’s Health Week in June 2008, when

the focus will be on improving men’s health

in the workplace. We already have govern-

ment support for this initiative.

This is a considerable workload for a

relatively small organisation and we are

sometimes guilty of letting our enthusiasm

for this work override our judgement about

what is practicable. Like many other small

charities in the UK, we also struggle to raise

the funds we need to sustain our activities.

However, we are fortunate to have a

talented and dedicated staff team, suppor-

tive trustees and a wide range of sponsors

and active partners. We know that, by

continuing to work together, we can begin

to end what has been one of the least-

recognised but most significant health

inequalities.

Peter Baker, MA

Chief Executive, Men’s Health Forum,

London, United Kingdom

peter.baker@menshealthforum.org.uk

http://www.menshealthforum.org.uk

Vol. 4, No. 4, pp. 474–475, December 2007 475