Statement: Queermed welcomes visualization of the problems through study results
- Samson Grzybek
- Köln
- A study by the Federal Anti-Discrimination Agency shows that people affected by discrimination in the healthcare sector are very often left to fend for themselves
- Queermed Managing Director and founder Sara Grzybek welcomes the fact that the results of the study have made this problem visible and also sees a strong need for action to strengthen the rights of patients and provide them with more information on where they can turn in the event of discrimination.
As the Federal Anti-Discrimination Agency also knows from its own 2017 study, one in four people surveyed experience discrimination, including in the healthcare sector. With a participant base of over 16,000 people, it is clear how many people may be affected nationwide.
According to the Federal Anti-Discrimination Agency, the AGG also applies to medical treatment contracts. Unfortunately, it has not yet been legally clarified whether those affected can invoke the AGG in the event of a lawsuit. However, it is important that people have a right to non-discriminatory treatment, especially in the healthcare sector.
Complaints mechanisms barely visible, although legal obligations exist
The results of the study rightly point out that hospitals and rehabilitation clinics in particular are legally obliged to set up a complaints office for patients and to advise patients in this regard. In addition, there are also chambers for outpatient practitioners, where complaints and reports of discrimination can be submitted. For practitioners without a chamber (e.g. physiotherapists, midwives), the health authorities are one of the possible points of contact. Otherwise, health insurance companies or the practitioners themselves can also be points of contact for discrimination cases. However, the latter are not the ideal contacts in such cases for various reasons.
In addition, there are counseling centers throughout Germany that support those affected not only in cases of discrimination in the healthcare system, but also in other areas of life.
As the study explains, all of these contact points differ greatly in their working methods and the extent to which they advise and support affected patients and also take up or pursue cases of discrimination.
The following research questions were asked in the study:
- What contact points and complaints offices exist and to what extent are they responsible for complaints and inquiries about experiences of discrimination?
- Do the contact points and complaints offices provide information about this responsibility and to what extent are they known?
- Who do those affected turn to and how high is the volume of complaints and inquiries at the contact and complaints offices?
The study also mentions that care facilities, both inpatient and outpatient, were not included in the study. Queermed would welcome it if this topic area were also addressed in the near future, as there are many reports of cases of discrimination and homicide in care facilities in Germany, especially when it comes to people with disabilities, and we also need a comprehensive source of information here in order to argue calls for action.
It is important that such questions are asked, because Queermed’s work also shows that people often do not know who to turn to in the event of discrimination in the healthcare system. At the same time, it is good that this study addresses the various levels of discrimination (racism, misogyny, ableism, ageism, homophobia, classism, ableism and discrimination based on religious affiliation) that are also visible in Queermed’s work, and also that the intersectional levels of the various discrimination factors can be interlinked.
Complaints offices in the healthcare sector: Nothing reported so nothing happens?
The results of the study show that the surveyed contact points in hospitals and rehabilitation clinics received hardly any complaints in 2021.
This is not surprising when we look at how rarely patients are proactively informed of their options for making a complaint in the event of experiencing discrimination. The figures in Figure 9 from the study results show that there are shockingly few references informing patients about their options for action in the event of discrimination during their hospital or rehabilitation stay. This means that patients are once again left alone and have to deal with the issue themselves. At the same time, the issue of discrimination is made invisible, although there are also many reports and studies that highlight cases of discrimination in the healthcare sector.
Furthermore, it can be stated that although there have been complaints with different levels of discrimination, these are received alarmingly rarely by the responsible authorities in hospitals and rehabilitation clinics.
This is in line with the findings we have from the NaDiRa report from 2023, among others, in which respondents stated that they did not make use of healthcare services for fear of experiencing further discrimination.
The question also arises if those affected are not informed whether they feel safe enough to file a complaint at all if it is not clear how sensitized the people in the responsible complaints offices are. Not only is there often a lack of awareness of intersectional realities, discrimination-sensitive work with patients or an understanding of anti-bias among hospital staff, but patients cannot take it for granted that they will be met with understanding in the event of discrimination.
What can we do to enable patients who have experienced discrimination to claim their rights?
As the study correctly states, there are several starting points for empowering patients in their rights.
The following recommendations for action can be derived from the study
- Improve access to existing counseling and complaints options through better information and accessibility.
- Professionalization of contact points through training and clear guidelines on how to deal with discrimination.
- Embedding complaints procedures in a comprehensive strategy for preventing and dealing with discrimination in healthcare institutions.
Only by informing patients about their rights and options can they act in a self-determined manner. This also includes informing more people about topics such as the “Patients’ Rights Act” in the German Civil Code, so that they know what rights they have in the healthcare system and what obligations healthcare providers have in return.
It is also important that those responsible in the complaints offices not only draw attention to themselves and their work, but are also made aware of it institutionally. With the certainty that discriminatory behavior has consequences. Patients must not be left alone with their experiences in the healthcare system.
“Discrimination does not stop at the doors of surgeries and clinics. Patients must therefore be informed about their rights and options so that they can act independently in such cases and are protected from further experiences of discrimination. There needs to be a comprehensive improvement in complaints management in institutions such as clinics and hospitals, but also in health insurance companies, chambers and health authorities. We need healthcare that doesn’t make us sick.”- Sara Grzybek, founder and managing director of Queermed Germany
Click here for the results of the study by the Federal Anti-Discrimination Agency:
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