The quest for culturally sensitive health-care systems in Scotland: insights for a multi-ethnic Europe

Health systems are serving increasingly ethnically diverse populations. This requires cultural sensitivity/competence. Sharing insights from multi-ethnic countries is important. Insights from Scotland, discussed in this paper, include that the creation of culturally sensitive health systems requires reduction of stigma associated with immigration and immigrants; the wider use of ethnicity alongside, or instead of, race, country of birth, nationality and immigrant status; prioritization of actions using the concept of inequity; understanding that meeting the needs of minorities improves health systems for everyone; more use of anti-discriminatory laws to drive national policy and locality planning; research to assess needs and effectiveness; evaluation of processes and outcomes; institutional and professional sincerity and confidence, and monitoring that policies are implemented and working. Even when conditions are favourable, as in Scotland, the challenges are many, implementation is tough and timescales long. Scotland's record is, nonetheless, comparatively strong in Europe. Sharing experience across national boundaries should spur on progress globally.