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Access to diabetes services: the experiences of Bangladeshi people in Bradford, UK

Recent years have seen a renewed emphasis in UK healthcare policy on access to services, yet there has been little research into possible inequalities in access for people from different ethnic backgrounds. This paper examines access from the point of view of a group of Bangladeshi people with diabetes, whose views were obtained as part of a wider evaluation of diabetes services. Their message is a powerful one. The problems they experienced, however, cannot be attributed solely to cultural insensitivity, in which providers adopt a ‘like it or lump it’ approach. The wider evaluation provides a context within which to identify similarities with, as well as differences from, other groups in the community, and the findings show that the experiences of this vulnerable group highlight more general weaknesses in service provision. The paper also shows that conventional analysis of access in terms of barriers to be overcome misses a crucial dimension: the ability to make full use of services. Gaining access does not mean that needs will be met appropriately, and patients vary in the extent to which they are able and enabled to play an active role in obtaining the services they need.