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Indirect discrimination in health and care services

This advice applies to Wales

Indirect discrimination can be more difficult to spot than direct discrimination. It’s when you’re treated in the same way as everyone else, but it has a worse effect on you because of certain reasons - for example, because you’re black or gay.

Indirect discrimination is unlawful under the Equality Act 2010. If you've experienced unlawful discrimination, you may be able to do something about it.

Read this page to find out more about indirect discrimination when you receive healthcare and care services.

When is it indirect discrimination?

The law which says you mustn’t be discriminated against is called the Equality Act 2010. Discrimination which is against the Equality Act is unlawful. This means you can take action in the civil courts.

Indirect discrimination is when a healthcare or care provider has a practice, policy or rule which applies to all it’s patients and clients, but it has a worse effect on some people than others because of who they are.

You can challenge indirect discrimination if it has a worse effect on you because of your:

  • age
  • disability
  • gender reassignment
  • race
  • religion or belief
  • sex
  • sexual orientation.

The Equality Act calls these things protected characteristics.

It’s not just individual staff who mustn’t discriminate against you - for example, when a GP makes a decision on how to treat you. Healthcare and care providers must also make sure they don’t discriminate against you when they plan their services. If they decide to do things a certain way or adopt rules which have a worse effect on some people than others, this could be indirect discrimination.


A GP surgery requires patients to provide proof of address when registering. This applies to all new patients regardless of their protected characteristic. But Gypsies and Travellers are less likely to be able to provide a proof of address and therefore they’ll find it more difficult to register.

This could be indirect discrimination against Gypsies and Travellers because of the protected characteristic of race. The rule seems fair, but it has a worse effect on this particular group of people.

You’re an Irish Traveller and want to register with the surgery. You could challenge this policy because you’re personally affected by it.

When is indirect discrimination lawful?

Indirect discrimination when you receive health and care services can sometimes be lawful under the Equality Act.

Justifying indirect discrimination

The Equality Act says it’s not indirect discrimination if the healthcare or care provider can show they have a good enough reason for discriminating against you. This is called a legitimate aim.

The healthcare or care provider would need to be able to prove this in court, if necessary. This is known in legal terms as objective justification.

Charging people from abroad

It’s not indirect race discrimination to charge some people from abroad for NHS healthcare. People who can be charged for healthcare are those who are not normally resident in the UK.

Blood donations

It’s not unlawful for a blood service to refuse your blood donation if there are real reasons to think there may be a health risk to you or other people if you donate your blood. For example, if you’ve recently come to the UK from a country where there’s malaria, it would not be indirect discrimination because of race if you were not allowed to donate blood.

Standards of behaviour

A healthcare or care provider can set standards of behaviour they expect their patients or clients to follow - for example, behaving with respect towards the staff and other patients. It’s not unlawful discrimination if a service provider treats you differently because you’ve behaved in way which is contrary to these rules - for example, by repeatedly insulting a member of staff.

But sometimes, the way you behave could be linked to a protected characteristic. In this case it could be indirect discrimination if someone provides you with a different service because of your behaviour.


Your disability means that you sometimes behave aggressively. Your home care provider has a policy which says its staff are allowed to refuse to provide certain services in case of aggressive behaviour by the client. This policy applies to all the clients, but it's likely to have a worse effect on some disabled people.

If your home carer refuses to provide you with a service because of your behaviour, this could be indirect discrimination unless they could justify their policy. This could also be discrimination because of something connected to your disability. You're discriminated against because of your behaviour which is connected to your disability.

Both indirect discrimination and discrimination because of something connected to your disability can be justified by the service provider if they have a good enough reason.

Next steps

Other useful information

Equality Advisory Support Service (EASS)

If you have experienced discrimination, you can get help from the EASS discrimination helpline.

Equality and Human Rights Commission (EHRC)

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