ABSTRACT
The primary care agenda, as we have seen, has been slow to provide accessible care appropriate to the needs of minority ethnic populations and rarely engages with broader debates about ethnicity and health. In response to this and to enable those working in primary care to reflect on these issues, this opening chapter establishes the theoretical context in which we make sense of the inequalities experienced by South Asian populations. We begin by discussing institutional racism and explore its value to making sense of the disadvantages faced by minority ethnic groups in relation to healthcare. Institutional racism has recently become a fashionable term, used to explain the failings of public institutions to respond to the needs of minority ethnic populations living in the UK.1 Nonetheless, in becoming fashion able the term risks becoming little more than a 'buzz' word of little or no analytical value. To recapture the meaning of institutional racism, the chapter breaks down the concept into its various themes and offers empirical examples to establish its validity. We then further sensitise the idea of institutional racism by critically evaluating what we mean by 'ethnicity' and in particular exploring its purpose as an explanatory variable in understanding disadvantage and discrimination. The chapter ends by emphasising the importance of using our awareness and know ledge of racism to transform policy and practice. As we shall see, focusing on the needs of South Asian populations is not the same as responding to these needs. Often there is a gap between our understanding of the issues and our willingness to act on their implications to improve service delivery.2,3 This will be a recur ring theme throughout the book.
