Everyone deserves healthcare that sees them, understands them, and keeps them safe, whoever they are, wherever they live, whatever language they speak, and however they come to a hospital or GP surgery. Right now, for millions of people in underserved communities across the UK, it doesn't.

Across the country, whole communities are being let down by the health system in the same four ways:

They are invisible in the data. Outdated ethnicity classifications, incomplete recording and poor use of existing data mean the NHS often cannot see who these communities are, what they need, or whether services are working for them.
There is no real accountability for inequality. A weak duty to merely "have regard to" health inequalities has not delivered change, there is no enforceable obligation to act, and no transparent reporting so the public can see whether progress is being made.
Patient choice doesn't work for everyone. Choice depends on reading letters, using websites, having a stable address and trusting the system. People with low literacy, limited English, insecure housing, or understandable mistrust built up through years of discrimination are excluded in practice.
When things go wrong, no one asks who was harmed. Patient safety investigations rarely examine whether harm falls disproportionately on particular communities — so patterns of unequal risk are never identified, and never learned from.

The result is stark. Romani (Gypsy), Roma and Irish Traveller people in England and Wales are more than twice as likely as the general population to report being in bad or very bad health,12.5% compared with 5.2%, according to the 2021 Census. Two-thirds of Romani (Gypsies) and Irish Travellers surveyed by the Traveller Movement describe their health as bad or very bad. But the same failures affect asylum seekers and refugees, people experiencing homelessness, many Black, Asian and minority ethnic communities, people with learning disabilities, migrant communities and others facing entrenched disadvantage. This is a system-wide problem, and it needs a system-wide fix.

The Health Bill currently going through Parliament is a rare, once-in-a-generation chance to put that fix into law permanently. Together with People's Health Trust, Race On The Agenda, Race Equality Foundation, Runnymede and a wider coalition of health and race equality organisations, we are asking the Government to support four targeted amendments. They are practical, proportionate, and build on commitments NHS England has already made:

1. Accurate ethnicity data (Clause 51 & Schedule 8). We want the 2021 Census ethnicity categories adopted in the Single Patient Record. At present, many communities, including Romani (Gypsy), Roma and Irish Traveller patients, who are routinely absorbed into a broad "White" category, disappear from the data used to plan and improve services. This amendment would make every underserved community visible, and give the NHS the evidence it needs to act.
2. A stronger duty to reduce health inequalities (Clause 4). We want a duty requiring all reasonable steps to be taken to reduce inequalities in access and outcomes, with particular consideration of inclusion health groups and communities experiencing racial inequity, and transparent annual reporting, so progress, or the lack of it, can be publicly scrutinised for every community.
3. Patient choice that everyone can actually use (Clause 16 & Schedule 2). We want choice arrangements to include accessible information formats, verbal explanations, community-language materials, flexible communication methods for people without a fixed address, and reasonable adjustments, so choice is real for people facing linguistic, cultural, administrative or practical barriers, not just those who already navigate the system with ease.
4. Patient safety investigations that look at inequality (Schedule 9). As safety investigations transfer to the Care Quality Commission, we want them required to consider whether harm disproportionately affects inclusion health groups, racialised communities and others facing inequitable access, treatment or outcomes, and to publish findings broken down where data allows, so patterns of unequal harm can no longer hide in averages.

Every one of these amendments would reach far beyond any single community. Romani (Gypsy), Roma and Irish Traveller people know these failures better than most, which is why the Traveller Movement is leading this campaign. But better data, stronger accountability, genuine choice and safer care make the NHS fairer for asylum seekers and refugees, homeless people, racialised minorities, people with disabilities, and every marginalised group. They make the health service more accountable and more effective for everyone who uses it.

NHS England already recognises these problems in its policies. What it lacks is a durable legal framework to fix them. The Health Bill is the moment to provide it.

We need your support
We are inviting health organisations, public health professionals, equality organisations, patient advocacy groups, inclusion health networks, researchers, charities and community organisations to stand with us.

By adding your name, you will be sending a clear message that tackling health inequalities must be at the heart of health reform.

Every signature helps demonstrate the breadth of support for these changes and the need for stronger protections for communities too often left behind.

Sign and share
Please sign the petition supporting the open letter and help us build the widest possible coalition of support.

Sign this petition to urge Baroness Merron and the Department of Health and Social Care to adopt or work constructively to refine and support these amendments, for every underserved community.

Read the full open letter to Baroness Merron and add your support today.