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Throughout Covid-19, many of us had to access digital health platforms for our previously routine medical needs. Although the NHS move to digitalisation was inevitable, the outbreak of Covid-19 sped up the process, aiming to help GPs manage already limited resources by directing people to pharmacists and nurses instead of the surgery. At the end of 2021, 22 million people had downloaded the NHS App.

For some, healthcare digitisation has worked well, so far, often mitigating the need for a time-consuming face-to-face appointment. For other demographics, however, the move has further decreased their chances of accessing healthcare at all.

One such demographic is the Roma population. Around two thirds of Big Issue North vendors are Roma –and despite facing greater health risks, they are less likely to seek medical help when compared to British vendors.

Described by Amnesty International as among the most deprived communities in Europe, across the continent Roma people suffer widespread discrimination, often denied their rights to housing, employment, education and healthcare.

This prejudice is also rife in the UK. Roma vendors experience racism and abuse on the street when working. Ana, a vendor based in York, has been selling the magazine to support her family. “Some people are racist because I am Roma,” she said. “They say: ‘You are a Gypsy!’ I don’t know why there is this racism. Some people here are very rude. They shout at me, swear at me. They say: ‘Go back to your country!’ That makes me feel sad, but I just leave them and say nothing.”

Many Roma people experience this bias, including within the healthcare system. As well as causing stress and upset, this can also result in a reluctance to seek medical attention.

“Mistrust of national healthcare systems and authorities is a problem,” said scientist Ed Holt, “It can be partly linked to specific episodes of violation of health ethics principles, such as decades of coerced or involuntary sterilisation of Roma women.”

Roma people also face a barrier when it comes to assessing and understanding medical information via apps or websites. A quarter of Roma vendors do not have a phone, and of those who do, only half have a smartphone, limiting their internet access.

Many are also unable to read, either in English or at all. Visiting a GP website to book an appointment requires a degree of computer literacy and English proficiency. Two-thirds of vendors do not speak English as a first language.

A digitised healthcare system has its benefits, and online appointments can be helpful to vendors. Selling Big Issue North is a legally recognised form of self-employment, with vendors buying magazines for £1.50 and selling them on for £3. They do not receive paid leave. As vendors often rely entirely on their income from selling the magazine, committing to appointments can pose logistical and financial challenges.

“It is a good job,” says Eugenia, a Roma vendor based in Ilkley, “My husband also sells the magazine. Because we don’t have any benefits or anything, this is how we earn our money.”

As we continue digitalisation of the health service, it is vital that Roma and other people who face barriers to accessing healthcare are further considered. Health initiatives must be more accessible, more inclusive, and culturally sensitive.

To find out more about our work, our vendors and how you can support them, please visit bigissuenorth.com. You can also learn more by downloading Street News from your app store.