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Objective To assess whether equity is achieved in use of general practitioner, outpatient, and inpatient services by children and young people according to their ethnic group and socioeconomic background. Design Secondary analysis of the British general household survey, 1991-94. Subjects 20 473 children and young people aged between 0 and 19 years. Main outcome measures Consultations with a general practitioner within a two week period, outpatient attendances within a three month period, and inpatient stays during the past year. Results There were no significant class differences in the use of health services by children and young people, and there was little evidence of variation in use of health services according to housing tenure and parental work status. South Asian children and young people used general practitioner services more than any other ethnic group after controlling for socioeconomic background and perceived health status, but the use of hospital outpatient and inpatient services was significantly lower for children and young people from all minority ethnic groups compared with the white population. Conclusions Our results differ from previous studies, which have reported significant class differences in use of health services for other age groups. We found no evidence that children and young people's use of health services varied according to their socioeconomic status, suggesting that equity has been achieved. A child or young person's ethnic origin, however, was clearly associated with use of general practitioner and hospital services, which could imply that children and young people from minority ethnic groups receive a poorer quality of health care than other children and young people.

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This paper explores the views of General Practitioners (GPs) about the appropriateness of children undertaking a task of interpretation between the GP and an adult patient in primary heath care consultations. We argue that the operational constraints that GPs face because of the limited availability of professional interpreters or bi-lingual Health Advocates create situations where children are accepted in this role by GPs, subject to specific limitations and contingencies. The contingent nature of perceptions of children's acceptability as informal interpreters is shown to be related primarily to the nature of the medical consultation in terms of whether it is likely to be straightforward, complex or sensitive. At the same time GPs express an ideological opposition to the appropriateness of this task for children generally. This ideological opposition is explicitly linked by GPs to broader constructions of a 'proper' childhood, characterised as a time of innocence and freedom from worry.

This paper argues that analysis of the ethnic patterning of health has failed adequately to examine the social meaning of ethnicity, while too often becoming enmeshed in unhelpful dualities which counterpose material to cultural explanations, multicultviralism to anti-racism, and sociology to epidemiology. Against the background of anthropological, objectivist and postmodern theories in the broader sociology of'race' and ethnicity, the paper develops a concept of ethnicity for the purposes of health research. This is used to evaluate biological, migration-based, material, cultural and racism-based explanations for the ethnic patterning of health. It is argued that these types of explanation are best understood within an interactive framework. The methodological implications of this for future research are discussed.