Since last year, institutional racism within NHS has raised many concerns. Despite the initial resistance to admit the depth of the existing problem and celebrating NHS as a “success story” due to its existing diverse workforce, an independent investigation by NHS Race and Health Observatory established the link between race and health.
Chair Marie Gabriel said, “The evidence it cites is clear: institutional racism exists in this country, it exists in the organisations that make up our health and care system, and it exists across wider public establishments.”
Deaths among medics during the pandemic and the general approach towards immigrants in NHS workforce have been alarming- and it was made worse by a report by Care Quality Commission on how Bristol hospital line managers told the ethnic minority hospital staff to use ‘easier to pronounce’ Western ‘work’ names.
To rethink, reshape and tackle blatant racism and ethnic minority under-representation in leadership positions across Trusts and providers around the NHS, Prof Partha Kar OBE, otherwise well known for his pioneering work in diabetes, has started a new role as the National Advisor for Medical Workforce based on Racial Equality this week.
In a recent article in the British Medical Journal, Dr Kar wrote, “10% of board members in NHS trusts are now from minority ethnic backgrounds, up from 7% in 2017. And 21.0% of staff in NHS trusts and clinical commissioning groups (CCGs) in England are now from a minority ethnic background, up 2.9% points since 2017.
“White applicants were 1.61 times as likely as ethnic minority applicants to be appointed from shortlisting across all posts. This was worse than in 2019 (1.46), which itself was no improvement on the previous year. In fact, the past five years have seen fluctuation but no overall improvement in this measure.
“Just 40.7% of ethnic minority staff, compared with 88.3% of white staff, believe that their organisation provides equal opportunities for career progression or promotion. The recent NHS staff survey shows even further evidence of the inequity, more pertinently during the pandemic. Ethnic minority staff bore the brunt, with 47% working in covid roles, compared with 31% of all staff. Those who reported facing discrimination rose from 16.5% to 19.4% in black ethnic groups and from 13.7% to 15.6% among Asian ethnicities.”
The problems are not just limited to NHS Trusts. GMC has also reportedly set itself a target to ‘eliminate’ the disproportionate complaints received from employers about ethnic minority GPs by 2026, through few steps- including ensuring cases are increasingly resolved locally, making it more ‘inclusive and supportive’.
Dr Kar, in an exclusive interview, told Asian Voice, “Unless you change the leadership positions, you will struggle to change any outcomes. What is the point of producing reports to say that every year that BAME populations are more victimised and more bullied when they're not getting into leadership positions themselves to impact any change? If you're not changing any of that, people will lose interest after a point.”
He further added, “People like us who came from India, Pakistan and Bangladesh- there is an ever-present undercurrent of being treated like a second-class citizen. Many are asked to do jobs local graduates won’t with added issues of lack of training as well.
“What support are we offering to those who are coming here -that is something we need to look at. So, I would anticipate all those things being investigated one after the other. We tackle the medical workforce first, then we look at the other workforces.”
His role, that has been created for the first time, promises to inspire younger generations to aspire for top positions within NHS, without any race-related fear or hesitance. But does Dr Kar anticipate resistance from the system to achieve his goal?
“When you're trying to change something there are always challenges- especially from people. Group one, people who will believe there are needs for change- so they are on board. Group two, the ones who are relaxed and casual about the existing issues. Group three, and the biggest challenge are the people who will say no to a change. I think that's where the push needs to happen. And let's face it, there will be some people who, whether unconscious bias or conscious- are also racists. We should not duck away from the fact that as with all parts of society, the NHS has their proportion of racism around it. I think those people need to be openly challenged.”
