Viewpoint: Racism still rife in NHS half a century after Martin Luther King's 'dream'

On a day marking the 50th anniversary of Martin Luther King's 'I Have A Dream' civil rights speech, racism and discrimination is still rife in the NHS.

Dr Chand: 'DH, royal colleges and BMA should take a more active lead to tackle racism and discrimination.'
Dr Chand: 'DH, royal colleges and BMA should take a more active lead to tackle racism and discrimination.'

According to the NHS Institute for Innovation and Improvement, there are 193,000 staff from black and minority ethnic (BME) backgrounds in the NHS – representing nearly 20% of the NHS workforce.

The NHS thrives on equality and diversity. In some specialities, such as general practice, we know that almost a third of the emerging workforce are overseas-qualified. Without these immigrant workers the NHS would come to a standstill. Estimates indicate that BME doctors have saved the Britain billions in training costs alone.

Despite this, many international medical graduates (IMGs) who have been the workhorses of the NHS, are over-represented in the lowest paid, least glamorous specialties in the least popular parts of the country.

Less recognition and slow promotion

Some of them have faced racism, less recognition for awards and slow promotion in their working life. To add insult to injury, IMGs from a BME background are likely to be dealt with more harshly by the GMC; they are three times more likely to be charged with serious professional misconduct, and therefore have a higher rate of receiving high-impact decisions than their white counterparts.

A BMA survey in 2003 revealed more than 80% of minority ethnic doctors believed that their ethnicity had a negative effect on their career advancement. In 2004 the Royal College of Psychiatrists accepted that racism existed in the NHS and in their own institution. Nothing much has improved since!

There are 30 BME executive directors out of an estimated 3,000 posts. In social care the picture isn't much better; the number of BME directors of adult services in England is four out of 150.There are only five BME chief executives across more than 300 NHS organisations. Even royal colleges and the BMA don’t do very well in representing BMEs at the highest level.  There is very obvious over-representation of BME staff at lower professional grades and under-representation in senior roles. To add insult to injury there are disproportionate rates at which BME staff are subject to disciplinary procedures.

Fairness, transparency and equity

BME staff are an essential and irreplaceable asset to the NHS, making up a quarter of the workforce overall, and higher proportions in some sections of the emerging workforce. Unequal treatment, racism and barriers to career progression are serious issues not just for the individuals affected but for the equality, efficiency and quality of the NHS overall. Without immigrant staff, the health service would come to a standstill. So why aren't BME health professionals treated fairly?

The DH, royal colleges and the BMA should also take a more active lead to tackle racism and discrimination. For those who are committed to a lifelong career in the NHS, I would like to see fairness, transparency and equity regardless of whatever stage they are at in their career as a tribute to Martin Luther King.

* Dr Kailash Chand is BMA deputy chairman and is writing in a personal capacity.

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