Structural racism 'prevalent in the NHS', warns BMA response to Sewell report

Evidence of structural racism in the NHS is 'enormous', significantly affecting outcomes and life chances for ethnic minority healthcare workers, the BMA has warned in a highly critical response to the Sewell report.

(Photo: Scott Barbour/Getty Images)

In a formal response to a report published this March by the Commission on Race and Ethnic Disparities led by Tony Sewell, the BMA said structural race inequality was 'prevalent in the NHS'.

This inequality - defined as 'a legacy of historic racist or discriminatory processes, policies, attitudes or behaviours that continue to shape the organisations and societies today' - was a major factor affecting the outcomes and life chances of many ethnic minority healthcare workers, the association said.

Pointing to evidence that doctors from ethnic minority backgrounds were more likely to face discrimination or bullying, less likely to pass postgraduate exams, have fewer opportunities to progress into senior roles and face a significant pay gap compared with doctors of white ethnicity, the BMA said systemic racism in the health service was clear and must be tackled.

Structural racism

The reponse comes as the RCGP continues to call for an independent review into potential bias against doctors from minority ethnic backgrounds in CQC inspections - and after a tribunal ruled that a GMC investigation racially discriminated against a doctor.

The BMA called the Sewell report a 'missed opportunity' and criticised its characterisation of the NHS as a ‘success story with significant overrepresentation of ethnic minorities in high status professional roles’ - and its description of the 'onward march of minorities into positions of power and responsibility in professions such as...medicine'.

The BMA says the Sewell report did not accurately portray barriers faced by many people from ethnic minority backgrounds such as 'racist, or discriminatory processes, policies, attitudes or behaviours within the healthcare sector'.

The Sewell report - commissioned by the government to assess race and ethnic disparities - found that the UK was not yet 'a post-racial society which has completed the long journey to equality of opportunity'. It concluded, however, that 'most of the disparities we examined, which some attribute to racial discrimination, often do not have their origins in racism'.


BMA chair Dr Chaand Nagpaul said: 'The way in which the authors chose to analyse the data and evidence submitted to the commission questions the validity of the entire report. They made sweeping statements of success and as such showed little acknowledgement of the indisputable disparities in experiences and outcomes for doctors from ethnic minority backgrounds.

'What the evidence does show is that structural racism is prevalent in the NHS. A recent BMA survey, which was submitted to the commission by the BMA, found that 16.7% of ethnic minority staff compared to 6.2% of white staff reported experiencing discrimination at work from a manager, team leader or other colleagues as well has reporting twice the level of bullying and harassment.

'Race disparities in the pass rate of postgraduate exams; unequal opportunities to progress into more senior roles; and the fact that several studies have shown there is a significant pay gap between doctors from an ethnic minority background compared with doctors from a white background, all demonstrate continued systemic racism.'

A consultant psychiatrist told the BMA: 'Throughout the course of my training as a doctor I have experienced too many examples of racism to count. Most of which I've repressed to preserve my ability to keep doing my job. I will never forget a patient complaining about not wanting to be treated by Africans - openly using the "N" word and demanding to be seen by a white clinician.'

Despite its criticism of the report, the BMA said it broadly agreed with some recommendations put forward by the commission. 

It backed calls in the review including a review of CQC handling of disciplinary actions against ethnic minority staff, work to understand the ethnicity pay gap in the NHS, calls for an 'Office of Health Disparities' to be established.

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