Workforce issues
Racism in the NHS: how far have we come?
In this article, Joshua Correia interviews different generations of healthcare professionals to gain an insight into the experiences of racism and discrimination in the NHS. He considers: how far have we come in tackling the issues and what support is available today?
When we look at how much of an impact racial inequality had on the inner workings of our society during the mid to late 1900s, it’s easy to make a distinction between the world of today and how things used to be. Currently, there is an overwhelming emphasis on the importance of equal opportunity for all individuals in employment regardless of race, gender, sexual orientation, socio-economic status or disability. Particularly over the past decade, any evidence of institutional racism and unconscious bias within the workplace is taken far more seriously; the implementation of the Equality Act in 2010 and other safeguards (such as unions) is supposed to ensure that employees are given adequate protection and support in any instance of racial discrimination or misconduct. On the surface level it seems that we’ve made good progress in creating a fairer society that commits itself to challenging inequality. Nevertheless, upon closer inspection there is still much room for improvement, especially when it comes to our National Health Service. The issue of racial inequality for doctors and nurses from BAME (Black, Asian and minority
ethnic) backgrounds is a recurring one, even more so in light of the COVID-19 pandemic. Regarding the pandemic and unequal access
to personal protection equipment (PPE), a report published by the National Institute for Health and Care Research (NIHR) claimed that there was a lack of care and consideration for NHS staff from minority backgrounds. It stated: “The NHS advised that all high-risk workers should have a personal risk assessment to minimise the risks they faced. However, some felt that risk assessments and recommendations were not taken seriously. Research found that those from ethnic minorities felt the risks more keenly than their White colleagues.”1 This is further supported by an RCN member
survey carried out during the height of the pandemic in 2020. Of all the BAME respondents working in high-risk environments, it found that: l Only 43% had adequate equipment for eye and face protection, in contrast to two-thirds (66%) of White British nursing staff.
l 37% did not have enough fluid-repellent gowns to use during their shift, compared with 19% of White British staff.
l More than half (53%) had been asked to re-use single-use PPE compared with 42% of White British respondents.2
More worryingly, in a survey carried out by the Royal College of Nursing, there was a startlingly clear contrast between NHS nurses from BAME backgrounds and White British nurses when it came to fit testing for filtering face piece respirators: “There was a substantial difference when exploring ethnicity; only half of BAME respondents (49%) said they had been adequately fit-tested for the filtering face piece respirators (FFP3 or FFP2/N95), whereas almost three-quarters of White British respondents had been adequately fit-tested (74%).”3 These findings illustrate the undeniable inequality and lack of consideration for NHS workers from BAME backgrounds who work in high-risk environments, despite them being at a higher risk from more serious COVID–19 health problems. These extracts are just the tip of the iceberg when highlighting instances of racism within the NHS and the issue isn’t exclusive to the amount of access BAME workers have to adequate PPE. Moving beyond the pandemic, one of the main focuses of this article is to examine how doctors and nurses are subjected to incidents of racial abuse, bullying and discrimination – either by patients or even their own co-workers. In a survey conducted last year, by the British Medical Association (BMA), covering more than 2,000 doctors and medical students, over 90% of Black and Asian respondents said they believed racism to be an issue within the medical profession. It should come as no surprise that almost 60% of doctors reported that such incidents of racist bullying had negatively affected their wellbeing including causing depression, anxiety, and increased stress levels. More specifically, the survey investigates instances of derogatory comments, social exclusion, bullying, and physical attacks or threats of violence. The survey makes for difficult reading, at times, and illustrates the
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