Time the NHS in Scotland took equality out of the 'too difficult' box

Those not too hungover from the ritual of seeing off the old year and welcoming in the new may well have missed a landmark moment, at least for those people who have to deal with the effects of prejudice and discrimination every day.

I refer to the announcement by Channel 4 that, in its own words :

"In the past, some elements of diversity have been put in the “too difficult” box. Our 360° Diversity Charter sets out to smash that box, by using all the talent available – both inside and outside our industry."

The C4 Diversity Charter sets out some ambitious goals and commits to being open and transparent about how it performs in meeting these.  Instead of seemingly forever working towards equality, C4 has decided it is long overdue that the journey was brought to an end and the product delivered.

One of the more obvious areas where equality can be made to happen is in its function as an employer.  Here C4 commits to moving from employing, currently, 15% of the workforce as Visible Minority Ethnic people [C4 uses BAME] to a level of 20%, all by the year 2020.  C4 wants to reach 6% of people with disabilities, from the current 1.9%.  And for people identifying as LGB, it wants to reach 6% by 2020, from the current 2.4%.

This C4 announcement was made just as I was analysing data provided by NHS Boards in Scotland on their employment equality performance as at March 2014.  When looked at side by side, one could be forgiven for concluding that C4 is on another planet from Scotland's NHS.

While C4 wants to increase the VME proportion of its workforce from 15% to 20% by 2020, the NHS in Scotland has managed, as at March 2014 to reach an average employment rate across all Boards of just 2.81%.  

In looking to provide equality of employment opportunity for disabled people, C4 currently has 1.9% of its workforce identifying as disabled and aims to increase that to 6% by 2020.  Scotland's NHS manages just 0.8% of the workforce identifying as disabled at March 2014.

C4 has an honourable if sometimes controversial track record in using drama output to reflect the lives and experiences of Lesbian, Gay and Bisexual [LGB] people.  It wants to ensure that in its function as an employer it matches that track record.  Currently it has 2.4% of the C4 workforce identifying as LGB and wants to increase this to 6% by 2020.  The NHS in Scotland currently has 1.2% of the workforce identifying as LGB.

C4 admits the challenges of making equality and diversity happen have often been put in the "too difficult" box.  It has set out a journey towards equality and diversity which smashes that box, maps out what the workplace should look like when it gets there, and has committed to an explicit timetable for arrival at the journey's end.  It has also made explicit a link between making that journey and the pay of senior staff, acknowledging that without that motivator the journey would remain stuck in the "too difficult" box.

The NHS ... has no vision of what the NHS workforce should look like, now or in the future, in terms of people's protected characteristics

The NHS in Scotland has no such plan.  It has no vision of what the NHS workforce should look like, now or in the future, in terms of people's protected characteristics.  It has no timetable for when measurable equality of employment opportunity will arrive for all people from all protected characteristics.  It has no carrot/stick with which to motivate senior NHS staff to make equality happen.

"the NHS’s continuing failure to act decisively on institutional discrimination means that some disabled people, VME people, and LGB people alive today will live out their lives and die before demonstrable equality of employment opportunity exists in the NHS"

In the same way that the NHS’s failure to eliminate health inequalities means that the man in Shettleston continues to die years before the man living in Barnton, so too does the NHS’s continuing failure to act decisively on institutional discrimination mean that some disabled people, VME people, and LGB people alive today will live out their lives and die before demonstrable equality of employment opportunity exists in the NHS.

Do WASPs still run Scotland's public sector ?

Scotland has a fine tradition of challenging power, and nowhere more obviously than in who owns Scotland, with numerous books and websites devoted to the issue.  While any decent socialist analysis of power-sharing would always look at land ownership as an indicator of just how much power-sharing there really is and how much privilege remains in the hands of the few, we rarely look closely at who actually runs Scotland's public sector.  Given the public sector has a £multi-billion budget and employs almost half a million people, this is an odd oversight.

not so diverse, a tad pale, dominated by suits and
imbued with good old Presbyterianism.  WASPs.

When talking about running the public sector, it is important to be clear that government farms this job out to public appointees, people appointed by various ministers to work in partnership with senior paid staff and deliver the public services that Scotland needs.  That is the theory.  It would be reasonable to expect those groups sitting round the board tables of public sector Scotland to be a diverse, egalitarian group, especially when it is kept in mind that they are appointed by government ministers.

When looked at through the lens of equality, the reality of who runs Scotland becomes clearer; not so diverse, a tad pale, dominated by suits and imbued with good old Presbyterianism.  WASPs.

Women are not really welcome in
Scotland's public sector boardrooms

Using data provided by government itself, you will find that women have just 35% of the 574 seats there are in running Scotland.  If the boards were to reflect the number of women in Scotland, they should have 51% of the seats.  The most basic arithmetical analysis suggests women are not really welcome in Scotland's public sector boardrooms.

Disabled people in Scotland make up 20% of the population.  Around the board tables, there is room for just 67 seats being taken by disabled people, just 12% of those available and some 48 seats short of what might be termed proportional representation.  Disabled people are absent in significant numbers from the strategic decision making on the nature and structure of public services in Scotland.  

Visible minority ethnic [VME] people give Scotland a vibrant diversity in so many ways and yet when it comes to the work in overseeing the strategic direction of public services in Scotland, they are allowed just 16 of the 574 seats available, 7 seats short of what could be termed equal access to power-sharing in Scotland's public sector.  

Another dimension to the power of these boards is the position of board chairperson, again an appointment made by government ministers.  On a purely arithmetical basis,

racism in the public sector will not be eliminated
while WASPs control the boards of the public sector

proportionality would mean that VME people would be chairperson in 3 of Scotland's 78 boards.  The reality is that a VME chairperson exists in just 1 of those 78 boards.  All the evidence points to lingering racism in the culture of political appointments in Scotland.  Bad enough in itself, this also means that the work supposed to be being done on race equality across the public sector has a strategic oversight which remains overwhelmingly white.  It is fair to say that racism in the public sector will not be eliminated while WASPs control the boards of the sector.

In the area of sexual orientation, government has managed to achieve a profile of board members which is the reverse of other trends identified for other equality communities.  There are 22 Lesbian, Gay or Bi-sexual [LGB] people at seats around board tables, 3 times the number required to demonstrate equality of opportunity.  

The final area examined in this research is the experience of people who are Catholics.  It remains one of those areas where Scotland appears to be reluctant to engage and yet evidence in employment data suggests there are very real barriers to Catholic people gaining equality of opportunity in access to and development of careers in the public sector.  At the strategic level in running Scotland's public sector, Catholics should have around 16% of the seats but in fact have just 8%, some 45 seats short of fair representation.  In comparison, Protestants have 177 seats, very close to the 186 seats proportionality would provide.  Sectarianism in the public sector workplace is unlikely to be eliminated when the strategic leadership on equality is dominated by Protestants.

Aristotle's musings on equality included the following :

"If liberty and equality, as is thought by some, are chiefly to be found in democracy, they will be best attained when all persons alike share in government to the utmost."

Scotland's disabled people, VME people and Catholics do not alike share in government to the utmost.  Government must be called to account for having allowed this hierarchy of inequality in how it runs its business to emerge.