Mirror, mirror on the wall, who is most racist of them all............... in Scotland's NHS ?

Just two years ago, Scotland's 22 Health Boards published their first reports on workforce equality profiling, as required to meet Scotland's then shiny new specific equality duties.

It was not a time for celebration.  No corks were popped for equality in April 2013.  It was hard for the NHS, collectively, to look in the mirror then and see the prejudice and bigotry 

It was hard for the NHS, collectively, to look in the mirror then and see the
prejudice and bigotry which stared back  as the data stacked up

which stared back as the data stacked up, Board by Board, to show that employment equality in the NHS for people sharing protected characteristics is as likely as the KKK is to stop flying the Confederate battle flag.  You can find the research reports which piled up the data sets on the protected characteristics of ethnicity, disability, sexual orientation and religion across our NHS in the Equality Here, Now website.

On race, the research in 2013 found that not one of the Boards managed to exceed the standard set by the BBC [then employing 12.3% of a Black Minority Ethnic (BME) workforce].  NHS NES was closest at 12.28%.  Only 1 other Board managed to report a BME employment rate into double figures, NHS Golden Jubilee at 11.39%.    If all 22 Boards had achieved the same employment levels reached by the BBC, there would have been 15,310 more BME people working in the NHS in Scotland.    If Boards had managed to mirror the national UK average of 8% BME people, this would mean an extra 8,502 BME people working in the NHS.  This is roughly equivalent to the population of Haddington and provided a graphic illustration of the number of BME people missing in 2013 from the workforce of the NHS.

Based on these figures, it was concluded that the NHS in Scotland appeared to have significant problems with institutional discrimination^[1] in the employment of BME people.  The research was shared with all 22 Board Chief Executives and with the Cabinet Secretary for Health, along with an invitation to discuss what the data revealed and to meet and discuss how performance on employment equality could be improved.  Not one of the poorly performing 20 Chief Executives believed they needed help.

Just last month, June 2015, more workforce equality profiling reports needed to be published to meet the now not so shiny new specific equality duties in Scotland.  For the 20 poorly performing Chief Executives, the mirror of independent research will have triggered a considerable and involuntary release of the trapped winds of denial.  Across the whole NHS in Scotland, the employment rate of BME people has fallen in the last 2 years, from the already dismal levels of 2.77% in 2013 to 2.44% in 2015.

Stephen Lawrence :
1974-1993

Alongside that dire figure, the proportion of the NHS workforce which refuses to provide their employer with their ethnic identity remains stubbornly stuck at close to 30%.  

While the Metropolitan Police force has been under intense and righteous scrutiny since the murder of Stephen Lawrence in 1993 and the Inquiry report from Sir William Macpherson in 1999, the Met has managed to admit to being racist in its function as a force and as an employer, and undertaken considerable work to eradicate that racism, all in the intense glare of public scrutiny and accountability.  

Scotland's NHS, the Board Chief Executives and the Cabinet Secretary for Health are curiously reluctant to take that crucial first step in eliminating racism.

[1] Institutional discrimination has been and will be defined in a range of ways.  The following definitions relate to race in the UK but can be amended to equally apply to all other protected characteristics.

"The collective failure of an organisation to provide an appropriate and professional service to people because of their colour, culture, or ethnic origin. It can be seen or detected in processes, attitudes and behaviour which amount to discrimination through unwitting prejudice, ignorance, thoughtlessness and racist stereotyping which disadvantage minority ethnic people."
The Macpherson report

"If racist consequences accrue to institutional laws, customs or practices, that institution is racist whether or not the individuals maintaining those practices have racial intentions."
The Commission for Racial Equality