Wannabe world-leading NHS Scotland takes the wooden spoon on race equality in its own back yard

Power. The part-aphrodisiac, part-narcotic for career politicians. 

The SNP has been wetting its beak in the Scottish version of this drug, heavily stepped on with porridge oats, since 2007. The SNP looks to continue its addiction to power in this year's parliamentary elections and so mark over a decade in power in Scotland, pulling the levers which decide what changes where and how deeply and quickly.

One of the areas in which the SNP has had complete freedom for the past 9 years to control and direct is in the NHS. The SNP's strategy for Scotland's NHS is that by 2020 it will deliver 'world-leading healthcare'. Equality gets no mention in the strategy, beyond some mealy-mouthed, management-speak in a 2 page summary of the strategy where it is explained that being a world-leading healthcare system requires : Recognising and valuing diversity. One could wonder that VisitScotland in airbrushing a young BME man into an otherwise all-white poster celebrating a Homecoming 2009 in Scotland, shows exactly what government means by 'recognising and valuing diversity'.  

One of the clear measures of equality is to be found in the profile, by protected characteristic, of those in employment.

Being in employment can bring multiple, potentially positive, impacts on the lived experiences of many people who share particular protected characteristics.  It can reduce dependence on the less than generous state welfare system and the increasing stigma attached to what little support is provided to people who are jobless for whatever reason.  It provides the opportunities for those previously excluded from key areas of society to be able to influence change and the future shape of societal structures from within.  

The Equality Act 2010 resulted in differing approaches being taken across Britain on how the underpin, usually in the form of different specific equality duties, guided the public sector in the general equality duty to eliminate discrimination.

Equality Here, Now has, in recent years, published research findings into establishing just how much Scotland’s specific equality duties, adopted in May 2012, have achieved in eliminating discrimination in the employment practices and cultures of the public sector.  

Recent research from Equality Here, Now provides a wider context for scrutiny of Scotland’s public sector performance by setting it alongside data gathered from other parts of Britain.  The scope of this report deals with the data made available by the NHS in Scotland, England, and Wales on the employment of Black Minority Ethnic people.

Previous researchinto the performance of Scotland’s NHS in employment equality showed that the proportion of NHS Scotland workers identifying as BME had fallen from 2.77% reported at 2013 to 2.39% reported at 2015.

Census data from 2011 indicates that Scotland has 4% of the population identifying as BME.  The falling rate of employment of BME people in NHS Scotland suggests significant institutional barriers exist between the community of BME people living in Scotland and the numbers of BME people able to obtain and retain a job with the NHS in Scotland.  

In England, the NHS has 14.81% of its workforce identifying as BME as at October 2014.

NHS England is the only part of Britain where employment equality data is gathered and made available centrally as a national figure as well as broken down by region.  

The 2011 Census figures for England show that 14% of the population identifies as BME. 

In a straightforward comparison, NHS England, operating within ‘lighter touch’ regulations on specific equality duties and with a higher  proportion of BME people in its national population, is beating the NHS Scotland employment rate of BME people by a significant margin.  NHS England also manages to employ BME people at a rate which roughly reflects the proportion of BME people in the population.

In Wales, the NHS has 4.73% of its workforce identifying as BME.

In NHS Wales, the data sets on the protected characteristics of the workforce are, like Scotland, published by individual Boards/Trusts only, with no central gathering and publication of a national workforce profile.  The Census 2011 for Wales shows that 4.4% of the population identifies as BME, higher [just] than Scotland but lower than England.

In a straightforward comparison, NHS Wales, operating within a challenging set of regulations on specific equality duties and with a slightly higher proportion of the national population identifying as BME, manages a lead over NHS Scotland’s performance in the employment of BME people.  Like NHS England, NHS Wales also employs BME people at a rate which roughly reflects the proportion of BME people in the population.

The NHS in Scotland, run by the SNP since 2007, is failing to deliver a measureable level of equality of employment opportunity for BME people when compared to the performance of neighbours.

Far from being anything like a world-leading health service, NHS Scotland is struggling to evidence that it even understands the institutional racism in its structures, cultures and practices and which will ensure it never reaches world-leading status. 

While Scottish government ministers look to snort ever deeper along the lines of power and patronage, racism in the NHS remains embedded and unchallenged, and the NHS elsewhere in Britain shows Scotland unable to compete in making race equality happen at local level.