NHS unable to evidence discrimination eliminated in health services - is equality a virtual reality for government ?

For a long time now, the institutions which make up so much of what we call society [police, schools, councils, health services and much more] have had legal responsibilities to identify and eliminate discrimination in what they do on our behalf and in what they provide us when we need to use their services.

It is worth remembering that the reason for the law on discrimination is not simply to allow public bodies to look as if they are doing something by sometimes elaborate dressing the window of their public face.  It is intended to bring about lasting and permanent change to how people experience what they do.

There are times when it appears that for the mainstream media, which reflects back mainstream society, equality occupies a similar curiosity joke shop to that where they shelve repeating stories of EU regulations on bent bananas and Health & Safety Executive directives on conker competitions at school.  Equality and the elimination of discrimination often seems to be covered in similar vein to the all too common media-inspired faux outrage over the human rights of prisoners, migrants and asylum seekers.

Discrimination is something which many thousands of people encounter on a daily basis and who find their lives, today and for years ahead, shaped and warped by that experience. This could be the impact on the pay cheques of women working in Scotland's health service who, according to data published by health boards themselves, earn 18.85% less than men [even though Scotland's Fist Minister promised to fix this Equal Pay Gap in 2009].  It could also be the BME people not working in the NHS.  Using data published by health boards themselves, we find BME people make up just 2.37% of the NHS workforce while they make up at least 4% of our population.

Women in the NHS earn 18.85%
less than men - Scotland's First
Minister promised to fix this Equal
Pay Gap in 2009

Since 2010, public sector bodies in Scotland have been given very clear guidance on how to evidence equality in their role as employers.  Major amounts of data, not always of high quality, has been published by health boards and, when analysed, shows that discrimination is stubbornly clinging, like some anitbiotic-resistant virus, to the cultures and practices of health boards as employers.

While there is no similar clear guidance on how to evidence equality in their role as service providers, some public sector bodies have started to gather and publish evidence that shows them where discrimination is identifiable in their services and so allowing them to take specific action to eliminate it. Stirling University is able to gather and analyse data on students which allows it to evidence that :

Proportions of students achieving a 1^st or 2:1 are very similar between BME students (67%) and white students (69%) which is a significant improvement from the position in 2011/12

In an effort to uncover exactly what our health boards are doing to eliminate discrimination in how people access, experience and secure outcomes from their use of health services across the country, research was undertaken earlier this year and using a Freedom of Information [FoI] request sent to all 22 Boards.  
It would not be unreasonable to conclude from this research that most if not all of Scotland’s Health Boards are at real risk of failing to have evidence that they are meeting the public sector equality duty on eliminating discrimination in the provision of services.

Similarly, there is strong evidence that institutional discrimination is present in the culture and practice of Health Boards providing services to people from all the protected characteristics.  Until this is recognised and admitted by Boards themselves, the point of arrival at a time where achieving the goal of eliminating discrimination can be heralded is being pushed ever further into the future and left as something to be achieved by another generation.

None of this will be news to the Chief Executives of all Health Boards in Scotland. Providing leadership on how staff meet the public sector equality duty on services is part of their job. None of it will be news to the Board members of each Health Board, appointed by government to provide effective governance to how each Health Board operates, including being satisfied that the legal duties, such as the public sector equality duty, are being met. They are supposed to ensure that the Chief Executives and staff provide them with formal reports which assure them legal duties are being met and at formal meetings doing a lot more than simply nodding through papers presented by the paid staff. Indeed, such is the apparent apathy at strategic level across the NHS on compliance with the public sector equality duty that one could be forgiven for thinking recent media reports on record levels of laughing gas abuse have underestimated the scale and spread of the abuse.

First Minister has been spending too long
with the virtual reality kit and is mistaking
what she sees there for what is really
happening in the unequal world she
is failing to change

And of course none of this is news to Ministers in government. They have access to the same data or - as this most recent research reveals - the lack of data. Making real, measurable, evidenced equality happen and removing discrimination from people's daily lives seems beyond the will or the wit of government. It would seem the First Minister has been spending too long with the virtual reality kit and is mistaking what she sees there for what is really happening in the unequal world she is failing to change.