Roots of institutional racism remain deep and undisturbed across much of the NHS in Scotland

500 years ago one Niccolo Machiavelli wrote [I paraphrase] that the status quo will defend itself, and all its many privileges, with great vigour against change to how things are.  When it comes to making race equality in employment happen in NHS Scotland as opposed to working towards it, then not a lot has changed in the last 50 years.

In 2012, Scotland patted itself on the back with the adoption of what was described as a better set of regulations on making equality happen than were put in place in other parts of the UK.  Some 5 years on and several thousands of pages in multiple equality reports published by Scotland's NHS Boards under the Scottish equality regulations, and the data suggests those charged with enforcing the regulations had not studied or read Machiavelli at university.  Or maybe they just thought he was Liza Minnelli's grandfather ? 

In the 3 cycles of employment equality data reports published by Scotland's 22 NHS Boards, their own figures show that the proportion of Black Minority Ethnic [BME] people employed in the NHS has fallen from forming 2.77% of the workforce in 2013 to 2.44% in 2017.

To get and keep a job anywhere, you first have to succeed in what is often termed the recruitment stage.  Research in recent years has shown this is not a place where equality flourishes, and certainly not for BME people.  In 2016, the Scottish Parliament's Equal Opportunities Committee found that there was a disproportionate failure of BME people at interview stage.
 

With that in the background to NHS Boards preparing their 2017 employment equality data reports, one could have been forgiven for presuming this area of their culture and practice would feature heavily in their 2017 reports.  On the basis of an analysis of the employment data reports published by NHS Boards in 2017, there is an almost total lack of evidence that active and positive use is being made of the employment data gathered on recruitment to show that Boards are creating discrimination-free gateways to equality of opportunity for BME people in getting and sustaining employment within the NHS.  

an almost total lack of evidence ... Boards are creating discrimination-free gateways to equality of opportunity for BME people

It would not be unreasonable to conclude that on the basis of what has been published, the recruitment systems and cultures in the NHS have changed little if at all since the Equality Act 2010 and that they act as a bulwark to the status-quo of a predominantly non-BME workforce.

It gets no better when looking at the other end of what comprises a job with Scotland's NHS these days - that point where you walk away.  The intention behind the equality regulations was that employers would gather data on people who had left, find out why they had left, compare the patterns of BME people with non-BME people and use that to find out if there were underlying discrimination which triggered resignations from BME people.  

The extent to which Boards are failing to gather and use data on BME people leaving employment, and why, is astonishing

The extent to which Boards are failing to gather and use data on BME people leaving employment, and why, is astonishing.  It must also be viewed as deeply worrying as none of the Boards provides any rationale for taking what is often a minimalist approach to gathering and using data to understand why BME people are leaving employment.  Not one of the Boards has opted to aggregate leaving data over several years [the obligation to gather data on ethnicity has a long legal history pre-dating the Equality Act 2010] as an aid to uncovering deep structural trends and patterns in BME and non-BME people joining, staying in and leaving the workforce. 

What appears to be an almost casual disregard amongst Boards for undertaking proper scrutiny, as set out in the specific equality duties, of why BME people are leaving employment inevitably means the potential for racial discrimination being the trigger for people deciding to leave employment will continue to remain hidden by poor data gathering systems and organisation cultures.  

the potential for racial discrimination being the trigger for people deciding to leave employment will continue to remain hidden by poor data gathering systems and organisation cultures

This latest examination of employment data published by Scotland’s 22 NHS Boards suggests little has changed since the Equality Act 2010 and that if anything the roots of institutional racism remain deep and undisturbed across much of the NHS.  What has emerged in this particular research report is growing evidence that the NHS in Scotland is reluctant to willingly and comprehensively embrace all that the specific equality duties requires as this would more than likely unearth practices and cultures which are racist and which would require institutional change.