For much of this decade, opened with the Equality Act 2010, I have been wondering why it is that measurable, visible progress with eliminating discrimination has become so ponderously slow. I was recently reminded of just how pitifully slow it is when someone else put it into a slightly different context. In an article from the Independent newspaper on Equal Pay, Young Women's Trust chief executive Carole Easton said "at the current rate [of progress], today's young women will be retired before equal pay becomes a reality".
If we are to change the pace on making equality a reality and ensure the privileged status quo gives ground in our life times, it is critical to understand what it is behind the eye-wateringly slow pace of change. In an effort to try and narrow down the reasons for the delays to the core causes, I undertook some research into one of Scotland's biggest public sector employers, NHS Scotland. As at March 2018, the 22 Health Boards which make up NHS Scotland were reporting that they employed 169,467 people. Training and re-training almost 170,000 people must suck up a lot of resources, so I used a freedom of information request to ask them all what was the aim of their equality training, how they delivered it, and how they checked whether the training they provided was actually helping them to eliminate discrimination from their roles as employers and service providers.
The key findings revealed by the responses go some way to explaining why equality keeps getting kicked down the road in the public sector in Scotland.
- Some Health Boards use ‘fair’ or ‘fairness’ in conjunction with equality, sometimes conflating the two. Given that achieving equality requires the elimination of discrimination and that ‘fairness’ is a relative state, it is likely that the confusion between discrimination and fairness will, for as long as it continues to inhabit the corporate thinking of public bodies, simply serve to sustain institutional discrimination. It is possible to imagine that this confusion is a deliberate act with the clear intention of delaying the arrival of equality and the elimination of discrimination
- Many of
Scotland’s 22 Health Boards are doing equality work - and the training in it - because they have to, by law,
not because they are passionate about it and believe it is the right thing
to do.
- the NHS in Scotland lacks clarity and coherency on why equality training is being delivered. This means that for many staff their journey towards eliminating discrimination will find them arrive at some very different places and often that will not be a place where discrimination has been eliminated.
- NHS
Grampian and NHS Orkney use classroom-style training and declare this
approach ‘vastly superior’ to online delivery of training, meaning the
rest of the NHS is using an inferior training delivery model
- NHS Health Scotland provides mandatory ‘unconscious bias’ training to all managers. Yet the Scottish Parliament’s Equal Opportunities Committee reported in 2016 that ‘unconscious bias’ training is “not the solution and can serve to mask underlying negative attitudes towards people from an ethnic minority background.”
- From the
169,000 workers Health Boards reported as working for them at March 2018,
they were only able to positively identify that 37,398 of them had received
equality training
- quality assurance as a concept is poorly understood and little or no quality assurance of equality training content across the NHS is actually being undertaken
- all Health Boards were asked what methodology they used to evaluate the effectiveness of equality training in helping them eliminate discrimination in their roles as employers and as service providers. This research reveals that there are no regular, structured checks being made across NHS Scotland on whether the significant efforts, time and resources being invested in equality training are yielding an equally significant reduction in and clear path to the elimination of discrimination in the NHS as an employer and as a service provider
In brief, NHS Scotland has for some years now been training one of the biggest workforces in Scotland on equality and the elimination of discrimination - and has not a clue whether that training is making any difference at all, good or bad. In order to change from what the NHS is now and what it needs to be when discrimination has been eliminated, the NHS needs to construct a 3-D model of what it will look like once the changes have been achieved. The Cabinet Secretary for Health doesn't know what the NHS should look like with discrimination eliminated, nor does the Chief Executive of NHS Scotland, and nor do the Chief Executives of each of the 22 Health Boards have a 3-D model of their own workforce or service profiles.
The NHS in Scotland is training workers to help it change and reach a destination it is unable to describe in any detail.
The present leadership in Scotland in the form of government ministers, senior civil servants advising ministers, and the senior staff running the 22 Health Boards, are clearly culpable in the shambles of how NHS staff are being trained to play their part in eliminating discrimination. Not only are they not prepared to blow the bloody doors off institutional discrimination in Scotland's NHS, they have locked the doors and thrown away the keys to ensure that institutional discrimination remains securely parked in Scotland's public sector.
[1] Ed
Ruscha, https://www.theguardian.com/artanddesign/2018/jun/12/ed-ruscha-interview-america-decline-course-of-empire-national-gallery
[2]
Charlie Croker, The Italian Job
