NHS in Scotland unable - or unwilling - to audit equality training and demonstrate whether it is reducing and eliminating discrimination or maintaining the status quo

Changing the status quo is never easy.  The natural instinct of those in charge of the status quo is to keep things as they are because it invariably means life is comfortable for them and people like them.

Several decades ago laws were introduced and work started on what is now commonly termed 'equality', triggered by a number of issues around overt racism in the UK.  That anti-racism work has been going on since then and growing to encompass work aimed at ending discrimination experienced by disabled people, women, lesbian, gay and bisexual people, Catholic people and others.  While in those intervening decades we have witnessed how we have the capacity to create huge change - from mobile phones to pictures of the surface of Mars - it seems that no matter how much effort we put in to 'equality' the same people continue to remain exiled, through discrimination, to living on the very margins of what we call society.

In an effort to understand why we have collectively failed to change the status quo, I looked at how employers trained staff in how they could help the employer change and eliminate discrimination in how they functioned.  I thought NHS Scotland would be a good sample of the public sector to examine and sent all of Scotland's 22 health boards a Freedom of Information request and focusing on critical aspects of how they trained their workforce in 'equality'.  You can read the research report here.  There are quite a number of revelations.

One of these is the focus of this blog.

Boards were asked for evidence that they evaluated the training they give staff [over 163,000 work in the NHS in Scotland] on equality and eliminating discrimination was actually leading to a measurable reduction in discrimination and that they were on track for eliminating discrimination.  

The research showed that there is no viable evaluation going on across NHS Scotland of whether equality training is doing what it should.  Considerable resources, time, creativity and effort has been and is being given over to training NHS Scotland staff in eliminating discrimination and on the Equality Act 2010 - yet there is no real check or audit or evaluation as to whether discrimination is being reduced, eliminated or indeed if it is increasing.

One Board, NHS Dumfries and Galloway, did grasp the scale of the challenge in evaluating equality training in relation to the goal of eliminating discrimination :

Equality training should eventually lead to a workforce which has a greater understanding of equality and diversity in relation to both staff and patients. It is hoped that over time, we will see a reduction in complaints which relate to equality and diversity and that greater awareness will be reflected within our staff Dignity at Work survey. Training and awareness features as part of our equality and diversity outcomes report and mainstreaming report but is something within which success is difficult to measure as it requires change to our culture which happens over a long period of time.

Credit to NHS Dumfries and Galloway for recognising the scale of the challenge.

Jeane Freeman
Cabinet Secretary for Health

The reality remains that significant resources are being used across NHS Scotland to train staff in equality - and no-one is checking to see if it offers value for money or if it is eliminating discrimination.  If the NHS is unable to show discrimination is being eliminated as an employer, it is more than likely that it is unable to evidence that it is eliminating discrimination in how it delivers health services.  Will Cabinet Secretary for Health, Jeane Freeman change the status quo in the NHS when it comes to equality or maintain it pretty much as is in the same way as her predecessor ?

Inferior equality training provided for most NHS Scotland staff - institutional discrimination remains deep rooted.

Changing the status quo is never easy.  The natural instinct of those in charge of the status quo is to keep things as they are because it invariably means life is comfortable for them and people like them.

Several decades ago laws were introduced and work started on what is now commonly termed 'equality', triggered by a number of issues around overt racism in the UK.  That anti-racism work has been going on since then and growing to encompass work aimed at ending discrimination experienced by disabled people, women, lesbian, gay and bisexual people, Catholic people and others.  While in those intervening decades we have witnessed how we have the capacity to create huge change - from mobile phones to pictures of the surface of Mars - it seems that no matter how much effort we put in to 'equality' the same people continue to remain exiled, through discrimination, to living on the very margins of what we call society.

In an effort to understand why we have collectively failed to change the status quo, I looked at how employers trained staff in how they could help the employer change and eliminate discrimination in how they functioned.  I thought NHS Scotland would be a good sample of the public sector to examine and sent all of Scotland's 22 health boards a Freedom of Information request and focusing on critical aspects of how they trained their workforce in 'equality'.  You can read the research report here.  There are quite a number of revelations.

One of these is the focus of this blog.

When asked how the equality training was delivered most Health Boards indicated they used a mix of e-modules and classroom settings.  Two Health Boards [Grampian and Orkney] were unequivocal - they used what they called 'face-to-face' training.  Those Health Boards explained :

"All of our Equality and Diversity training is delivered “face to face”. Research done by another Health Board and followed up by NHS Grampian and NHS Orkney has shown that “face to face” training is vastly superior to e-learning in this field for a number of reasons"

If we accept the position of NHS Grampian and NHS Orkney - that their face-to-face method of training delivery is 'vastly superior to e-learning' - then it is reasonable to conclude that much of the equality training delivered by the other 20 Health Boards in Scotland is vastly inferior.

Jeane Freeman, Cabinet Secretary for Health

Is this single issue the reason why NHS Scotland seems unable to pull up the deep roots of institutional discrimination which are in evidence from the employment data the Health Boards publish on a regular basis ?  I have sent a copy of the research report to the new Cabinet Secretary for Health and invited her comment on the superior/inferior delivery of equality training across NHS Scotland.