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A waste of talent

A waste of talent

Racism harms healthcare by holding back skilled people, says Dr Kailash Chand

Healthcare thrives on equality and diversity. In some specialities, such as general practice, we know that almost a third of the emerging workforce qualified overseas. Without these immigrant workers the NHS would come to a standstill. BME doctors have saved Britain billions in training costs alone. And it’s not just doctors. According to the NHS Institute for Innovation and Improvement, there are 193,000 staff from black and minority ethnic (BME) backgrounds in the NHS – representing nearly 20% of the workforce.
Yet racism and discrimination are still rife in the NHS. Many international medical graduates (IMGs), the workhorses of the NHS, are over-represented in the lowest paid, least glamorous specialties in the least popular parts of the country.
Some of them have faced overt racism. Even without that, they are less likely to be recognised for pay awards and have a slower rate of progress through the ranks. IMGs from a BME background are likely to be dealt with more harshly by the GMC; they are three times more likely to be charged with serious professional misconduct, and therefore have a higher rate of receiving high-impact decisions than their white counterparts.
A 2003 BMA survey 2003 revealed more than 80% of BME doctors believed that their ethnicity had a negative effect on their career advancement. In 2004 the Royal College of Psychiatrists accepted that racism existed in the NHS and in their own institution. Nothing much has improved since.
There are only 30 BME executive directors, out of an estimated 3,000 posts. In social care the picture isn't much better; there are four BME directors of adult services in England, out of 150.There are only five BME chief executives across more than 300 NHS organisations. Royal colleges and the BMA don’t do any better at in representing BMEs at the highest level. There is very obvious over-representation of BME staff at lower professional grades and under-representation in senior roles. BME staff are far more likely to face disciplinary procedures.
Fairness, transparency and equity
BME staff are an essential and irreplaceable asset to the NHS, making up a quarter of the overall workforce, and higher proportions in some sections. Unequal treatment, racism and barriers to career progression are serious issues, not just for the individuals affected but for the equality, efficiency and quality of the NHS overall. Without immigrant staff, the health service would come to a standstill. But BME health professionals are clearly not treated fairly.
The DHSC, royal colleges, GMC and the BMA should take a more active lead to tackle racism and discrimination. For those who are committed to a lifelong career in the NHS, I would like to see fairness, transparency and equity. 
Dr Kailash Chand is Chair of Healthwatch Tameside and the former deputy chair of BMA council. Twitter @kailashchandobe


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