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Government commission ‘ignores’ NHS structural racism, BMA says

by Jess Hacker
2 July 2021

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The Government commission into racial disparities in the UK failed to address the racist or discriminatory policies, processes and behaviours present in the healthcare sector, the BMA has said.

The Commission on Race and Ethnic Disparities (CRED) published its report on 31 March, which the BMA said ‘is missing opportunities to identify effective solutions to tackle racial inequalities within the UK’.

Responding yesterday (1 July) – more than three months after the initial report – the BMA said the paper ‘ignores the lived experience’ of many ethnic minority healthcare workers.

It added that it ‘firmly refutes’ the report’s overall findings.

Increased accountability

In its own recommendations for the Government, the BMA stated that employers of healthcare staff should face increased accountability for failing to address race-related harassment.

The BMA said that, although it supports several of the CRED report’s recommendations – including the formation of an Office for Health Disparities and a review of the CQC’s inspection process – the Government must readdress structural and systemic racism.

This would mean accepting that structural racism exists and committing to cultural transformation across all levels of the healthcare sector, it said.

The BMA recommended:

  • Anyone who recruits overseas doctors must provide them with mentoring and ongoing support.
  • Mandatory race training for decision-makers in all healthcare bodies.
  • All organisations should publish summaries of equality impact assessments relating to processes which have been proven to have different outcomes based on race.

Report’s validity questioned

Dr Chaand Nagpaul, BMA chair of council, said that the authors’ use of sweeping statements in its analysis of the evidence called into question ‘the validity of the entire report’.

He said that ‘the authors’ decision to ignore the well-documented facts presented to them failed to use the Commission as an opportunity to address the root causes’ and provide solutions.

‘Having missed an opportunity with this report we’d strongly urge the Government to take the BMA’s response seriously and begin to tackle structural racism within the health service so that the values of fairness and equity we ascribe to patient care applies equally to those that work within the NHS,’ he added.

A spokesperson for the Commission today said: ‘The Commission found that ethnic disparities exist when it comes to health care and has made a number of recommendations to reduce health inequalities across all groups including the establishment of the Office of Health Disparities and a review of the Care Quality Commission’s inspection process.’

‘Deeply personal attacks’

The CRED report was widely criticised at the time of publication, prompting the Commission to issue a statement on 2 April. It said that ‘in some cases fair and robust disagreement’ with its work had ‘tipped into misrepresentation’ and there was a need to ‘set the record straight’.

‘We have never said that racism does not exist in society or in institutions. We say the contrary: racism is real and we must do more to tackle it,’ it added.

‘That is why our very first recommendation to the Government is to challenge racist and discriminatory action and increase funding to the Equality and Human Rights Commission (EHRC) to pursue investigations.’

It also said that members of the commission had faced ‘deeply personal attacks’ following publication of the report.

‘We hope that going forward, the report will be read carefully and considered in the round. Our experience since publication only reinforces the need for informed debate on race based on mutual respect,’ the Commission added.