Partha Kar: Talk is cheap. The NHS needs anti-racist action, not empty words or virtue signalling
BMJ 2024; 386 doi: https://doi.org/10.1136/bmj.q1903 (Published 03 September 2024) Cite this as: BMJ 2024;386:q1903
- Partha Kar, consultant in diabetes and endocrinology
- drparthakar{at}gmail.com
Follow Partha on X @parthaskar
The race riots that broke out recently in the UK were horrific, brought on by Islamophobia coupled with the far right pushing a narrative that scapegoats immigrants as the reason for all the UK’s woes. Whatever the underlying politics, reasons, and narrative, one thing was certain: it was one of the first times that I’ve thought twice about a trip to London because of the colour of my skin—or asked my children to stay at home when social media flagged far right marches in Portsmouth.
However, we must balance these events with what then transpired. The masses of people who came out against the hateful ones was heartwarming to see—a reminder of what this country seemed to stand for before the divisions of Brexit were sown by a few at the expense of many. Amid the riots and counterprotests it was fascinating to see the response of the NHS as a whole: it took some time, but thankfully Amanda Pritchard, chief of NHS England, led the way in reaffirming the NHS’s commitment to all its staff, with many other leaders following suit.
Yet their responses fell short of changing the mood regarding the commitment to tackle racism in the NHS. The talk continues to be strong, but the accompanying action falls short. NHS leaders strongly speaking up against race riots, while doing little to confront its own failures on this topic, made the contrast even more stark.
Let’s look at some facts. The work of the NHS Workforce Race Equality Standard (WRES), which started in 2015, has now become an afterthought. Nothing exemplifies this better than the recent WRES report in 2023 being available as a drab Word file, rather than the previous glossy documents.1 The data show little to no improvement, a dire indictment of failure among the NHS organisations involved. Some clutched at certain data to justify “progress” but failed to convince many people.
The NHS published its first and only Medical Workforce Race Equality Standard report in 2021,2 with priorities to tackle racism in the medical workforce. This was followed by an action plan published in 2023, but that work has been delegated to partner organisations, with the NHS deciding not to lead on this issue. The leadership position dedicated to challenging racism in England’s workforce has remained empty since 2023: the previous incumbent, Anton Emmanuel, is now working on similar issues in Wales.
Political whims
Wrapped in an amorphous bubble called diversity, equity, and inclusion (DEI), this approach reduces neither sexism nor racism, or for that matter any discrimination based on a protected characteristic under threat. When everything is a priority, very rarely is anything a priority—and that’s how it has transpired under the leadership of NHS England’s workforce training and education team. It’s ironic to see the NHS encourage its employees to fill in staff surveys when, despite repeated surveys showing racism to be the protected characteristic with the worst outcomes, the NHS has little to show for its work.
Talk is cheap, and I’ll say so publicly to many in NHS England’s senior team. There’s a clear lack of diversity in the team, and they must show more willingness to approach this issue with more than words. Reinstating the work against racism with relevant leads and datasets would be only one step forward. As the largest employer in the country, the NHS should be leading the change for a society that works together, not pandering to political whims or rhetoric.
A recent development shows the lack of seriousness with which NHS organisations have approached the topic of racism. There’s been much debate about X (formerly Twitter) and whether it has facilitated the rise of the far right unchecked. A wider debate is warranted about whether leaving the social media platform is conceding to fascist views, but to see NHS organisations discuss whether they should leave X “in protest” is an act of gaslighting towards NHS staff. Don’t wonder why staff have little faith in you, or even less when the colour of your skin becomes a topic for virtue signalling.
NHS leaders need to focus on tackling issues of racism in society that percolate into the workforce too. As someone who has faced enough bias and battled through the system, I ask all leaders to match their rhetoric with actions. Either that or they must be honest about it not being a priority. Silence is complicity—which is worth remembering when you next consider making a statement about racism in the NHS.
Footnotes
Competing interests: see www.bmj.com/about-bmj/freelance-contributors. Partha Kar is national specialty adviser, diabetes, and former lead of the Medical Workforce Race Equality Standard.
Provenance and peer review: Commissioned; not externally peer reviewed.