Healthcare leaders reject “damaging” denial that institutional racism exists

A controversial government commissioned review1 which found “no evidence of systemic or institutional racism” in the UK has been roundly criticised by healthcare leaders.

The review from the Commission on Race and Ethnic Disparities (CRED), published last week, was commissioned by the UK government to examine race relations in the UK in the wake of high covid-19 death rates in some ethnic minority groups and last year’s Black Lives Matter protests. But it has faced a fierce backlash after concluding that the UK is “no longer” a country where “the system is deliberately rigged against ethnic minorities.”

The commission, chaired by chief executive of educational charity Generating Genius Tony Sewell, did not deny that racism exists, but said that factors such as where people live, family influence, socioeconomic background, culture, and religion have more significant impact on life chances than the existence of racism.

But NHS and medical leaders said the report’s conclusions did not match the experiences of staff working in healthcare.

Saffron Cordery, the deputy chief executive of NHS Providers, which represents NHS trusts, said, “We disagree with the conclusions of this report. Within the largest employer in the country—the NHS—there is clear and unmistakable evidence that staff from ethnic minorities have worse experiences at work and face more barriers in progressing their careers than their white counterparts.

“While some progress has been made, to pretend that discrimination does not exist is damaging as is denying the link between structural racism and wider health inequalities.”

David Chung, co-chair of the Royal College of Emergency Medicine’s equity, diversity, and inclusion committee, said, “The NHS staff survey 2020 found that staff from ethnic minorities were more likely to be deployed onto covid wards and our own survey found that ethnic minority staff were less likely to be risk assessed, less likely to have access to appropriate personal protective equipment (PPE), and were less likely to have PPE fitted.

“The CRED report suggests a different story and fails to recognise what is in plain sight. That within the NHS systemic and structural racism is prevalent: across recruitment; pay; career progression and opportunity; and the experience of bullying, harassment, or abuse.”

He added, “We must be honest about racism and not gloss over the matter. If we fail to acknowledge racism within the NHS, we could fail to recognise any racism towards patients. There is a link between structural racism and health inequalities, and we must admit that so we can begin to tackle it.”

The NHS Race and Health Observatory, which was established in 2020 to investigate the effects of race and ethnicity on people’s health,2 said it was “disappointed by several of the headline conclusions of the report, including those on the causes of ethnic inequalities.”

“The evidence it cites is clear: institutional racism exists in this country, it exists in the organisations that make up our health and care system, and it exists across wider public establishments,” said a statement from the observatory.

Among 24 recommendations in the commission’s report were to establish a new Office for Health Disparities to work alongside the NHS to improve healthy life expectancy and reduce inequalities in all groups, and for the NHS to commission a strategic review of the causes of disparate pay across NHS England and how to tackle them.