Now is the time!
In this in-depth and impassioned op-ed, Paul Draycott, Director of Workforce, Organisational Development and Communications at Southern Health NHS Foundation Trust, delivers a withering summary of inequalities facing BAME colleagues within the NHS and sets out how we can all take action to make the Trust a more diverse and inclusive place.
Now is the time!
Nobody will have missed the changes in our world over the past few months. Covid-19 has had a profound impact on what we do and how we do it; and so has the death of George Floyd in the US and the continuing rise of Black Lives Matter — a movement trying to fight the centuries of discrimination and environments that don’t value diversity and inclusivity.
Diversity brings richness to our world. We are all different. Different heritage, ideals, values, education, talents, likes and dislikes. In teams diversity brings greater success especially when considering problem solving, innovation, strategy and difficult challenges. Being inclusive and enabling people to thrive and give of their best is essential to this organisation and in us being able to deliver the best possible services to our diverse population.
Being inclusive — welcoming everyone and embracing difference — has to be the bedrock of our culture. Southern Health is here to be inclusive: “the practice or policy of providing equal access to opportunities and resources for people who might otherwise be excluded or marginalized, such as those having physical or mental disabilities or belonging to other minority groups.”
The fabulous Roger Kline has summarised beautifully, and far more powerfully than I could, why inclusion and anti-discriminatory practices matter, in his most recent blog (available on LinkedIn), stating, amongst other things, that it is unethical, wastes talent, undermines patient care and actually impedes the improvement of services.
I am sure we would all echo those views.
Going back to George Floyd. I have heard a number of people say “he had a string of convictions” and “he was a criminal” as if that somehow justifies one of four police officers kneeling for 8 minutes and 45 seconds on his throat whilst he pleaded for his life. What happened was obscene and horrific — perpetrated by people entrusted with the safety of the US citizens. The statistics in the US are far from good in respect to discrimination against people of colour.
A recent study in the US by the Robert Wood Johnson Foundation found:
· nearly half (45%) of African Americans experienced racial discrimination when trying to rent an apartment or buy a home
· 18% of Asian Americans say they have experienced discrimination when interacting with police
· and, nearly 1 in 5 Latinos have avoided medical care due to concern of being discriminated against or treated poorly.
However the issues go far, far wider than what happens in the United States and for a far longer period of time.
Here in the UK it sometimes feels that we conveniently forget, or gloss over the fact, that slavery drove our prosperity from 1640 to 1807.
During this time, over three million black people were enslaved. That is more than twice the number of people working in our NHS today, forced into slavery. The Industrial Revolution that placed the UK front and centre in the world was fuelled by the profits of slavery. Additionally 450,000 people died in horrific conditions being transported to their destinations.
The deaths didn’t stop there. Back in 1993 Stephen Lawrence was brutally murdered for being black and in the wrong place — it took 18 years to bring his killers to justice.
We still have inequality today. Black people account for 3% of the population, but 8% of deaths in custody. (The Guardian 11 June 2020).
From the government’s own website in the year to March 2019, Black people were more than four times as likely as White people to be detained under the Mental Health Act — 306.8 detentions per 100,000 people, compared with 72.9 per 100,000 people.
Let’s look at the NHS. According to UK census data (2011), People from Black, Asian and Minority Ethnic (BAME) backgrounds make up 13% of the national population (about one in eight people). However, 20.8% (more than one in five) of NHS workers are from BAME backgrounds: a significant over-representation. The richness of that diversity is part of what makes our NHS great.
What doesn’t make us great though, is the clear evidence that many people of colour struggle to progress in their careers after becoming part of this wonderful NHS family. What doesn’t make us great is that from the 233 NHS provider organisations in England, there is only a handful of Directors of Nursing from BAME backgrounds and only slightly larger number of Chief Executives. Between Bands 8a and 9 BAME representation nearly halves from 20.8% to 12.5%. At Director level, only 7% of roles are filled by BAME colleagues.
Those numbers just don’t seem right do they? 20.8% to 12.5% to 7% — something is wrong.
Then when you consider that 61% of healthcare workers who died from COVID were from BAME backgrounds it should make us reflect. I make no apologies — it feels uncomfortable to me and many other people because it should do.
It is not just the wider NHS. Let’s look at Southern Health. Around 9% of the population we serve are from a BAME background. As a Trust we have a BAME workforce of just over 9%. We are broadly representative of our population, which is good.
But let’s break it down a little.
Our representation of BAME colleagues at Band 2 is 12% and at Band 5 it is 13% — these bands are important because they are typical levels for people first entering the NHS. As we move to higher paid roles representation plummets. At Band 7 this moves to 5% and by Band 8c it is down to 3%. We attract colleagues then we “superglue their shoes to the floor.”
We do not allow our colleagues to progress — and it can’t be related to their ability otherwise people wouldn’t be employed. We (I) am getting this wrong. We have not been enabling people of colour to flourish in the same way as white colleagues.
There are 38% of BAME colleagues reporting experience of bullying/harassment in the past 12 months from patients/service users/public (compared to 26% white colleagues); 12.7% experienced discrimination from their manger (5.5% white) and 72% BAME colleagues having equal access to career progression compared to 87% white colleagues. It isn’t pretty reading and we know it isn’t.
We have already identified the need for ALL levels of our organisation to be representative of our local population. It is one of our key workforce priorities for us to achieve by 2024/25. Last year the Board had a four-hour open meeting on Diversity and Inclusion. As well as looking closely at the numbers presented above, the Board heard staff stories and lived experience which has helped inform our next steps.
However we want to go further and quicker.
Renée Graham said “People of colour challenge racism every day; we’ve never had a choice. Yet since we did not build, and fortify for centuries, a system of white supremacy … we alone cannot be expected to undo it. That, white people, is on you — and your privilege.”
It is for all of us to make this change and within Southern Health we have committed to being fully representative of the population we serve at all levels within the next 5 years. Alongside this we have also committed to a number of other things including: following up every incident of racism reported, looking closely at BAME candidates and appointments to understand why we might not make an appointment and to publish statistics on BAME recruitment and representation within the Trust the same we publish Director pay or treatment times.
It feels that we are very much at a critical point in the movement to improve social justice and eliminate racism. Diversity and inclusivity are beautiful things and reap such reward. I sincerely hope that we can look back in 10 years and say 2020 and the Black Lives Matter movement changed things for the better here at Southern Health, across the NHS, the UK and around the world.
