The NHS staffing crisis won't be fixed until it solves its problem with racism

The NHS is close to collapse because of the government’s neglect. A squeeze on pay that has lasted for more than a decade, a failure to train enough staff and a hostile attitude to migration from the very top of government have all contributed to a catastrophic staffing crisis.

After an 8 per cent fall in real terms pay over the last decade, nurses have now been forced to take the unprecedented step of national strike action. They are also being joined by ambulance workers, with other NHS staff currently being balloted.

Staff often work in the NHS knowing that they could likely earn more if they pursued another career path, and they are motivated by the desire to help others. But this altruism should not be taken for granted. If the government really cared about our health service, it would not be creating a situation where hospitals are having to set up food banks to serve their own staff.

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I support an inflation-proof pay rise for NHS staff. As we know, Black and minority ethnic (BME) staff within the NHS are disproportionately located within lower paid roles, especially Black staff, and so it is they who will face the brunt of the cost of living crisis without a proper pay rise.

I’ve also been concerned that the impact racial discrimination is having on NHS staff from Black and ethnic minority backgrounds has not been part of the conversation regarding the wider staffing crisis. Having worked in the NHS for many years myself, both as a GP practice manager and as an executive assistant in an out of hours service, this is especially close to my heart, and I was pleased to raise it in a recent debate in Parliament on the NHS staffing crisis.

There has been great work done on racial disparities in health outcomes for patients, notably that FiveXMore have done around the disproportionate rates of Black maternal mortality. There is also a widespread awareness that those of us from minority ethnic groups were at greater risk of adverse outcomes from Covid-19. However, this same attention hasn’t been paid to the treatment of BME staff within the NHS.

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Perhaps this neglect is because BME staff are disproportionately represented in the NHS compared to the wider population, making up 22.4 per cent of the workforce, despite being underrepresented at senior levels. Indeed, it is impossible to tell the history of the NHS without mentioning the contribution of Black and minority ethnic staff, just as it is impossible to tell the story of Black and minority ethnic people in Britain without mentioning the NHS. While this is a history that deserves telling, we should not seek to sugarcoat it. As we know, those from the Windrush generation were often subject to horrific discrimination from patients and other staff. Discrimination which has still not been eradicated.

The BME Leadership Network for the NHS Confederation produced a report earlier this year titled Shattered Hopes, detailing the experiences of staff. The report found that more than half of BME leaders within the NHS had considered leaving in the past three years because of their experience of racist treatment, and that colleagues and managers were more common sources of this treatment than members of the public.

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There was also a lack of confidence from BME staff that the NHS is meeting its commitments to diversity and equality, with just 10 per cent confident that it is meeting commitments to tackle institutional racism. This means that when staff are themselves subject to discrimination, they do not feel sufficiently supported by the organisation to actively challenge racism or seek redress for particular incidents.

This is having a huge knock-on effect, creating barriers to staff feeling comfortable in their jobs, maximising their potential and being successful in applying for higher level positions. Not to mention that the experiences some staff will have working within the health service will force them to quit altogether, or potentially dissuade others from joining in the first place. This is only further contributing to the staffing shortage.

Sadly, the common sense within the current Conservative Party, as expressed by last year’s Sewell Report on Race and Ethnic Disparities, is that we need to stop talking so much about race. Those of us who understand the continued prevalence of discrimination are deemed to be on the wrong side of the ‘War on Woke’.

Truly tackling this issue will require serious action. The NHS must have a real commitment to becoming an anti-racist organisation. This will involve empowering existing BME leaders and staff networks to be able to seriously challenge racism, provide support and mentor colleagues, as well as implementing a more inclusive recruitment approach for senior roles.

While an ambitious approach from NHS management can make a difference, ultimately this will also take the willpower from political leadership in Westminster to drive the radical change needed.

Kate Osamor is Labour MP for Edmonton. @KateOsamor

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