Emily Carver is Media Manager at the Institute of Economic Affairs.
New research from the Nuffield Trust, an independent health think tank, has claimed that inequality among NHS staff members of different races and religions “is getting worse”.
Its study Attracting, Supporting and Retaining a Diverse NHS Workforce, commissioned by NHS Employers, part of the NHS Confederation, highlights statistical disparities in the experiences and professional outcomes of staff by group, including along the lines of gender, religion, and ethnicity.
According to data from last year’s NHS staff survey, Muslim staff are more than twice as likely to report experiencing discrimination than staff of no religion, and those who prefer to self-describe their gender are twice as likely to report experiencing discrimination as male or female staff.
In terms of professional advancement, male nurses were found to be twice as likely to progress up two pay bands than female nurses; ethnic minority staff 27 per cent less likely than white staff to be “very senior managers”; and candidates with Bangladeshi ethnicity were found, on average, to be half as likely to be appointed from an NHS shortlist than a white British person. Where there has been an increase in representation of a minority group, this is described as an “improvement”.
Of course, discrimination and bullying in the workplace should be seriously investigated, addressed, and dealt with swiftly. But what’s troubling is the implication that runs through the report that diversity is an end goal in and of itself, and that any discrepancy is likely a result of discrimination, bias or a lack of commitment to diversity and inclusion. Its authors claim that “despite considerable effort and countless initiatives, inequality between NHS staff groups is persisting or even getting worse – and the health service does not have the tools to address this”.
In the same way that much of the analysis on gender pay gap reporting blames sexism for any discrepancies in earnings between men and women, the Nuffield Trust’s report assumes that any disparity between identity groups is down to discrimination – or at least provides little acknowledgement that there may be other factors at play.
The reader is clearly meant to believe that any disparities between groups, be it in terms of progressing up pay bands, or gaining a position in senior management, must be due to discrimination.
What’s concerning is how this translates into action. Commenting on the report, Danny Mortimer, Chief Executive of NHS Employers said, “there’s an absolute commitment from our members to finally address the inequities in our workplaces”, and that the report “reminds us that far more urgency and impact is needed in every part of the NHS”.
Pat Cullen, The Royal College of Nursing Chief Executive, responded by saying that the NHS leadership has “no alternative but to act on the findings” of the report, and that lack of inclusion and diversity can’t be pushed down the list of priorities any longer. This is ironic, considering the recent exposure of just how much we’re spending on NHS Diversity and Inclusion officers every year.
Mortimer says that we must address inequities. But what does this actually mean? What actions are they advocating to ensure there are no such inequities? Does this mean that unless there is parity between groups, that the NHS has failed? And why is this even desirable? Should equality of outcome among staff now be the priority, in an organisation that is creaking at the seams? Surely, the last thing we need is more of our money spent on diversity and inclusion managers.
But judging by the proposals made by the Nuffield Trust, this is exactly what its authors want. The report recommends that NHS England regularly provides information to employers on their ‘relative and absolute performance’ on equality and diversity. This means continuous data gathering on age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion or belief, sex and sexual orientation, as well as socioeconomic status, national origin and carer status. All to be supported by “continuous training” for NHS ‘diversity leads’.
Applying to jobs in the public sector and parts of the private sector has become a diversity and inclusion minefield. Demands to fill in your ethnicity, gender, even sexuality are commonplace, while in parts of the civil service they no longer want to see your academic background. Increasingly, it feels as though job ads may as well just put at the top of the job ad notice: “white, heterosexual, able-bodied men need not apply”.
Diversity and inclusion may be dressed up in the language of equality, progress and advancement but it leads to quite the reverse. It’s lunacy that it has to be said but individuals should be judged as just that, individuals, not by their group identity or by their supposed ‘privileges’.
An institution like the NHS should focus on meritocracy, rather than engaging in pursuits that look suspiciously like social engineering. Come down hard on genuine accusations of discrimination, but whether a nurse is black or white should be of little consequence.