October signals another Black History Month. It brings with it an opportunity to celebrate the ongoing commitment that Black, Asian and other minority ethnic nurses, healthcare workers and students have made and continue to make to the NHS.
I pay homage to the nursing pioneers who broke down barriers and paved the way for future generations of Black, Asian and other minority ethnic nurses. These trailblazers faced and continue to face unacceptable challenges. Racial discrimination impacts on their lives day in and day out. Holloway (2023), reports in The Voice, that many workplaces are ‘hostile environments' for Black workers, which may well be having a detrimental impact on employees’ mental health.
Despite these obstacles, these nurses persevere, displaying incredible resilience and determination and at the same time providing high-quality, safe and effective care to people in a wide spectrum of care settings.
However, these prosaisms being made here by a white male, cannot begin to address how, in 21st century Britain, 87% of Black people surveyed have reported that they expect to receive a substandard level of healthcare because of their race (Semple et al, 2023). The British Black Voices Project (University of Cambridge, 2023) reports on the experience of being Black in Britain. This is a national survey of 10 000 Black Britons along with in-depth interviews of leading Black British commentators. The aim was to build understanding, drive change, increase prosperity, improve policy, overcome obstacles and maximise participation in key institutions and professions – this is a big ask.
The research suggests that racial prejudice and insensitivity in UK workplaces remains entrenched, with a high percentage of respondents (88%) reporting that they have experienced racial discrimination at work. Almost all respondents (98%) said that they have compromised self-expression and identity to fit into the workplace. They report having to do this by adapting speech or hairstyles, with appearance and cultural background cited as factors influencing their lack of promotion or development. It could be suggested that the majority of minority ethnic nurses reading the report will respond to this by saying ‘this is not news to me, this is something I live with’.
The wide-ranging inequalities that Black people experience (not just feel) with regards to the provision of healthcare, for example, has to concern all of us. Our NHS is not considered a safe, supportive or adequate environment by a large number of people because of their race (Semple et al, 2023). Less than 1 in 60 respondents said they were fairly treated within the healthcare system, which was largely depicted as a hostile environment. This perception is reinforced by studies of healthcare sectors. For example, in obstetrics, death rates are 4 times as high among Black women as their White counterparts. Explanations for these patterns were predominantly focused on the systemic nature of racism that occurs across British society (Semple, 2023). Semple et al (2023) report that, although it was felt that improvements could be made to medical education and to diversity awareness in the health services, a high degree of scepticism existed about the difference such measures could make, given the deep structural roots of the problem.
The report states: ‘This report needs to start a conversation into the unequal outcomes that members of Black communities face in Britain’ (University of Cambridge, 2023). How many more reports do we need? Why have previous reports (and there have been many) not started that conversation, finished that conversation and dealt with the gross inequalities Black Britons experience? There has been no learning, we are still not listening and we should all be ashamed of that.