NEWS FOCUS: The NHS does not have a great record on race relations, but new legislation aims to rectify that by giving patients and staff equal access to services and jobs respectively. Anne Gulland investigates

Race reared its head as an election issue even before polling day was announced: a number of MPs were in hot water for refusing to sign a pledge condemning racist electioneering; Labour failed to meet its quota of ethnic minority parliamentary candidates; and it was only last month that Asian teenagers in Bradford and Oldham were on the rampage.

The publication on the statute book of the Race Relations (Amendment) Act 2000 last month only adds to the debate.

The act - partly a result of the 1999 Macpherson inquiry into the murder of black teenager Stephen Lawrence - makes it a statutory duty of all public bodies, the NHS included, to actively promote racial equality.

It makes all types of discrimination illegal, whether direct, indirect or unintentional, with a shift in emphasis that means managers will have to be proactive in ensuring that ethnic minority staff and patients get equal access to opportunities and services. This contrasts with the 1976 legislation, which focused on penalising discriminatory employers and employment practices.

What the law will mean to managers in practice is still to be worked out. Over the next few months, the Commission for Racial Equality will publish codes of practice for NHS managers that will be open to public consultation.

Whatever the nitty-gritty, the act will affect managers. Even in Bradford, where people from ethnic minorities make up 20 per cent of the population and where one might imagine race relations policies are well established, the inquiry into the death of Stephen Lawrence had an impact.

Selina Ullah, senior manager for the race and health strategy at Bradford Community trust, says that when the inquiry was published managers took the view that it affected everyone in the trust. They conducted a review of services and talked to staff about the inquiry and its implications.

'We tried to get staff involved in saying what they felt were the issues, ' says Ms Ullah. 'Many staff interpreted positive action to promote racial equality as positive discrimination and they were not happy with this.

'Service managers have now come to us and admitted that they were institutionally racist. For example, in mental health services, when patients are admitted we now make sure that someone who speaks their language welcomes them. Before, we would do it on an ad-hoc basis: if there was a member of staff on duty who spoke that language, we would ask them to help out.

'Of course, we have a large Asian community but we also have Afro-Caribbean and eastern European service users. It is easy to overlook the minority within a minority and We are now more sensitive to their needs, ' she says.

The NHS does not have a great record on race - a survey of trusts in London, the South East, the South West and Eastern regions published by the CRE in February found that, although 95 per cent of the 128 trusts that responded had formal written equal opportunities policies on race, just 5 per cent of trusts had implemented racial equality action plans. A third - 34 per cent - were in the process of implementing them and 11 per cent had plans scheduled for implementation.

Poole Hospital trust in Dorset was praised in the CRE report.

Despite the fact the area's ethnic minority population is less than 1 per cent, managers felt it made good business sense to take racial equality seriously.

Managers came together in an equal opportunities working group that carried out an audit of staff by ethnic origin, gender, disability and caring or dependent responsibilities. The trust monitors all vacancies to check whether ethnic minorities are being shortlisted and whether the selection process is fair.

Marie Cleary, human resources manager, says: 'We started looking at this about seven years ago and we certainly didn't feel that the make-up of our workforce or our local community should affect our equal opportunities policy. '

The trust is now discussing how the act will affect its policies. Ms Cleary says: 'We hope we will attract more ethnic minority candidates, although this is difficult to quantify. The better known we get as an equal opportunities organisation, the more people will want to work here. '