With the new year come new opportunities to improve the health service and strengthen its commitment to racial equality. Helen Hally shares her NHS wish list for 2008

  • that targets relating to achieving measurable improvements in race equality feature in the objectives and appraisal process for all NHS chairs, chief executives and directors. If this is a key component of the role of NHS leaders, then it will inevitably cascade throughout the whole NHS. Waiting times were not reduced because some middle managers were given the responsibility to reduce them. The organisation and its leaders were charged with making the changes. Why then do we so often place the responsibility for race equality on the shoulders of some junior member of staff, who is not even located in the corporate heart of the organisation?
  • that all NHS organisations pledge to comply with the requirements of the Race Relations Amendment Act and achieve this compliance. The findings of the Healthcare Commission's latest audit reveal we are very far away from that position. People may question whether the publication schedule that is required for documentation in this area is a good proxy measure for activity designed to drive forward race equality. However, if organisations cannot demonstrate that they are doing the easy bit, why should we assume they are progressing with the more complex work of making race equality a reality?
  • that race equality schemes move from being burdens to being opportunities, embraced by and shaped by all staff and service users. Would it not be wonderful if prospective employees quizzed interview panels on the quality and scope of their scheme? Can you imagine the vibrancy of an organisation that every month held an open meeting to review and revise the scheme, and that participation in those meetings was encouraged and experienced as highly rewarding?
  • that those conditions that have a significantly higher prevalence among people from black and minority ethnic communities, for example diabetes, coronary heart disease, stroke, perinatal mortality and mental illness, are placed at the forefront when commissioning and delivering services and allocating research funding. This should not be at the expense of attention being given to other conditions, but unless these areas are brought into the forefront of our thinking, planning and delivery, the potential for the health inequality gap to widen further is very great.
  • that all NHS bodies recognise that "health" is not just what happens in clinical settings, and that to achieve lasting improvements in the health of people from BME communities effective local partnerships must be established between the NHS, social services, education, police, commerce, housing, leisure services and the diverse communities themselves. It would be great to see a blossoming of local forums where local people could shape the community in which they lived and where public sector providers could be held to account.
  • that comprehensive language services and cultural mediation are considered to be as integral parts of modern healthcare as sphygmomanometers and hand-washing. I strongly support the idea that people who come to this country to live should be encouraged and supported in learning English. However, I have significant difficulty with the notions that without fluent English one is not entitled to the same quality of care, or that when someone is experiencing a health crisis it is a good time to encourage new language acquisition.
  • that we stop philosophising, prevaricating and procrastinating about race equality, and just get on and make it happen. In June, it will be 60 years since Empire Windrush docked at Tilbury, bringing the first of many waves of migrants who have worked for and enriched this country in general and the NHS in particular. How much longer must our fellow citizens wait to be treated as equals? If I could have only one wish, it would be for race equality for all our citizens. The rest of my wish list is merely means to this end. Nothing short of race equality is acceptable in the 21st century. Now let us together take action.

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