The NHS's most senior equality official has warned that the Department of Health could stop working with organisations that do not fulfil their obligations under race equality legislation.

DoH national director for equality and human rights Surinder Sharma told last week's Race for Health and HSJ conference on race equality the department was considering not working with NHS organisations that are not meeting their legal obligations. 'That's got to be the line in the sand,' he said.

His comments came less than a month after an audit of trust websites by the Healthcare Commission revealed that just 9 per cent of trusts are publishing everything they are required to under the Race Relations Act 1976 [for more background, click here].

He told HSJ: 'If people show no commitment and show no leadership on this issue then obviously we will call into question whether we should, either by expertise or support, be working with organisations who are not showing any leadership around this.'

He told the conference that the NHS compared unfavourably with other organisations such as the BBC or motor companies in its efforts to improve equality.

Leadership is critical and chief executives and boards have to take responsibility, he said. 'How many primary care trusts are prepared to take no performance-related pay because they have not actually met their legal duties? That's what it is, we are not performing.

'We talk about it, we put it in the too difficult to do box over there and do our day job and then we turn our attention to tackling race equality if we have got time to do it. That's got to change.'

He told PCTs that, as commissioners, they were the 'linchpin'; they could hold others to account using their leverage as procurers of services.

Information policy fellow at the Healthcare Commission Veena Raleigh told the conference there was not enough information on patients' ethnicity. 'The foundation for achieving change has to be the availability of good information for commissioners about which patients are where, which services they are accessing and that information does not exist.

'As the regulator we can't assess whether organisations are fulfilling their duties in this respect.'

Responding to a similar request for the DoH to insist on more data collection, put by King's Fund health policy fellow Ruth Thorlby, junior health minister responsible for equality Ivan Lewis said he would consider the issue.

He said the NHS needed to undergo a 'cultural shift' in the way it saw its relationships with cultural groups, faith groups and the voluntary sector.

'It's about recognising the fact that the NHS in terms of conventional, traditional means of providing healthcare may well not have all of the solutions,' he said.