Health minister John Denham has announced tough new targets to break the 'glass ceiling' in NHS management and ensure that women and ethnic minorities secure more of the top posts.
The launch of the equalities framework has coincided with an exclusive HSJ survey which reveals that ethnic minority staff are still stuck in the lower ranks - and some NHS employers have no equal opportunities policy.
Under the new framework, from April 2004 at least 7 per cent of all trust and health authority managers at executive board level should be from an ethnic minority background, and at least 40 per cent should be women. But HSJ's survey has found that in HAs only 3.3 per cent of executive board members and 2.18 per cent of senior managers are from ethnic minorities.
For trusts the figures are 3.46 per cent at executive board level, and 2.96 per cent of senior managers below board level.
The framework also requires all NHS employers to set targets for reducing the number of incidents of harassment in the workplace, and demonstrate progress, year on year.
They must also be able to show, via staff surveys, an annual increase in staff 'confidence' in their ability to tackle harassment.
The Vital Connection: working together for quality and equality says that by April 2001 boards must have undertaken training on 'managing equality and diversity', and guarantee to interview qualified disabled applicants.
An 'equalities statement' must be included in the annual report, outlining how the organisation has met local and national priorities, and future plans for action.
HSJ's survey found that though the NHS employs a greater proportion of staff from ethnic minorities than exist in the general population - 11 per cent of the NHS's employees are non-white compared to 6.48 per cent of the population - they are mostly in the lower ranks of the service. Overall only 3.03 per cent of senior managers are from ethnic minorities.
Just 71 per cent of HAs collected information on the ethnic backgrounds of staff (23 per cent did not collect, and 6 per cent were 'unsure' whether they did). Trusts did better, with 86 per cent collecting this information.
Nearly half of all respondents did not actively recruit from ethnic minorities.
The survey was conducted earlier this year for HSJ by Binley's, the specialist healthcare database company, with the support of the Institute of Healthcare Management. It was sent to 2, 800 named individuals working in trusts, HAs, primary care groups, local healthcare groups and co-operatives. Walter Brinzer, director of Binley's, said some of the respondents' comments - especially those from areas with very small ethnic minority populations - revealed an 'element of complacency'.
Chris Myant of the Commission for Racial Equality said the low number of ethnic minority senior managers was 'a poor outcome for an organisation that has employed people from ethnic minority backgrounds for half a century'.
Sam Everington, British Medical Association council member and author of studies on discrimination towards ethnic minority medical students and doctors, said the failure of some organisations to collect even basic information was 'completely unacceptable'.