Your report on racism in the NHS provides powerful statistical support to the view that racism is not simply about recruitment.

It is also about the failure of management to get to grips with managing a diverse workforce. Black and minority ethnic staff are much more likely to be involved in bullying, harassment, grievance and capability procedures. This is not evidence of managers being racist but of their lack of confidence in dealing with racism and a failure to convince black staff that policies and procedures will be applied fairly.

If all staff feel valued and respected, if they feel they are treated fairly, then the organisation they work for is unlikely to be characterised by bullying, harassment and discrimination. This requires managers to become more sensitive to people's needs and to improve their leadership skills by gaining insight into how their behaviour affects the people they manage.

Unfortunately, persisting management style and culture within the NHS do not make people feel valued and respected.

Blair McPherson, director of community services, Lancashire county council