Exclusive: GPs’ survey finds race discrimination in NHS treatment of primary care

The survey, instigated by GPs in Doncaster, South Yorkshire, also found more staff from a minority ethnic background said they had experienced some form of bullying or harassment, including “instances of physical violence”.

The work is thought to be unusual in primary care — annual “workforce race equality standard” surveys are required by NHS England for NHS trusts and, in the past year, clinical commissioning groups, but not in primary care. 

The survey in October was instigated by Doncaster Primary Care BAME Network and facilitated by Doncaster clinical commissioning group. It was sent to GPs and practice staff, community pharmacy staff, and other “healthcare professionals” in primary care. There were 136 respondents.

The report of the results said minority ethnic staff felt they were less able to make decisions to improve the work of primary care, less involved in decisions regarding their area of work and less respected by their colleagues compared with their white colleagues.

It said: “The experience of [black, Asian and minority ethnic] colleagues is a cause for concern. BAME colleagues shared that they are less able to make suggestions to improve the work of primary care, less involved in the decision [making] about their area and [feel] less respected by their colleagues than non-BAME colleagues.”

It added: “BAME colleagues reported experiencing discrimination based on their ethnic background and a high proportion felt that the NHS did not act fairly in relation to career progression.”

Nearly two-thirds (63.5 per cent) of minority ethnic respondents said they did not feel the NHS acts fairly regarding career progression, while this was 6 per cent among white respondents.

It is unclear which parts of the NHS are concerned, as most staff in primary care are employed by independent contractors, such as GPs, dentists and pharmacists.   

However, Suman Thullimalli and Vijay Kumar, joint chairs of the Doncaster primary care BAME network, told HSJ most of the minority ethnic doctors who responded felt their voices were not heard.

They cited a “them-and-us culture”, a feeling of “significant ‘white privilege’” in how staff were treated by the local NHS, and an apparent “old boys’ network”.

The statement added: “Whilst the CCG is starting to be supportive post-George Floyd [and Black Lives Matter], there is significant work to be done.

“As co-chairs of the BAME network, we have to do a significant amount of work in Doncaster to see true racial equality, which includes having difficult conversations and challenging practices.”

Harassment and bullying 

The survey found 82 per cent of minority ethnic respondents said they have experienced a form of harassment, bullying or abuse within their workplace, including “instances of physical violence”.

It was 52.5 per cent for white colleagues, and figures showed these instances were “less likely to be reported by BAME colleagues who also did not feel safe to speak up”. The figure was 44.5 per cent for minority ethnic staff compared with 14 per cent of those who are white.

Precisely half of all minority ethnic respondents said they had personally experienced discrimination at work, from patients or service users, their relatives or other members of the public, in the past 12 months compared with 3.5 per cent of white respondents.

When asked on what grounds, 91 per cent of minority ethnic respondents said it was due to their ethnic background and a further 9 per cent due to their gender.

This was evenly split among white respondents — between ethnic background, gender, sexual orientation and age — at 25 per cent each.

Doncaster CCG said it takes “very seriously” its commitment to supporting minority ethnic colleagues working in primary care, and will “continue to encourage and support a diverse and inclusive work environment for everyone”.

Clive Clarke, director of inclusion for NHS North East and Yorkshire said: “As part of the People Plan, NHS employers are committed to increasing [BAME] representation in senior roles and it was encouraging to see some improvement in this area in the most recent workforce race equality standard data.

“While we know there is more to do, we will continue to improve the experience of our people from BAME backgrounds, not just in primary care, but across the whole NHS.”