In this post, our guest blogger Anaane writes about the underrepresentation of ethnic minorities in the Scottish health sector at management level. From his experience, there is a gap between equalities policies and practice, a problem that cannot be overcome if affected migrants and individuals from ethnic minorities do not speak up and act together.
Anaane is a volunteer with Migrants’ Rights Scotland. He holds a BSc in Biology and a Postgraduate Certificate in Environmental Health.
Having come to Scotland a few years ago, I have been working for the NHS Greater Glasgow and Clyde for over three years. Throughout my experience of working in various hospitals in the area, many of my colleagues providing frontline services to patients were from ethnic minority backgrounds, either migrants or people born and raised here, but I have never seen a single ward manager from an ethnic minority (EM) background.
Although it is estimated that around 35% of medical and dental staff working in the NHS in England are from an EM background, only around 1% of chief executives within the NHS are from EM groups, with a slightly better representation of the EM population in middle management in recent years (figures for 2008); however, they seem to be hitting a glass ceiling and their underrepresentation on all management levels has remained (The Guardian, 14 Jan 2009).
In Scotland, this seems to be even worse. However, making the case based on official data is impossible: The Skills for Health’s Scotland Sector Skills Assessment 2011 concluded that “examination of NHS data by ethnicity profile across Scotland is not possible”, as ethnicity for around 36% of the NHS Scotland workforce is unknown. The latest workforce data provided by NHS Scotland for March 2011 showing that around 57.3% of the overall workforce are white Scottish or white British and only around 6.6% from EM backgrounds are therefore very unreliable. Also, with regard to migrant workers, Audit Scotland reported in 2007 that while around 89% of overseas staff employed in the NHS Scotland are thought to be doctors or nurses, “the NHS in Scotland does not have an accurate picture of the number of overseas staff employed”. And my inquiries to NHS Scotland did not produce any information on the representation of EM groups by occupational categories or grades.
Despite this lack of official figures, it seems a widely accepted fact that the make-up of NHS Scotland management is failing to match its workforce, being disproportionately managed by whites from the majority population. Most EM people are hardworking, dedicated and highly educated, and if persons from EM backgrounds are good enough to hold various positions in the health sector, what is preventing them from holding management posts?
In the hospital where I currently work, there was a management job which two nurses applied for. I happen to have worked with and know both nurses. One was an indigenous Scottish and the other a nurse from Africa. The African nurse had five years work experience in the same ward and held higher qualifications than the Scottish counterpart. The Scottish nurse had less than two years experience in that ward, but eventually still got the management job. Bearing in mind that I know both nurses and that I am a union rep, I wanted to take the case up to find out why the African nurse did not get the job. But “surprise surprise”, the nurse said she did not want the case to be taken up because she did not want to cause trouble. She had given up.
According to the experiences of many people I have spoken to, employers are not making it easy for EM people to occupy management posts; stereotyping, biased recruitment and selection processes, undervaluing of experiences and qualifications, being excluded from communication and informal networks etc. all seem to play a role. Although NHS Scotland has equality policies and as a public body is obliged to promote equality of opportunity in its workforce, they are not sufficiently enforced. There is no active policy in place to ensure that people from EM backgrounds are given equal opportunity within the organisation, especially at management level. Often EM people seem to feel that there is nothing we can do: employers are never going to employ EM people at management level, people have tried to break these barriers before, but they couldn’t etc.
So, how can we solve this? I strongly believe that we as EM people have to speak up and make employers understand that we are not going to stop fighting until we are given equal opportunities at all levels. Nobody is going to talk for equal opportunities for you if you do not stand up and fight for your right, fight for what is due you.
This struggle is going to be much easier if one is fighting from higher or highest level of the job ladder. Imagine an EM person being in a decision-making position; he or she can reduce the amount of discrimination or unfair treatment against EM people. So, let’s not sit down and remain silent.
Employers themselves are doing very little or nothing at all to stop it, so we have to remind them and tell those employers who do not know that EM people have got the right to equal opportunity also with regard to management job positions. This is not the type of fight one would punch one blow and sit back. One got to fight until the battle is won. Remember, in the 50s, 60s and possibly 70s people could write in their hotels entrances, “NO CATS, NO DOGS AND NO BLACK PEOPLE’’. Some people stood up and made sure people are not discriminated against because of their colour. We are enjoying this freedom today free of charge. What are you doing for your children and grandchildren to enjoy in the future? If you do not pick the fight for yourself, please, join the fight against unfair treatment for your children sake.
Afternote: I met Nicola Sturgeon MSP (previously Cabinet Secretary for Health and Wellbeing, now responsible for Health, Wellbeing and City Strategy in the new Scottish Cabinet) on the election campaign trail and took the opportunity to ask her about the problem of underrepresentation of EM groups at management level in the NHS and the issue of equal opportunities. Here’s what she replied.