Institutional racism remains ‘a stain’ on NHS, warns royal college president

The new president of the Royal College of Psychiatrists has said institutional racism “is a stain” on the NHS, and warned that the health service needs to get better at acting against racist abuse.

In his valedictory address as president, Dr Adrian James told the college’s International Congress in Liverpool that unacceptable levels of racism remain in the NHS, which harms patients and drives psychiatrists and other health practitioners to leave the service.

“Institutional racism is rife in society and the NHS is not immune. We see its pernicious effects on colleagues who are leaving the NHS in droves,” he said.

“It can be seen in the unfair ethnic pay gaps, in the disparities in disciplinary processes and in the glass ceiling that stops doctors from minoritised ethnic backgrounds securing management positions. Tackling racism in the workplace is key to recruiting and retaining psychiatrists and other health practitioners.

“Let me be clear: there is absolutely no place for racism in today’s society. It is a stain on the NHS. It damages mental health and makes existing mental illness worse. It destroys lives – the lives of patients and colleagues. The NHS has a moral, ethical and legal duty to do much more to stamp out racism in all its forms,” Dr James added.

In 2021, a survey of college members found that six in ten (58%) doctors from minority ethnic backgrounds have faced overt or covert racism at work.

More than a quarter (29%) of those who experienced racism said it affected their health and four in ten (41%) said it had an impact on patients or carers.

Dr James also pointed to NHS data that showed doctors from minority ethnic backgrounds are paid 7% less on average than comparable White colleagues.

The NHS Medical Workforce Race Equality Standard report also found doctors from minority ethnic backgrounds make up 41.9% of the medical workforce in England but just 20.3% of medical directors.

In 2022, the Mental Welfare Commission Scotland published a report that found almost a third of doctors reported they had seen or experienced racism directed at their NHS colleagues.

As a result, the college has launched a new campaign, Act Against Racism, calling on mental health employers across the UK to adopt 15 actions to tackle racism in the workplace. The guidance includes a step-by-step guide with practical examples of how to address institutional and interpersonal racism.

“Our Tackling Racism in the Workplace guidance will help every mental health employer in the UK to ‘Act Against Racism’ at a strategic and systemic level,” said Dr James.

“It provides clear, measurable actions for employers and implementation guidance. It shows employers how to recognise and respond to instances of discrimination on racial and ethnic grounds and signposts them to sources of support within and outside their own organisation,” he added.

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