Healthcare Forum Blog 3

Employment in Healthcare

“Inside Out: The Shortfalls of the Healthcare System”

The All Wales Black, Asian, and Minority Ethnic Engagement Team brought in the New Year with another forum, this time focusing on Race and Healthcare. In light of the pandemic and the unprecedented effect on Black, Asian, and Minority Ethnic employees on the front line EYST dove into the healthcare system, both before and during the pandemic, to see what is being done to safeguard and protect these communities as service providers and users. The findings make for unpleasant reading, but there is a real chance for change within the system to strengthen the protection for Black, Asian, and Minority Ethnic employees as well as the Healthcare system?

Joining us on the day as key speakers were the brilliant Allison Hulmes of BASW, Josh Law of All Wales Forum, and Alex Osbourne of Disability Wales.

So, what did we learn? Today’s blog discusses issues facing those who work in healthcare settings, and findings from the First Minister’s Black, Asian, and Minority Ethnic Covid Advisory Group’s report (‘the report’).

Black, Asian, and Minority Ethnic Healthcare Staff

The report shared the high rate of Black, Asian, and Minority Ethnic employment in front facing roles, “BAME people are over-represented in some sectors of the NHS, comprising over a third of medical and dental staff in Wales.” and “those from BAME backgrounds are over-represented in healthcare (11.2% or employees are BAME) and social care (7.2%), as well as taxi drivers and chauffeurs (40.2%) and chefs (22.8%).”

Despite this, there are three main issues plaguing Black, Asian, and Minority Ethnic staff, namely:

• a lack of training;

• the passing off of Black, Asian, and Minority Ethnic patients to Black, Asian, and Minority Ethnic staff;

• unequal job allocation.

The reliance on Black, Asian, and Minority Ethnic staff to delivery Equality, Diversity and Inclusion training meant that they were being put in an awkward situation with their colleagues and were missing out on training that they also needed. These staff are not educated in delivering training and could not provide the level of training needed to safeguard Black, Asian, and Minority Ethnic staff.

Furthermore, these Black, Asian, and Minority Ethnic staff would be allocated Black, Asian, and Minority Ethnic patients based on the unfair assumption that they would understand the patients best, but then these patients were left by the wayside when Black, Asian, and Minority Ethnic staff were not on shift. This being on shift issue is exacerbated by the fact that Black, Asian, and Minority Ethnic staff were normally only allocated part-time roles, as stated by Dr Shah-Kent, but an RCN survey in 2019 found that Black, Asian, and Minority Ethnic nurses were more likely to work additional hours, yet far less likely to be employed in higher pay grades. Unfair burdens are placed on Black, Asian, and Minority Ethnic staff, both in their job roles but also additional duties expected of them, such as delivering training, and they are not rewarded correctly for their efforts and are frozen out of the advancement and promotions.

Black, Asian, and Minority Ethnic  staff and the Covid-19 pandemic

As noted in the report, people from Black, Asian and Minority Ethnic groups are much more likely to work in high-risk jobs, comprising 40% of taxi drivers and 11% of healthcare workers. On top of this, those from ethnic groups are up to 2x more likely to die from the disease than their White counterparts. The risk of a Covid-19-related death for Black people was 1.9x more likely than those of from a White background, and Bangladeshi and Pakistani males were 1.8x more likely to have a Covid-19-related death than White males. This fits with the findings from Intensive Care National Audit and Research Centre (ICNARC) that a third of those cases admitted to critical care (in England, Wales and Northern Ireland) with confirmed Covid-19, were people from Black, Asian, or Minority Ethnic  backgrounds.

In particular, the Filipino community have suffered greatly from the pandemic. The report shared how “Approximately 18,500 Filipino nationals work in the UK's National Health Service (NHS), the third-largest group after white and Indian groups. Out of more than 100 healthcare workers who have died after contracting the virus in the UK, at least 25 have been from the Philippines[...]That includes health and social care workers and hospital staff.” This has not been addressed, and as pointed out in a UNISON survey ethnic respondents did not feel that their workplace had carried lout a workplace assessment in relation to their race and Covid-19.

Despite these risks and serious consequences, the Royal College of Nursing found that not only are Black, Asian, and Minority Ethnic staff more likely to be asked to work on Covid wards, but they were offered less PPE, “less than half (43%) of respondents from a BAME background said they had enough eye and face protection, compared to 66% of white British. There was a similar disparity in the numbers of fluid-repellent gowns; 19% of white British staff reported they did not have enough gowns to see them through a shift. That percentage increased to 37% of BAME respondents.” These statistics highlight the grim reality for our Black, Asian, and Minority Ethnic healthcare workers, and the lack of protection put in place for them.