‘Too few Asians in top NHS leadership roles’

By Nadeem Badshah

URGENT action is needed to address the lack of Asians in top management jobs in the NHS, according to leading health campaigners.

New figures show that people of south Asian origin made up nearly 30 per cent of medical staff in the NHS in 2019, accounting for 32,308 employees, but this fell to eight per cent in non-medical roles.

But Asians made up just 4.6 per cent of "very senior managers"  - compared to 92.9 per cent among white people - and just 6.1 per cent of senior roles and 8.9 per cent of middle management positions.

The percentage of white health service non-medical staff increased as grades became more senior in both the graduate and non-graduate grades, the NHS data showed. But for graduate entry jobs, staff of south Asian heritage made up a smaller percentage of senior grades than junior grades.

And Asian staff made up 6.7 per cent of the workforce in the most senior non-graduate entry band compared with 9.5 per cent in the most junior band.

Professor Mahendra Patel, senior member of the South Asian Health Foundation, called for more role models in leadership positions to inspire applicants.

He told Eastern Eye: "The figure of 4.6 per cent - we seem to be thumping on about this for a long time.

"People have to come forward to get into the positions, it is alright saying they are not represented but people have to come forward.

"It is clear there is inequality there that needs to be addressed. Maybe they are not being selected or supported and some feel they are not going to get the job and are not putting themselves forward.

"We need to do something on both sides of the fence. If they are lacking confidence, putting support mechanisms in there.

"If there is unconscious or conscious prejudice, selection processes should have BAME people on the panel to make them feel comfortable."

In medical roles, more Asians are reaching the top with 31 per cent becoming senior doctors and around 29 per cent of junior medics.

Previous research showed that 18 per cent of staff were from a BAME background in 2017, falling to seven per cent among top senior managers.

Dr Amit Kochhar, the British Medical Association's (BMA) staff, associate specialist and speciality doctors committee chair, said despite the enormous contribution Asian doctors make to the health service, they continue to be under-represented in consultant posts.

He told Eastern Eye: "For years, the NHS has relied on recruitment of doctors from overseas to fill staff shortages and maintain the health service but they have not properly supported them or offered the same progression and development opportunities as medical graduates from the UK.

Dr Amit Kochhar

“However, Asian doctors make up over 40 per cent of associate specialist and speciality doctors – who are also senior doctors – and we know at the BMA that these doctors are more likely to suffer bullying, harassment and undermining; indeed around one in three say they have experienced such treatment in the past year.

“There has been a lot of talk about race equality in the NHS in recent years but we need more tangible action such as access to mentoring, better peer support and promotion of Black, Asian and Minority Ethnic role models.

"We also need better ongoing induction and training packages for those doctors recruited from overseas, and the contribution of associate specialist and speciality doctors needs to be recognised and properly valued.”

Dr Kailash Chand, a retired GP, said in NHS employment and in some aspects of patient services, evidence of racism is common.

He added: "A good start would be ensuring there are more BME voices at the top of the profession, yet despite modest gains highlighted since last year, minority voices remain grossly underrepresented in senior management positions.

"The NHS must undergo a cultural change to increase understanding of and commitment to equality and diversity, with a focus on the benefits of diversity to staff, patients and the NHS system.

"This must include all levels and branches of the NHS system as well as the wider medical community.

"We need to pledge that all arms of the service, and other medical bodies, take a hard look in the mirror and reflect on how transparency, fairness, and equality should frame its future."

The Workforce Race Equality Standard (WRES) was introduced to the NHS in 2015 to ensure employees from BAME backgrounds have equal access to career opportunities and receive fair treatment in the workplace.

In response to the figures, Habib Naqvi, deputy director of the NHS WRES, said: “Migrants have played and continue to play an essential role in the NHS since its inception in 1948, including the south Asian doctors who in the first few decades of the NHS helped to keep local family surgeries and community health services afloat.

“Today, people from Asian backgrounds are still well-represented among senior doctors, but there’s no doubt that we still have a long way to go to make sure that staff from minority ethnic, black and Asian communities have equitable access to opportunities for progression, and receive as fair treatment and career development as other staff in the NHS, which is why the NHS Workforce Race Equality Standard is working to drive faster progress.”