- Partha Kar, consultant in diabetes and endocrinology
- Portsmouth Hospitals NHS Trust
Follow Partha on Twitter: @parthaskar
Progress means getting closer to the place you want to be—so said C S Lewis. That quote has never seemed more apt to me than during the work on an action plan to tackle inequality based on one’s ethnicity in the medical workforce.
One would think it straightforward. After all, we’ve converted rainforests of paper into reports documenting this inequality; we’ve spent aeons eulogising the importance of confronting it; and we’ve piled accolades onto leaders seen to be driving progress in tackling it. The datasets have been stubborn, the case reports have been bruising, and the feedback from the ground has been consistent.
Change, if it’s happened at all, has been marginal, and there’s little to be proud of at a system level. We have to recognise that the modern NHS hasn’t quite embraced the concept of having a multicultural workforce where everyone is treated on a par. We’ve now come to the point of publishing the Medical Workforce Race Equality Standard (MWRES) commitment to collaborate.1 It’s taken many discussions and meetings, and much cajoling, for all stakeholders to reach some form of commonly agreed position. There’s been a strong urge to water down recommendations, yet also an awareness that this would only maintain the status quo. And, in the main, we’ve been able to hold our ground.
Working with multiple stakeholders—and negotiating with all committees involved, while NHS England came to grips with its merger with Health Education England—made one empathise with Frodo Baggins and his journey to bring that ring to Mordor. But that ring also united many peoples, and hopefully this effort by the medical workforce has also set a pattern of working together.
So, what next? There are unresolved questions about implementation, and we’re not yet sure who will be involved in which roles to take the action plan forward. Yet the plan itself is clear: it has five core areas, with a focus on having data to track, challenge, and improve equality. The plan has been agreed by all concerned, so the markers are likely to change. Yet it needs far more than a piece of paper to drive that change. It needs data, drilling into specific areas. It needs tracking. It needs challenging when a trust has an inequality in referrals to the General Medical Council based on ethnicity or in an annual review of competency progression based on the colour of a candidate’s skin.
I look forward with intrigue and interest. The first part of my designated role around the MWRES was to create an action plan and to ensure that all stakeholders were on board. To be honest, that was the easy part. The “fun” bit is the implementation, and I’m here for that—or at least to publicly hold to account whoever gets the job of delivering improvement in achievement against the markers. I’m tired of documents reporting the same numbers and outcomes, followed by shock and surprise about the results.
We live in hope, and we look forward with positive intent. In the words of Stan Lee: “Excelsior!” or “Ever onwards.” There is no other option.
Competing interests: see www.bmj.com/about-bmj/freelance-contributors. Partha Kar is national specialty adviser, diabetes, and lead of the Medical Workforce Race Equality Standard.
Provenance and peer review: Commissioned; not externally peer reviewed.