We have to talk about racism in the UK’s health care system

To date the UK government has not released figures that provide a breakdown by ethnicity of health care staff who have died from Covid-19. This is despite the early evidence compiled through media reports which indicated black, Asian and ethnic minority staff were disproportionately impacted.

At every moment during the pandemic the government has sought to suppress information about the impact of racism in UK health care.

Stakeholder evidence from more than 1000 organisations relating to black, Asian and minority ethnic communities were removed from a Public Health England report – Beyond the data: Understanding the impact of COVID-19 on BAME groups (2020).  

Until the government and key organisations like the NHS name racism as an issue, they cannot take appropriate action to challenge it.

In 2020 the Nursing Narratives project set out to document the experiences of racialised minority workers within health care in the UK during the Pandemic. Our research paints a bleak picture of widespread discriminatory practices.

''The Black Lives Matter protests that erupted in 2020 gave many health care workers the lift and determination to challenge racism and to organise against it.''

The ‘Nursing Narratives; Racism and the Pandemic’ project sought to give space to health workers to amplify their voices so that society can learn from their experiences. In total, 353 black and brown health care workers participated in our research through an online survey, as well as audio and filmed interviews.

The experiences of these workers during the pandemic highlights four key areas of racialised discrimination that put the lives of black and brown staff more at risk of serious injury and death: Work allocation, PPE provision, risk assessment provision and a culture of neglect.

All the forms of structural and institutional racism that existed before the pandemic compounded the vulnerability of black and brown staff. It created the perfect storm.

We found that Black and Brown staff have historically been expected them to work harder, accept more significant risks, frequently with less overall workplace support. Their experiences in the Pandemic need to be seen as a continuation of pre-pandemic issues resulting from a systemic culture of racism. 

In our survey, 52.6% of the black and brown staff experienced unfair treatment in the pandemic concerning either Covid deployment, PPE or risk assessment provision.

Staff who we interviewed spoke of intimidation and threats of losing their job if they did not agree to be delegated to wards treating Covid patients. In midwifery, participants spoke of being allocated the Covid patients despite their own known vulnerabilities.

There were examples of white managers hoarding the PPE and giving it to their friends or of black workers being allocated to work on wards with Covid patients with surgical masks. Others spoke of PPE being locked away at night leaving night staff, often black, without protection.

We are pleased to announce the Birmingham Premier of 'Exposed' Racism & the Pandemic - Film + Q&A on July 11. Tickets free at link below. @BCUNursingteam @UniBham_Nursing @bcukevcrimmons @MDSEquality @RCNWestMids @olgalwalters @ruthpearce18 @ProfAnnieT https://t.co/1rDMn6Dqar

— Racism and the Pandemic (@Nursesnarrate) June 21, 2022

Risk assessments were described as a tick-boxing exercise with staff vulnerabilities ignored.

We heard of one black nurse who was told she was clear to work in Covid environments during the first and second waves of the pandemic, subsequently being informed that she should be shielding.

Migrant staff were particularly vulnerable. A Filipino nurse said: “We were chosen to be exposed”. They felt they were treated as though they were disposable.

As one migrant nurse who was forced to leave the NHS reflected: “We are not just a commodity, we are human”. 

In reality, all those we spoke to are the survivors of an unjust system.

Indeed, racism is systemic in the UK health care system. One of the most shocking statistics from our survey was that over 77% of black and brown respondents who had raised issues of racism felt they were not fairly treated.

These findings mirror the sense of neglect and lack of compassion felt across the workforce, from managers to health care assistants.

“They don't care about us. No compassion, no understanding, no nothing. Just cold as ice or colder than ice” explained a black British health care assistant.

An Indian nursing manager shared: “Because I worked in a very ethnic minority heavy area, I felt a lot more angry because I felt like you were just letting them die. It doesn't matter because obviously, they're all ethnic minorities, you know”.

The impact of racism has had devastating consequences for many. A total of 59% of participants had experienced racism during their working lives which made it difficult for them to do their job, 53% said racism had impacted their mental health, 36% had left a job as a result of racism during their working lives and 33.4% had been forced to take sick leave as a result of racism.

The Black Lives Matter protests that erupted in 2020 gave many health care workers the lift and determination to challenge racism and to organise against it. During the pandemic, Equality for Black Nurses, The Filipino Nurses Association, British Indian Nurses Association and Nurses of Colour were all established to defend the rights and the lives of black and migrant nurses.

The UK is in desperate need of recruiting nurses from overseas and from its own racialised minority groups. Yet so far the system has failed to address the neglect of staff from these very communities.

An important outcome of bringing workers together to speak about their experiences has been the Manifesto for Change. Participants produced this anti-racist manifesto which has already been signed by 22 black, Asian and migrant health care organisations. They continue to collect signatories and build support by asking individuals to screen the film Exposed in their workplaces and communities, and to raise awareness of the issues that the government has clearly ignored.

Screenings of Exposed are taking place across the UK.

Anandi Ramamurthy is an anti-racist activist. She works as a Professor of Media and Culture at Sheffield Hallam University. Her academic work focuses on documenting anti-racist histories and cultures and amplifying the voices of the oppressed. 

Follow her on Twitter: @Anandimanc

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