Hamed Chapman
Vast and widespread ethnic inequalities in health outcomes are evident at every stage of life, from cradle to the grave, the first true scale of the issues facing Black, Asian and Minority Ethnic (BAME) people in England has found.
The damning study, commissioned by the NHS Race and Health Observatory, shows clear, convincing and persistent evidence that ethnic minorities are being failed and that, despite repeated pledges of action over the years, there has been no “significant change” in the NHS.
“By drawing together the evidence, and plugging the gaps where we find them, we have made a clear and overwhelming case for radical action on race inequity in our healthcare system,” said Habib Naqvi, the Director of the Observatory, an independent body established by the NHS in 2020 to investigate health inequalities in England.
Labour’s Shadow Women and Equalities Minister, Taiwo Owatemi, said that the findings were a “damning indictment of the Conservatives’ failure to prioritise inequalities in health for over a decade.”
“Their appalling mismanagement of the NHS has not only left minority ethnic patients at a much higher risk of discriminatory treatment across the board but also created a glaring racial pay gap within the NHS,” Owatemi warned.
The 166-page report is littered with striking examples and evidence of inequity in the NHS. It concludes that inequalities in access to, experiences and outcomes of healthcare in the NHS “are rooted in experiences of structural, institutional and interpersonal racism”.
The rapid review was led by the University of Manchester. It paints a devastating picture of a healthcare system that is still failing minority ethnic patients. This includes mental health to maternity care as well as digital access to healthcare and genetic testing and genomic medicine, despite concerns repeatedly raised about the harm being caused.
It found such discriminations that GPs were less likely to refer ethnic minority patients to the Improving Access to Psychological Therapies programme compared to White patients. In addition, barriers were faced by patients who delayed or avoided seeking help for health problems due to their fear of racist treatment from NHS professionals.
Intriguingly, there was evidence that the ethnic inequalities in mental healthcare for adult populations are being reproduced in younger populations. This was demonstrated by one study in the review showing that Black children were 10 times more likely to be referred to Child and Adolescent Mental Health Services.
Among 12 papers on attitudes to help-seeking and experiences of general mental health services, four studies that interviewed Pakistani people in the UK cited that the language barriers and lack of access to official interpreters as impeding access.
In maternal care, there were some positive relationships with midwives, but they were limited by poor communication between women and health providers. Women who did not have English as a first language also often lacked access to quality interpreting services. In one study, researchers found Asian babies were over-represented in admissions to neonatal units for jaundice.
With respect to the NHS workforce, the impact of racism on careers and professional development was also explored in the review. There was evidence of an ethnic pay gap affecting Black, Asian, Mixed and Other groups, and to a lesser extent, Chinese staff.
Lead investigator Dharmi Kapadia said that the health of ethnic minority people has been negatively impacted by a lack of high-quality ethnic monitoring data recorded in NHS systems for many years and the review confirmed that these issues are still to be tackled.
“The evidence on the poor healthcare outcomes for many ethnic minority groups across a range of services is overwhelming and convincing. The time for critical action on ethnic inequalities in healthcare is now,” Kapadia said.
