As COVID-19 progressed, data revealed just how prevalent the inequalities in accessing healthcare were for black, Asian and minority ethnic (BAME) communities with them being disproportionately affected. It was reported the BAME community was 1.9 times more likely to die during COVID-19 compared to their white counterparts, this is nearly double the likelihood, however, why is this? Several factors could explain this: their occupation making them more vulnerable to suspecting the virus, the location of where they live, household composition and pre-existing health conditions. Despite this recent data being published, has the UK government actively taken measures to reduce these inequalities for the future?
In 2001, the Race Relations Amendment was introduced with the NHS to 'have due regard to eliminate unlawful discrimination' with it being unlawful to discriminate on the grounds of race, colour, nationality and ethnic origin. This was established with the aim to increase accessibility and promote equality. The establishment of this amendment led to staff being trained, undergoing performance assessment procedures, being subjected to disciplinary measures and in some cases were even required to leave employment if they could not abide by the amendment. Hospitals and NHS trusts were also required to monitor and publish data of differential treatment towards racial groups, their investigations of overcoming these issues and how they dealt with it. Although, in theory this should have significantly reduced inequalities for BAME communities regarding healthcare, it didn’t make much of an impact as COVID-19 clearly highlighted. Despite there being an increase in data being recorded, completion levels remained low, making it difficult to identify areas of disparities in healthcare across the UK. Whilst, the introduction of this amendment has led to monitoring, which was not previously recorded or at least in a regulated, formal way, it has not quite had the impact with which it was established with. The amendment also only focused on BAME patients experiences but disregarded to take a more holistic view and monitor BAME staff and their experiences too.
It could be said that the most valuable resource the NHS has is its staff, with approximately one in five of its workforce being BAME. Despite this, BAME staff are treated considerably worse where they don’t have the same career progression opportunities, with them being 1.74 times less likely than white short-listed candidates to be appointed. A NHS report commissioned by employees revealed that BAME staff are twice as likely to be disciplined compared to white staff. To combat this, in 2015 the NHS Workforce Race Equality (WRES) was founded with the intention to monitor BAME staff experiences to provide equal access to career opportunities and fair treatment in the workplace. Not only is it important to have staff being treated equally, it also would result in higher quality patient care increasing patient satisfaction by having a valued workforce. Every year the WRES report shows there has been improvements however a lot more change is needed especially in specific hospital trusts where there has been very minimal improvements. To have more significant improvements the government needs to identify specific areas which require bigger change and to provide interventions and education to staff as well as closely monitoring these locations.
Although, collecting and monitoring data is very useful to understand where the inequalities for BAME patients and staff lies across the UK it is more important what is done with this information and the proactive measures enforced to reduce these inequalities. The government and NHS need to work together to actively break barriers to decrease the gap between communities. This could involve communicating messages which are tailored to different cultures and religious viewpoints. For example, during COVID-19, the government could have put more of a conscious effort to be more inclusive and communicate more effectively. Specifically, regarding high-risk events such as Eid and weddings which tend to be on a much larger scale.
Language barrier also contributes to the inequalities for BAME communities as it reduces their accessibility to healthcare. To decrease the gap, the NHS could create an initiative where BAME patients have the option to have a translator of their spoken language to be present during their appointment. Although, this is currently available at some hospitals it is only in action on a small scale due to resources being very limited. To resolve this, the government needs to spread their costs more equally where they look at socioeconomic maps regarding the BAME community to identify areas in the UK which would benefit the most from this scheme. This would reduce miscommunication and anxiety where BAME communities who may be of older age and don’t have family, could potentially feel quite anxious and maybe even apprehensive to go to the doctors as they feel as though they cannot communicate effectively. There needs to be more awareness when presenting information especially in relation to the COVID-19 vaccination. A lot of BAME communities may not be willing to trust the government due to past historical issues and institutionalised racism. To combat this there should be more reinforcement of facts and to give credible evidence and data to support what is being communicated. A policy intervention could be using community leaders to help spread information about vaccinations. Although, this was seen later during the COVID-19 period, it was an independent move, not a governmental organisation.
Inequalities for accessing healthcare amongst the BAME community stems from institutionalised racism. The gap of inequality will continue to be there unless conscious efforts are made to reduce this. Although, the current government initiatives are good as there is increased monitoring on the treatment and conduct for BAME patients and staff, this is only of use if proactive measures are taken into action from the data being collected. The government needs to make an active change by reducing language barriers and being more inclusive when communicating public health measures. As reports and data has shown the inequalities are reducing however a lot more is still yet to be done for the BAME community and currently the government is not wholeheartedly putting in their efforts to make active change.