It's OK to talk about race

In 2020 the University of Aberdeen Medical School and NHS Grampian (NHSG) were called out by medical students who, in an open letter, described a number of racist incidents they had experienced. These incidents occurred within academic as well as clinical settings and forced NHSG to confront a number of uncomfortable truths about the way people of colour are treated.

The open letter triggered a number of actions to explore the working environment within the NHS, including a survey of Foundation Doctors across the North of Scotland. Over a third reported experiences of racism, involving either patients or colleagues and one of them commented that “the Board [was] still stuck in the 1970s with regards to race”. The survey also revealed that many individuals who wanted to speak up about their experiences did not know how to go about this and some were fearful of reprisals. 

Freedom to raise legitimate concerns is an essential part of a quality improvement strategy for any organisation and speaking up is a powerful tool for individuals who seek protection from abuse, harassment and discrimination. In helping to ensure staff wellbeing and safety, it has the potential to enhance clinical productivity and safety. 

Despite encouragement from regulatory bodies like General Medical Council, acting as a whistle blower is difficult for many healthcare workers who are anxious about potential consequences. Many students and trainees feel that raising concerns against senior colleagues could jeopardise their training and future careers. Their fears maybe justified in the absence of a robust anti-racist culture which is willing to listen to them. There is also a lack of awareness of how non-minority bystanders can support colleagues from racialised groups by speaking up for them. Other reasons for not vocalising concerns include unclear reporting and feedback pathways as well as lack of support from senior colleagues.

Through its Equality, Diversity and Human Rights working Group, NHSG has been proactive in sending a strong message that racism exists and needs to be talked about such that staff understand their role in tackling the problem. Three NHSG clinicians from racialised groups have shared their stories in a 20-minute-long video "It's okay to talk about race" NHS Grampian Staff Share Their Experience With Racism - YouTube . Each of them has experienced the hurt of being treated differently due to their racial backgrounds and their message is, they want to be respected for who they are, and live and work in an environment free of discrimination.

Efforts to overcome some of the barriers to speaking up have included the creation of a simplified, anonymous, rapid reporting system and active bystander training for those who might have witnessed racist incidents but lack the confidence to speak up. These examples highlight the importance of starting the conversation about race and empowering individuals to talk about their personal and observed experiences as key initial steps in creating an anti-racist environment.  

Changing culture is not easy in a large organization comprising thousands of staff, trainees and students. We are at the start of a journey but there is much work still to be done. The key initial message is “it’s ok to talk about race” – with honesty, without fear and with confidence that this is the first pivotal step towards positive change.

Authors: 

Dr Bianca Ebtehadj 
Consultant, Accident and Emergency, Aberdeen Royal Infirmary 

Miss Sesi Hotonu 
StR, Paediatric Surgery, NHS Lothian 

Dr Snehashish Banik 
Consultant Physician & EDI Champion, NHSG; Specialized Foundation Program Director, North of Scotland