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The question as to whether the NHS should have a positive action programme rears its head periodically and people debate what it means and whether we should do it.
I believe very few people know the difference between positive action and positive discrimination and the very sound reasons why positive action exists and is in fact embedded within the law. At the risk of teaching my grandmothers to suck eggs, I feel it is important to explain why today in 2010 the NHS still needs a positive action programme.
Section 37 of the 2000 Race Relations Amendment Act states that the term 'positive action' refers to measures that may lawfully be taken to meet special needs or to train or encourage people from a racial group that is under-represented in particular work.
There can be no doubt that people from black and minority ethnic backgrounds are under represented at the most senior levels of the NHS.
Section 37 allows training or encouragement to be provided for a particular racial group that is under-represented in particular areas of work. Again, we can justify the existence of any programme as a vehicle to train, develop and encourage people from under representative groups. At this point I need to remind the reader that section 37 falls within the RACE RELATIONS ACT, positive action is about under representative groups from different racial backgrounds, this I fear is where the complication begins. There are many people that believe that singling out a group of people for what they perceive to be special treatment is wrong, divisive and unfair. What they do not acknowledge or understand is the history behind the development of the law in the first place. Quite simply racism and discrimination were and unfortunately still are prevalent in society and something needed to be done to support people from different ethnic groups to fulfill their potential. The situation is further complicated by unclear descriptions of what constitutes an ethnic group. This is a red herring. It is irrelevant what racial group an individual is from from providing they are in a group that is under representative in a particular job or profession.
The law goes on to state that where there is national under-representation - that is, where, during the previous 12 months, no one from a particular racial group has done the work in question in Great Britain, or where the proportion of people from that group doing that work was small compared to its proportion of the population of Great Britain. In this case, training or encouragement can be provided exclusively for the racial group (or groups) in question.
England is made up of a population of approximately 60 million people, 10% of whom are from ethnic minorities, this figure is expected to grow and by 2020 we expect there will be over 20% of the population from black and minority ethnic backgrounds.
Over 1.3 million people work in the NHS and around 17% of them are from ethnic backgrounds, that is a substantial number of people. There are approximately 1810 executive director level positions in the NHS and having recently completed a piece of work across all SHAs we know that there are currently around 60 executive directors form BME backgrounds (including the 6 CEOs we currently have in post). 3.3%. By anyone’s standards statistically this is under representation.
It is this under representation at the highest levels of the NHS that makes the clearest case for positive action in order that true to its founding principles the NHS is a service where the needs of all members of Britain’s population are met.
I believe the legal explanation as to what positive action is and why it is necessary is as clear as it could be and the answer to the NLC question about positive action is that the NHS should have a positive action programme.
I believe the question that should perhaps be asked is not does the NHS need a positive action programme but does it really want one?