Diversity for Doctors: towards solutions to the major equality and diversity challenges faced by doctors
28 March 2006
Conference report
The conference was jointly organised by NHS Employers, the General Medical Council and the British Medical Association to identify further action and build on the existing objectives set out in the NHS Employers’ partnership action plan, 'Equal Values: Equal Outcomes'. This plan was published in 2005 and defines a programme for collaborative working in order to improve diversity and equality in the NHS.
Keynote speakers at the conference were Dame Gill Morgan (NHS Confederation), Professor Aneez Esmail (BMA) and Dr Edwin Borman (GMC).
The conference used an 'open space' format in which participants created self-managed sessions related to a central theme of strategic importance to the conference. The themes identified for exploration during the open space sessions included whistleblowing, dealing with bullying and harassment, using support networks and mentoring; IMGs and refugee doctors coming into the NHS in the UK; and work/life balance and the effects of stress and ill health for doctors. There were three open space sessions, and delegates moved between tables in order to contribute to different discussions. Each session built on the discussion and ideas developed at the previous session. At the end of the sessions, each table of delegates (approximately 14 tables) produced a list of priority action points. A summary of these points was circulated to delegates post conference.
A graphic artist was present at the conference to produce an illustrative record of the themes and ideas that emerged from the group discussions. This picture describes the journey towards our collective vision of equality and diversity. It acknowledges the importance of individuals, within our different roles, as well as the value of supportive relationships. In order for organisations to change, there needs to be effort from individuals, in addition to strong leadership. This can be backed up by collective intelligence. Our individual perspectives are underpinned to some extent by our own vision, culture and values. However, this need not present a barrier if our overall aims are shared. Even though there may be conflict along the way, this can be productive if it leads to effective decision making and moves us closer to our collective vision to promote equality and diversity in all its forms.
The conference concluded with a panel session facilitated by Dame Gill Morgan.
The panel members were:
Mr Steve Barnett, Director, NHS Employers
Dr Edwin Borman, Chair, Committee for Diversity and Equality, GMC
Ms Naaz Coker, Chair, Refugee Council
Dr Sam Everington, Co-chair, Equal Opportunities Committee, BMA
Ms Liz Sayce, Policy Director, Disability Rights Commission
Mr Ben Summerskill, Chief Executive, Stonewall
Panel discussion
The panel discussion focused on three areas:
1. What can organisations do to show leadership in relation to equality and diversity within the NHS?
2. What do we mean by diversity?
3. What can individuals do, and how can we collectively support individuals in championing equality at a local level?
What can organisations do?
British Medical Association
The BMA can demonstrate leadership, firstly by ensuring that its own internal structures and functions promote equality. This would impact on the BMA committee membership who, in turn, could influence people within their own medical and medico-political fields. Such action includes, adapting the way committees operate in order to make them more inclusive, and providing different opportunities, such as breakfast meetings, for individuals to have their voices heard. It was suggested that the BMA considers asking all committee members to sign a commitment acknowledging the importance of equality. Individuals, in their leadership roles, could then take this commitment back to their own organisations in order to support individuals championing diversity at a local level. Individuals can also have enormous influence by acting as mentors.
Externally, the BMA does a great deal of work, especially through the equal opportunities committee. This work includes looking at ways to ensure fairness within the clinical excellence awards scheme, equality monitoring by the GMC in relation to complaints, and in royal colleges examinations. The BMA can also use its lobbying power to promote equality and diversity and take advantage of opportunities that arise, such as in contract negotiations, when communicating with Trusts and through the work of its Press Office and Parliamentary Unit.
General Medical Council
The GMC would like to see every member of the profession in a position to promote equality. The GMC’s leadership approach consists of three parallel strands:
- To address any internal issues and make sure that the GMC becomes a good practice example for diversity and equality;
- To ensure that the profession functions in a similar way;
- To ensure that the profession itself becomes a good practice example to engender UK wide change.
NHS Employers
NHS Employers offer leadership on equality and diversity through their links with NHS organisations and other partner organisations across the health sector. NHS Employers and employers themselves are actively engaged in this area – principally through programmes like Improving Working Lives and Positively Diverse. A major campaign to help employers manage stress within organisations has just been launched and a campaign on bullying and harassment will follow later in the year. In addition, NHS Employers are involved with the Doctors’ Forum and with the Home Office and other groups on a project to support refugee doctors. Further work is underway across NHS Employers to draw together the range of things which are currently impacting on the medical workforce - such as PMETB, MMC and developments in recruitment, retention and training arrangements for doctors. Equality and diversity will be an integral part of this work. Further details can be found on their NHS Employers website.
What do we mean by diversity?
Although the conference set out to include all diversity strands, the delegates’ focus was still more on ethnicity and less on other areas such as disability and sexual orientation. Although the challenges faced by these groups are often similar, in order to make a difference, a broad diversity agenda was needed.
The conference concluded that progress is being made in relation to physical disabilities and access, but concerns remain about the lack of monitoring data in relation to disabilities. This would be particularly important in view of the positive duty on public sector organisations which is due to come into force in December. The panel commented that anecdotal evidence suggests that employees in the NHS (and other organisations) are often reluctant to disclose information about a disability or mental health problem.
In order to ensure that doctors, medical students and prospective medical students feel safe to talk about a disability, and that they are not going to be treated unfairly, organisations need to show leadership through the support that they provide to individuals who are championing equality at a local level. NHS organisations and the medical profession are in a key position to demonstrate best practice in the employment of disabled people and those with long term health conditions.
In relation to sexual orientation, the panel commented that organisations have a clear leadership role to tackle discrimination and harassment because this would have a positive impact on patient care. Diversity is about recognising that everyone is different, precisely so they can be served better.
What can individuals do, and how can we collectively support individuals who are championing equality at a local level?
In order to collectively support individuals, the various stakeholder organisations felt that they need to take a much more joined-up approach. Managers need to be engaged so that the organisations can work more closely together, rather than focusing on their own work.
More needs to be done to identify what organisations can do to support people who are championing equality at a local level. The BMA could do this by supporting individuals who feel they have been subject to discrimination, but individuals also need support to become advocates within their own organisations. The BMA could support this through its committee members who could, in turn, act as champions at the local level. Other organisations should consider what support they can give to individuals, and how they can work together more effectively to support diversity champions.
Additional information
BMA members can log in and view BMA News coverage of the conference, including an interview with EOC co-chair Professor Aneez Esmail.