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Racism, health and why we must do more

A joint statement by the president and CEO of the RCP and the president of the Faculty of Physician Associates.

Inequality in our society has come into sharp focus over the past few months as COVID-19 has taken a greater toll on people already living with poorer health and prospects. Then, on 25 May, George Perry Floyd Jr was killed by police in Minneapolis and the injustices and inequalities faced by black people in the US, UK and across the world provoked anger and outrage.

As a global family, the RCP stands with our members, our staff, the Black Lives Matter movement and our sister college, the American College of Physicians, when it says it is ‘Gravely concerned about discrimination and violence by public authorities and others’ as an issue of public health. We must stand with and amplify the voices of our black members as together we seek to eradicate racism and structural inequalities in all parts of our society.

In the UK, just last week Public Health England published a report which reaffirmed the disproportionate impact of COVID-19 deaths on people from BAME backgrounds. The report also showed that people of black ethnic groups have the highest age standardised diagnosis rates of COVID-19. We know that our members from BAME backgrounds have been extremely worried about their health during the pandemic and we have made clear to employers that those staff most at risk should have had or receive a risk assessment within the next week.

We can take little pride in medicine and the NHS when it comes to racism with too many staff and patients sharing their experiences of discrimination. As Lord Victor Adebowale CBE and Professor Mala Rao OBE put it in the recent BMJ edition on racism in medicine:

‘The NHS isn’t immune to these challenges, as the reflections and insights portrayed in this collection of articles confirm. Research has shown differential attainment by ethnicity in the medical workforce across all measures of training and career progression. Ethnic minority doctors are more likely to face referral to the General Medical Council, more likely to have their cases investigated, and may face harsher sanctions after an investigation. Other studies have highlighted differences by ethnicity in doctors’ pay, and in the likelihood of experiencing bullying and harassment in the workplace.

‘In healthcare too, ethnic inequalities in service provision, access, and outcomes are evident in areas as diverse as genetic counselling, artificial intelligence, and maternal health. These disparities are set against a higher prevalence of numerous health conditions, including diabetes, cardiovascular disease, and mental ill health in ethnic minority populations in the UK.’

And just like the NHS, the RCP and the Faculty of Physician Associates (FPA) are no different. We must do better and do it fast.

Late last year we commissioned an independent review into equality, diversity and inclusion. Over 1,000 of you, our members, staff and stakeholders helped us by telling us what you really think – thank you. The report will be presented to our Council in July before we publish its findings, our response and action plan after the summer. This will include ensuring that all aspects of the RCP reflect our membership and wider society, improved monitoring and reporting the trends in issues around our workforce by ethnicity, and a real focus on reducing health inequalities.

This is only a small step to address the impact of centuries of ethnic inequality in our profession. But it is our acknowledgment that we must do more to remove barriers, open doors and confront unacceptable behaviour. We know we have a long way to go, as demonstrated by the fact that in our over 500-year history, the RCP has only ever had white presidents and CEOs. The same is true of the presidency of the FPA since it was established.

The work we have done and will do is part of our ambition to take a much more prominent role in highlighting the inequalities in society. Soon we will establish the Inequalities in Health Alliance, and we know the vast majority of our members will join us in this campaign.

There is no room for complacency, as leaders it is our responsibility to do better. Our renewed focus starts today by asking all the leaders in our organisation to have conversations with the staff and members they work with to draw attention to this statement and to our commitment to ensure that the RCP is doing everything it can to eradicate racism and structural inequalities.

Professor Andrew Goddard, president, Royal College of Physicians
Kate Straughton, president, Faculty of Physician Associates
Dr Ian Bullock, CEO, Royal College of Physicians