Putting into perspective the NHS ethnic pay gap during Covid-19

The frequent battle cry of populist and far-right discourse centres around the “dangers” of immigration: the stealing of jobs; the loss of “our” identity; the threat of criminality. In light of this criticism that ethnic minorities are often confronted with, a viral video poem entitled “You Clap for Me Now” emphasises the underappreciation for vital communities within our society. The video features medics, delivery drivers and teachers from ethnic minorities sustaining the UK’s vital infrastructure amid the coronavirus crisis. Indeed, what the global pandemic has highlighted is that it is immigrants and ethnic minorities that are frequently at the forefront of the essential services fighting the pandemic – often with great risk to themselves.

However, the crisis has also further underscored inequalities that affect the daily lives of BAME workers within these essential services. As but one example from earlier this week, Carol Cooper, head of equality, diversity and human rights at Birmingham Community Hospital, reported that BAME healthcare workers feel they are being made to work on COVID-19 wards more than their white counterparts.

Indeed, recent revelations seem to confirm that BAME workers in the NHS face significant disadvantages in the workplace, including evidence of significant salary disparities between BAME workers and their white colleagues. In 2018, an analysis of 750,000 staff salaries in the NHS in England revealed that Black doctors in the NHS are paid on average, almost £10,000 a year less than their white counterparts, while black nurses received £2,700 less.

Meanwhile, it was also revealed that white consultants (senior hospital doctors) are paid on average £4,664 a year more than those from other BAME backgrounds. A breakdown of the data shows that the average pay for white consultants stands at 3.5% higher than black consultants, 4.9% more than Asian consultants, and 6.1% more than those of mixed heritage.

This pay gap is even more acute for women, who often face discrimination for their gender as well as their ethnicity. In 2016, the House of Commons Women and Equalities Committee stated that Muslim women face a triple penalty in the employment sphere due to being women, being from an ethnic minority background, and for being Muslim. This penalty can be felt even in the NHS, which interestingly employs substantially more women than men. It appears that structural inequalities have resulted in senior positions in the NHS being dominated by men, and women receiving an average of 15% less pay.

Certainly, the significant disparity in salaries between white and BAME workers is underlined by a lack of BAME representation in senior positions. BAME staff make up around 20% of the NHS workforce, yet just 7% are senior managers. This lack of diversity within NHS leadership ultimately hinders the ability of healthcare systems to reflect or support the population it serves. Optimum healthcare provision demands an understanding of the specific needs of patents, which thus necessitates senior levels of the NHS to reflect the diversity of its population in order to provide holistic healthcare and improve overall levels of care and satisfaction.

Improving the representation of BAME communities within senior ranks of any profession involves a review of every level of recruitment, retention, and progression. The NHS has already committed to eliminating the ethnicity pay gap and ensuring proportionate BAME representation in senior leadership by 2028, and has made promising progress in a variety of areas (for example, the use of name-blind applications during recruitment). However, it must consider what more it can do to provide sufficient support and mentorship to junior staff in order to empower them to progress and thrive.

The global pandemic has accentuated the valuable contributions of BAME communities to our essential services. However, it has also highlighted significant inequalities that were well documented even before the current crisis. While public health is naturally the primary concern at this stage, in reviewing the UK’s response to the pandemic, it is important that the disproportionate sacrifices of BAME communities are recognised and effective strategies are developed to address them.