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Tackling inequalities in the health system

Dame Donna Kinnair 9 Jun 2020 Chief Executive and General Secretary

Beyond COVID-19, we need action and investment to address systemic inequality in our health and care systems.

In ordinary times, this week would be Congress 2020. It would have been a memorable one coinciding with International Year of the Nurse and Midwife, and the bicentenary of Florence Nightingale’s birth.

Even though we can’t come together physically, no one can minimise the impact past Congresses have had on public policy. Scrapping the immigration health surcharge was first discussed by a congregation of nursing staff before the government relented.

When we speak with one voice, policymakers listen.

An issue that’s often been discussed at Congress is the structural inequalities in our health and care system. The NMC Code is clear that we must treat people as individuals and uphold their dignity by respecting and upholding human rights.

The consequences of a system in which some people’s health is determined by their ethnicity has been laid bare in the recent report from Public Health England on the effects of COVID-19 on BAME communities.

This report is clear evidence that BAME health and care staff are at an increased risk of contracting the virus. The Equality and Human Rights Commission (EHRC) has launched a much-needed inquiry into racial inequalities but nursing staff will once again have to wait for answers.

In the face of mounting evidence, many of you will be as disappointed as me at the lack of recommendations in PHE’s report, particularly given the urgent need for solutions.

Many employers have stepped into the breach and asked for our advice in ensuring any staff member who could be more vulnerable to COVID-19 receives a proper risk assessment. But this alone won’t save lives.

What we do know is that where there is proper PPE, there is less chance of contracting the virus. But I am really concerned about the level of pressure that some Trusts are putting on healthcare staff to prevent them from speaking out when PPE is not provided.

Beyond COVID-19, the UK government must invest in public health and develop a proper cross government strategy with clear actions to tackle race inequalities. To achieve this, there must be a detailed and open discussion with black and minority ethnic communities about what this should look like. We need decisive action to tackle structural and systemic inequality.

If Congress was happening this week, coming together would have given us the opportunity to discuss how to support each other and what we need from our colleagues, from our political leaders, from our neighbours and our friends.

But we cannot wait until Congress 2021 to hear what you think. In fact, this may be something we discuss in the coming months, with a series of online discussions being agreed by the Agenda Committee soon.

The current debates on race and discrimination have given us an opportunity to re-examine our working practices and cultures, to ensure that we stand up to the racism and discrimination that affects staff and patients.

I know I am not alone in wanting to address the profound impact of these inequalities. Both the PHE report and the Black Lives Matter movement show us all that this work is nowhere near done yet. We now need answers to the question 'why’ so that action can be taken.

Please stay safe.
Dame Donna Kinnair

Dame Donna Kinnair

Chief Executive & General Secretary

Prior to her appointment as Acting Chief Executive & General Secretary, Dame Donna was Director of Nursing, Policy and Practice and worked with UK-wide RCN staff to drive and implement RCN professional nursing, policy and practice strategy.

Before joining the RCN, Donna held various roles, including Clinical Director of Emergency Medicine at Barking, Havering and Redbridge University Hospitals Trust.
 
Donna advised the PM’s Commission on the future of Nursing and Midwifery in 2010 and served as nurse/child health assessor to the Victoria Climbié Inquiry.

Page last updated - 09/06/2020