Top flight associates in mental health and social care delivering service improvement



Sensationalist reporting, institutional racism and the NHS

By Hári Sewell

Posted: Saturday November 10 2012

An exploration of issues to be considered when raising issues of institutional racism, given that it is a term that invariably causes resistance to change rather than promoing progress.

Public, widely reported accusations of institutional racism in the NHS usually cause a stir.  This has nothing to do with whether it is true. 


Any assertion of institutional racism needs to be preceded by at least three considerations: what is the utility being served and for whom; what impact is intended and expected and thirdly whether there is a common understanding of the term institutional racism that enables it to be used reliably for conveying a point?


When interviewed recently by the BBC and asked whether I thought the NHS was institutionally racist I considered the points above and gave a balanced view.  I outlined in considerable detail the need to understand the reality of people’s lives, the inequalities in relation to education, housing and access to revenue and capital wealth which along with greater caring responsibilities are major influences on people’s ability to progress in the workplace.

I have since written to the BBC to complain about a misrepresentation of my interview.


With regard to the utility of accusing the NHS of racism I think there is not much to be gained.  It is unlikely that an organisation will say “yes, we are institutionally racist”.  For me, there is no utility in alienating leaders with whom I currently work and hope to work with in future.  My company strap line “Creating Solutions With You” summarises my passion for coproduction in problem solving.  It begs the question as to whose purposes would be served by a sensationalist headline.

The second consideration raised here was the intended impact.  I have worked with healthcare organisations looking at issues of possible unfairness and possible discrimination.  In my experience change is engendered more successfully when there is a context of trust.  Feeling accused often causes organisations to become defensive, making it harder to discuss areas for development and work towards the very improvements being sought by people who shout institutional racism.  

The third consideration was around whether the term ‘institutional racism’ can be used reliably to communicate concepts.  I find this issue frustrating.  Institutional racism describes the way in which organisations can inadvertently have policies, cultures or practices which lead to poorer outcomes (the Macpherson definition in the inquiry report into the murder of Stephen Lawrence includes three key points, i.e. poorer outcomes, unwitting behaviours and collective action).  Most leaders in organisations who are working towards change accept that there are possibly areas of unwitting biases within their organisation.  One good test of effective communication is to be able to say something and to have someone describe their understanding of it in a way that matches the intended meaning.  Unfortunately the term institutional racism often leads to variable interpretations, particularly in mass communication to a non specific audience.  This lies at the heart of why I would rather describe specific behaviours than to throw out a deliberately incendiary headline.


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