How the British National Health Service Deals with Ethnic Diversity

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Provides a valuable insight into the experiences of minority ethnic communities both as patients and staff members in the NHS. It charts the nature of the problems they face, from language barriers to cultural misunderstandings. Issues of discrimination are explored and a unique insight is provided into the perceptions of a range of NHS staff in relation to the political climate in the wake of the Macpherson Report (1999). A fresh perspective is offered from the point of view of users into the concept of institutional racism, which questions the unwitting nature of prejudice as defined in the Report.


“ ... This book reveals the confusions and contradictions at the heart of employment and service delivery policies in the National Health Service (NHS), long seen as a pioneer in all these fields. Based on thorough scholarship and research, it offers a new way forward on pressing issues ... Dr. Nick Johns shows that the persistence of cultures of professional exclusion, blaming and stereotyping in the NHS is complex and multi-layered. Partly it is related to ideas about ‘equal treatment’ – that no group should be favored over any other. Partly it reflects structural factors, where the ethos and location of hospitals and clinics effectively discriminate against recruitment from minorities. But most subtly, efficiency-driven criteria for service organizations do not allow the special contribution of staff from minority communities to be recognized and valued. Hence many of the needs of these groups of patients go unmet. I commend this book for its contribution to the debate about public services, as the context for citizenship and civic culture in the United Kingdom. But it is also of great value to the wider discussion of how diversity can be seen as a strength in our society, and how our institutions can encompass equality and difference.” – (from the Preface) Professor Bill Jordan, University of Huddersfield

“This book is a timely contribution to the discourse in this area, since there have been few attempts to date to conceptualize ethnic diversity as it relates directly to public policy. It also deals with important issues in relation to health policy and its evolution, and charts the impact of racism on the delivery of services to minority ethnic communities, taking into account recent contributions ... a valuable resource for both policy-makers and academics in the field.” – Professor Michael Sheppard, University of Plymouth

“ ... The quality of Dr. Johns’ writing and his ability to analyze complex issues with clarity and precision stand out in this book. It represents excellent scholarship, and the subject matter is one which chimes with many contemporary concerns; it should attract a wide readership.” – Dr. Daniel Gilling, University of Plymouth

Table of Contents

List of Charts and Tables
Preface by Bill Jordan
1. Setting the Scene
Section One – Meeting the Needs of Minority Ethnic Communities
2. Communication Barriers: The Product of Ignorance and Ideology
3. Institutional Racism in the NHS
Section Two – Improving Service Provision to Minority Ethnic Communities
4. The Internal Market
5. Minding our Language
6. The Value of Cultural Awareness Training
Section Three – Ethnic Diversity in the NHS
7. The Meaning of Ethnic Diversity
8. Taking Positive Action
9. The Management of Diversity
10. Conclusion
Appendices 1-5

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