The GMC’s annual report on equality, diversity and inclusion presents a mixed picture. While fitness to practise referrals have slumped, much still needs to be done on medical education.
Inequalities in healthcare are issues that Healthcare Today has covered in detail. “When we talk about health inequalities and the social determinants of health, it’s crucial to understand that 80% of what affects someone’s health happens outside of healthcare,” MaryAnn Ferreux, chief medical officer for Health Innovation Kent Surrey Sussex and a non-executive director for Kent and Medway NHS Partnership Trust, told us last year.
But deep-rooted inequalities within medicine and how it continues to impact careers and opportunities for ethnic minority and non-UK qualified doctors working in the NHS are, perhaps, less well known.
A new report from the General Medical Council (GMC) on equality, diversity and inclusion presents a mixed picture.
The GMC committed to eliminating disproportionate employer fitness to practise referrals of doctors from an ethnic minority, or who qualified outside the UK, and who are more likely to be referred to the regulator, by the end of the year.
It says it is on track to achieve this. Latest figures in the report show the proportion of employers where data suggests excess referrals in relation to a doctor’s ethnicity or place of qualification has almost halved – from 5.6% down to 2.9% – since the initial benchmark of 2016–2020.
Fairness and equality
The regulator has also set an ambition to eradicate discrimination, disadvantage and unfairness in medical education and training by 2031, but progress against this longer-term aim is slower.
“Fairness and equality aren’t simply matters of principle – they are prerequisites for productivity and translate to better patient care. Every doctor, no matter their background, must be able to work, learn and thrive in an environment where they feel they belong,” said the GMC’s chief executive Charlie Massey.
“Our report shows we have a system moving at two speeds. Unmistakable momentum towards eradicating disproportionality in employer referrals, but limited, and in some measures absent, progress against our ambitions in education, which must be addressed,” he continued, emphasising that if doctors face disadvantage early in their careers, or before they begin them, they are already on an unequal footing.
The report makes several recommendations for system leaders, employers and educators to act on the challenges raised.
These include prioritising equality, diversity and inclusion activity through proactive organisational change and workforce plans; practice workshops as part of an induction programme for doctors new to the UK; monitoring and measuring the overall impact of diversity activity and interventions; and ensuring that the health services in Britain each develop and deliver anti-racism resources.
Education a concern
“These findings underline the fact that there is still a lot for the NHS to do to tackle discrimination and inequality in medicine,” admits Daniel Elkeles, chief executive of NHS Providers, calling the lack of progress in medical education and training “a real concern” for doctors, patients and the NHS.
The Royal College of Physicians focused on the issue of training and education.
“Fairness in training, assessment and employment is not optional – it is essential to retaining doctors, supporting morale, and delivering safe, high-quality patient care,” said Mumtaz Patel, president of the Royal College.
‘For the RCP, this report reinforces what we have heard consistently through our next-generation campaign: the medical training system needs a fundamental reset. We need more postgraduate training places, genuinely flexible career pathways, and sustained investment in high-quality training and supervision if we are serious about retaining physicians in the NHS,” she continued.
Her points were echoed by the Royal College of Physicians of Edinburgh.
“The report is right to highlight just how deep-rooted some of the inequalities in medicine are. These inequalities are harmful to doctors themselves and to our NHS as a whole, and the care it can provide to patients. Clearly, there is much still to be done, especially in relation to education and training, where progress seems to be especially challenging in some aspects,” said the college’s president Andrew Elder.
