I think that there is a difference in specifying the services of an
Afro-Caribbean male to work with disengaged Afro-Caribbean males living in a
country which is in essence foreign to what is known and perhaps the norm to
them. The Afro-Caribbean staff member might be better suited to understand
the reasons for them having disengaged in the first place. There is the
issue of having to adjust in a foreign country, and the experience of how
people react to you, be it as a foreigner or a minority accessing health
care services. Would there be a need to specify the need for an
Afro-Caribbean male in an Afican/Caribbean country to care for disengaged
males?
This is different to someone refusing to be treated by someone on the basis
of their race. Does it imply that people are incapable of providing good
care because of their ethnicity/race. This request appears unreasonable and
are we setting a precedent here? What would be next? Service users dictating
the religion,sexuality,height,weight,hair colour of staff who will be
acceptable to treat them?
The effect this has on the staff member concerned has also to be taken into
consideration. I believe that the impact this has on the person can only be
understood by someone who has experienced this. It is humiliating and
demeaning, and has no place in the NHS, and hopefully nowhere else in any
service. How would this situation be handled to prevent any unpleasantness
to staff if service users are allowed to choose people on the basis of their
race/ethnicity? Have units staffed by hetero-sexual, red haired males for
hetero-sexual red haired male service users?
Issues of race/ethnicity are complex and have to be viewed in the right
context and sensitivity to all.
Victoria Manzini
Cross Cultural Lead Nurse
Mornington Unit
St Pancras Hospital
-----Original Message-----
From: James Stephen [mailto:[log in to unmask]]
Sent: 11 November 2004 09:41
To: [log in to unmask]
Subject: Re: refusal to be treated by a member of staff on the grounds
of their ethnicity
Refusal of treatment is towards the worse end of a continuum of prejudice
that many Black NHS staff encounter in everyday working life. I would say
the patient's behaviour amounts to harassment and there should be a
bullying/harassment policy in the Trust.
I would not advise a Trust to comply with the patient's wishes, because if
it were to do so it would almost certainly be discriminating unlawfully by
restricting the duties of Black staff on the basis of their race. A parallel
might be the case of a hotel that only allows white staff in front-of-house
roles and keeps Black staff behind the scenes.
But if a Black member of staff wishes to avoid a situation in which she will
very likely encounter racial abuse and other (white) staff would not run the
same risk then the Trust could probably use its discretion in how far it
*obliges* everyone to do the same work all the time, provided it can do so
without colluding with the racial abuse. The Trust may have a duty of care
under HASAW with regard to this.
The patient is making an unreasonable request in asking the Trust to act
unlawfully. By making
this unreasonable request a condition of consent to treatment, it could
perhaps be argued that the patient is, in effect, refusing treatment. So the
issue becomes one of consent rather than race.
As a footnote, the patient may herself be contravening the Human Rights Act
by discriminating against a person on the grounds of their race. (The same
Act used by nightclub worker Sophie Amogbokpa who allegedly suffered
discrimination at the hands of Cheryl Tweedy. Sorry to drag 'Girls Aloud'
into the discussion.
http://news.bbc.co.uk/cbbcnews/hi/music/newsid_3201000/3201312.stm) The
patient has certainly behaved very rudely and hurtfully, and if deaf to the
claims of racial equality may not even listen to an appeal to simple good
manners.
I believe Alison's first example confuses prejudice with discrimination.
Exemption from RRA should not be on the basis that some Black folks prefer
not to be treated by white folks or vice versa. Whilst that may well be
true, because we all perhaps have some odd prejudices, it is beside the
point. Exempt posts exist because some communities do not yet have access to
health services on the basis of their need, and action is needed to redress
an evidenced imbalance. I don't believe we would find evidence of such an
imbalance in the case of "upper/upper-middle class elderly of Chelsea". But
we can find whimsical or distasteful prejudices almost everywhere we look,
in ourselves as well as in others.
The case of a man asking for a male doctor is different. In some places this
would be an accepted preference. I think the emphasis on women's preferences
is justified partly by differences in health needs and partly by imbalance
of sexual power. If there were a male equivalent of a cervical smear I am
confident that men would protect their dignity and influence health services
accordingly. Sexual abuse and harassment of patients by medical staff is
extremely rare but insofar as it does occur the perpetrator is far more
likely to be a man.
There may not be specific guidelines for the Bradford case, but there should
be other policies that apply, e.g. bullying/harassment policy, consent
protocol, health and safety at work policy, race equality scheme.
* * * * * * * * * * * * * * * * * * * * * * * * * *
Stephen James, Head of Partnerships and Diversity, Ealing Primary Care
Trust, 1 Armstrong Way, Southall, Middlesex UB2 4SA. Tel: 020 8893 0318.
Fax: 020 8893 0398. email: [log in to unmask]
Ealing PCT hosts the West London Renewal SRB Scheme
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* Please visit www.renewalsrb.org.uk.
-----Original Message-----
From: Devlin Alison (Central and North West London Mental Health NHS
Trust) [mailto:[log in to unmask]]
Sent: Wednesday, November 10, 2004 4:21 PM
To: [log in to unmask]
Subject: Re: refusal to be treated by a member of staff on the grounds
of their ethnicity
Ah, this should get discussion going nicely.
It's that fine line between: all clinicians being equally
qualified to treat, irrespective of race and ethnicity, on
the one hand, and the efforts that we go to to provide
services for a specific group by someone from that group to
ensure cultural sensitivity and sometimes even credibility.
We(that's the the royal 'we' I'm using here, not just my
workplace) don't question specifying the need for an African-
Caribbean man to develop services with disengaged African-
Caribbean men within community mental health services, but
would you feel as comfortable specifying the need for a
white, middle class female to work with the upper/upper-
middle class elderly of Chelsea? No of course you wouldn't,
because technically, it's not legal to do so and i can't
think of a tribunal precedent for a white worker being
allowed for the 'personal care' genuine occupational
qualification opt-out of the RRA.
So in answer to your question, it is my inderstanding that it
is not legal to act on a patient's request for 'a white one'
when faced with a Black African nurse, however we can make
efforts to find a Black or Asian clinician where cultural
understanding and community credibility is perceived to be a
barrier. Ditto, female patients asking for female doctors
are responded to but i don't get to hear about many the other
way (male patients getting male doctors on request - they are
told not to be so sexist and are reminded of the female
doctor's qualifications / experience etc)
As far as i understand it, it's a legal grey area that has us
Diversity Managers fair tearing our hair out. Unless I've
misread the law and then someone please correct me (Sarah
Collett? Georgina English? Brian Coleman?)and I can sleep
easy again
Alison Devlin
Equalities and Diversity Co-ordinator and prematurely bald
Central and North West London Mental Health NHS Trsut
---- Original message ----
>Date: Wed, 10 Nov 2004 15:03:48 +0000
>From: Selina Ullah <[log in to unmask]>
>Subject: refusal to be treated by a member of staff on the
grounds of their ethnicity
>To: [log in to unmask]
>
>I hope some one can help me with a query I have recently
received.
>
>Does anyone have any policies/protocols or guidelines to
address service user refusal to be treated by a member of
staff on the grounds of their ethnicity or race. I would be
particularly interested in policies from mental health
providers.
>
>Many thanks in anticipation of your help.
>
>
>
>
>
>Selina Ullah
>Assistant Director, Modernisation and Diversity
>
>tel: 01274 228370
>mbl: 07957425451
>email: [log in to unmask]
>
>Bradford District Care Trust
>New Mill
>Victoria Road
>Saltaire
>Nr, Shipley
>West Yorkshire
>BD18 3LD
>
>
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