Prof Donna Kinnair on racism in the NHS: 'In every community, BAME patients suffer the most'

The head of the Royal College of Nursing on why the health service is failing people of colour – both those using it and its workforce

After university, I signed up for Marks & Spencer’s management trainee scheme. When I was pregnant with my first child, I went to see a nurse. I said to her: “I’ve always wanted to be a nurse, you know.” She said: “I don’t see any reason why you can’t be.”

I started my training in 1983 at the Royal London hospital when my son was six months old. My sister had applied to do nursing at that same hospital a year before me. When she went for her interview, they tried to persuade her to train as a state-enrolled nurse, which is a lower grade than a registered general nurse.

She told me: “Watch out, they’ll try to push you into a lower grade.” She was right. In my interview they started saying it would be better for me to be a state-enrolled nurse. I said: “No thank you, not with my qualifications, and if you don’t want me I’ve got an interview at Bart’s down the road.” That was my first experience of racism in the NHS. 

Sometimes patients would say: “I don’t want to have any black hands on me.” That was fairly common in the 1980s. It was obvious that some people didn’t expect me to progress. They would be surprised that I had such a good education, as if black people couldn’t go to university. But there were also people who were white and saw the talent I had. They created opportunities for me to flourish.

When I took on the role of chief executive of the Royal College of Nursing in 2018 (to which I was permanently appointed in April 2019), I became the UK’s second black female trade union leader. As a black leader, you are always aware that if you are not a good role model, someone coming up behind you may not be afforded the same opportunity you’ve been given. There are, sadly, too few of us. We only have 10 black, Asian and minority ethnic (BAME) chief nurses across the whole of the NHS in England. The leadership of the NHS is not reflective of the workforce, or the communities we serve. 

There are huge structural issues at work when it comes to how BAME communities access healthcare in the UK. When you look at the outcomes for BAME patients, they’re worse in almost every category, from heart disease to diabetes. In every community we work with, BAME patients suffer the most. 

When you rock up to your GP as a BAME person, your illness isn’t taken as seriously. Sometimes it takes five or six visits before you get into the system. Every step of the way, from services to treatment, some BAME patients have a worse experience of the NHS than their white counterparts. 

Coronavirus has exposed the underlying healthcare inequalities experienced by BAME communities. People of Bangladeshi ethnicity are twice as likely to die of Covid-19 compared with white people. People of Chinese, Indian, Pakistani, Caribbean and black ethnicity have between a 10 and 50% higher risk of death from Covid-19 compared with white people [according to Public Health England]. That’s before we even get on to the health and care staff who have died; at least 250, and more than 60% were from BAME communities. 

We need to recognise that this loss of life is deeply distressing. Every death is a tragedy. We need to understand how we can prevent this happening in the future. Do we need to give BAME healthcare workers better personal protective equipment? Should we redeploy them away from the frontline, in case there is a second wave of the pandemic? How are we risk-assessing our staff, to ensure that we aren’t putting healthcare workers with underlying conditions at unnecessary risk?

When I’m in the street, people don’t see me as the head of the Royal College of Nursing; they see me as a black woman. It’s part of the everyday experience of my life, and my family’s life. Whether it’s being looked at differently in a shop, or my son being stopped repeatedly by police as he tries to make his way across London. Racism happens every day. It’s about how I react to it.

Coronavirus has shone a spotlight on the contributions made by immigrants to our NHS. Let’s not forget that a year ago we had the government talking about a hostile environment. Too many immigrants were supposedly “taking our jobs”. And now we’re clapping immigrant healthcare workers. I hope we recognise the contribution healthcare workers make in a material sense. Let’s not just have clapping or words of empty praise. If we value our nurses, let’s pay them properly.

• This story was amended on 22 June 2020 to remove a reference to Professor Dame Donna Kinnair’s sister being the first black nurse at the Royal London. Although it’s likely that she was one of the first black registered general nurses at the hospital, the first ever black nurse is believed to have been Annie Brewster, who worked there from 1881 to 1902.


As told to Sirin Kale

The GuardianTramp

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