Author Archives: Yvonne Veronica

About Yvonne Veronica

I suppose the key things to say about me is that I am first and foremost a black woman and the mother of three beautiful and quite brilliant children. I'm married, have been for sometime and quite simply I love my life. My family and friends sustain and nurture me. I am also a nurse and have worked in the NHS for a long time, a very long time.

Sometimes I wonder…

Sometimes I wonder what it will take to make the necessary changes in our world to improve race equality. The more I learn about the complexity and challenges inherent in the race equality agenda, the more impossible it seems that change is likely. Last week, Russia invaded the Ukraine and I along with the rest of the world watched in horror the incomprehensible difficulties faced by people trying to escape war, something I hope I never to have to do. It was noticeable and quite depressing that black and Asian people trying to leave Kyiv were having an even harder time of trying to escape the bombardments than their white counterparts. We saw in brilliant technicolour black people struggling to get out of the country and being turned back at railway stations and at border control checkpoints in Poland. Perhaps we are not seeing or hearing the whole story, who knows but some of the reporting has been interesting, highlighting the difference in language used for white people in this situation as opposed to black or brown people. Fleeing people are evacuees not refugees, asylum seekers or migrants like those fleeing from similar situations in Afghanistan and Syria. “How can this be happening to people that have blonde hair and blue eyes? one commentator asked, “people like us”. It seems that war zones in countries where European people live have a higher level of significance, because in the eyes of the predominantly white western world, it could be them.

Today, I read an article entitled, about Sun-down Towns  This article put a shiver down my spine and made me think about the amount of energy we as black and brown people have to expend on keeping ourselves safe and out of harm’s way, it really does take its toll on us psychologically and physically.

This led me to thinking about  The Ethnic inequalities in health care: A rapid Review  https://www.nhsrho.org/wp-content/uploads/2022/02/RHO-Rapid-Review-Final-Report_v.7.pdf published in February by the NHS Race and Health Observatory, it highlighted the inequalities experienced by black and Asian people in getting the same treatment and outcomes as their white counterparts.  Paper after paper, report after report, highlights and documents the inequalities experienced by some sections of the population and the question often asked is why? I believe we all know the answer, it is the elephant in the room that nobody wants to acknowledge, that fundamentally we live in a deeply racist, colourist world. I believe that changing the current situation will be harder than we might think. For a start it needs leaders to really believe that change needs to happen and that the current situation is untenable. David Olusoga  Historian and TV personality wrote a piece in The Guardian  responding to the NHS RHO report, he asked what was going to be done about the current situation in terms of health inequalities for black, some Asian and some minority ethnic groups. The silence of the response to this question has been deafening.

Over the last year or so we have heard about the unfairness and inequalities and its impact on people from black Asian and minority ethnic backgrounds, the old excuse of not knowing can no longer be used. George Floyd, disproportionate deaths from Covid, the European football tournament and the backlash received by those three black players that missed penalties, more recently the reports about racism in cricket, in the police and unfortunately even reports on the high levels of racism being rife in the health service, reports on black women being 4 times more likely to die in child birth and 40% more likely to experience a miscarriage, the list of inequalities goes on.

These reports and incidents are hard for anyone to hear and digest. It is particularly troubling that in 2022, in this society, there are people that will not like, value or appreciate others based on the colour of their skin. These reports have highlighted the negative and damaging treatment that people of colour receive as a consequence of this blatant and overt racism, from name calling and out and out discrimination to stopping people from boarding trains and not allowing them to cross borders or having sun down towns where black people cannot walk safely after dark. What is interesting about many of the incidents highlighted above is that they have been overt, it has been impossible to ignore them and you would have had to have been on Mars for the last few years not to know that this country and many parts of the world has a serious problem with race equality. No longer can we point across the Atlantic and say, ‘it’s them not us’.

The fact that the kind of racism that’s described above is still present is bad enough, however it’s the more insidious invisible racism that gets into your psyche and does the real physical and psychological damage. It’s curious that everyone I meet talks about the importance of equality and inclusion of fairness and equity, yet everything stays the same.

When Cressida Dick resigned from her role as Police Commissioner for the Metropolitan Police, the Health secretary’s brother Deputy Assistant Commissioner Bas Javid, admitted there was racism in the Metropolitan Police, but only went as far as to say that there were a few bad apples in the Met and that the organisation wasn’t institutionally racist. I would beg to differ from that view. Institutional or systemic racism are silent but extremely effective and can be deadly. A definition of systemic and institutional racism from the Macpherson report is that it is “The collective failure of an organisation to provide an appropriate and professional service to people because of their colour, culture, or ethnic origin”. Institutional and systemic racism is developed in the places where policies are made and are shored up by leadership behaviours, human resource practices and procedures. It lives in the very depths of the cultures we have in our organisations, where racial slurs go unchallenged or dismissed as banter. It allows complaints about bullying and harassment that black Asian and minority ethnic staff experience to be seen as them playing the race card and not being believed. It lives in the places that enable the status quo to continue to exist so that some people are more able to thrive than others.

Why when as a society we have so much evidence that shows that people from black Asian and minority ethnic backgrounds have a worse experience during the course of their lives than their white counterparts, that black women are 40 times more likely to miscarry than their white counter parts, that black and Asian women more likely to lose their lives and or their babies in childbirth. That black men are more likely to end up in secure psychiatric hospitals and that many more black and Asian people died of Covid 19 than their white counterparts. The one statistic that particularly stood out for me was that black children are 10 times more likely to be referred to Child and Adolescent Mental Health services (CAMHS) via social services than white children. These are just a few of the facts and data we have that show health inequalities are, on the whole more prevalent amongst people from black Asian and minority ethnic backgrounds

When I read the Ethnic Inequalities in Health Report I reflected on the strength of the evidence in the report. Evidence pulled together from 13,161 references, 178 studies as well as focus groups and it seemed to me that some of the solutions to these inequalities were not that difficult to implement, for instance ensuring we have robust data collection systems to collect and analyse data, having zero tolerance policies in place that are adhered to. Having clear lines in the sand about what is acceptable behaviour and what is not.

One of the recommendations from the report highlights the need for serious commitment from NHS England and Improvement to tackle racist attitudes and behaviours amongst healthcare staff and to address structural dimensions of NHS Systems that discriminate against ethnic minority women and their babies.

I welcome and wholly recommend this excellent report by the RHO, its findings as well as the recommendations are excuse remover in terms of us not being more proactive and more determined to reduce these inequalities in the lives of a substantial number of people living in this country. The RHO have highlighted the fact that there are no lack of reports and their corresponding recommendations on the inequalities that exist in healthcare for black Asian and minority ethnic people. The steps that now need to be taken are to acknowledge their validity and openly accept and agree with what they are saying and to demonstrably put systems in place to make a real and tangible difference for people of colour.

I started this piece by saying that I sometimes wonder what it will take to make people sit up and take notice of the deeply complex and difficult issue of race inequality in our world, Sadly, I don’t have the answer. We can only hope that one day more people will want change than don’t and we can really start to make a positive difference for people of colour in healthcare and ultimately in the wider world.

Appreciation is the 8th A

Appreciation is the 8th A

Maybe it’s because of the trauma, the humiliation and cruelty that we as black people have had to endure for centuries that we know how to celebrate, party and really enjoy ourselves. Anyone that has been to a Caribbean or African wedding will know that celebrating and partying is something we do really well, that and the making and eating of the fabulous food that goes with it of course. This thought came to me on Friday 29th October at the Black Country and West Birmingham NHS Trusts black history month awards event. It was an outstanding evening and what was even more uplifting to see was how the joy and delight overflowed and infected white colleagues that were there too. The atmosphere and perhaps a few glasses of wine made many of them relax and find their way onto the dance floor. I was impressed to see them dancing to ‘Jerusalema’ and my favourite, ‘the candy’.

So here we are at the end of another black history month, 31 days when the country sits up and takes notice of the contribution of people of African descent to this country. That contribution has not been inconsequential and lot of it has been accompanied by blood, sweat and tears.

2 years ago, after a number of white leaders in the NHS asked me how they could practically and demonstrably support people from black Asian and minority ethnic backgrounds, how they could become true allys, I wrote the 7 A’s of Authentic Allyship ©. The model was designed specifically to support white colleagues in how they could become authentic ally’s and support the cause for racial equality in a practical and positive way. I am delighted that the 7 A’s has been widely circulated in the NHS with many people using it to develop training modules on allyship, like Candace Bedu Mensah at Lancashire and South cumbria NHS FT.

On Friday evening amidst the celebrations at the Birmingham and black country awards ceremony, it came to me that another A needs to be added to the model.  That A being appreciation. True, wholehearted and genuine appreciation of the contribution of black people to society and the world at large is sadly lacking, apart from during black history month that is. The truth of the matter is that black and white history are inextricably linked and without black history there is no white history, the stories of each group are interconnected and should be told together. Over the years this has not been done, we hear stories about white heroes and heroines, over and over again, they are deeply embedded in our minds, we know their names and what they do or have done off by heart, however we know little of black people that have also made significant contributions not to mention sacrifices in the world. Yes the names of Nelson Mandela and Martin Luther King are known but what about people that invented household items, things we use every day, a black man called Thomas Stewart invented the mop, Sarah Boone, a black woman, the ironing board, and Thomas Ray another black man, the dustpan.  Black people have been ground breaking scientists and mathematician’s like Mary W. Jackson, Katherine Johnson and Dorothy Vaughan the three amazing black women that helped put astronauts into space at NASA. We need to show a genuine and heartfelt appreciation of what people with African heritage have brought to this country and the world at large over many years. Black people have contributed in sport, politics and the arts too many people to name here, sadly appreciation of their contributions and achievements are muted, whitewashed or not celebrated at all.

Appreciation does several things, it makes people feel valued, lifts their confidence and self-esteem. It makes you feel valued and worthwhile, it gives you that extra spring in your step when people appreciate and value what you have done. Appreciating people comes in different forms, it comes in saying thank you, in bothering to take an interest, it comes from valuing the contribution of the individual and the communities they come from. This A is essential if we are to really get to grips with being authentic allys.

On Friday night at the awards ceremony, appreciation was shown in so many ways, and you could actually feel the energy in the room go up, energy that could be harnessed to ensure patients received a high-quality service from valued and appreciated staff, particularly at this difficult time for so many in the service.

cid:381DA350-6B57-48C7-90E8-CB574230954DAt the event, 93-year-old Jamaican born, Neil Flanigan was in the room. Neil came to the UK in 1943 and fought alongside other Caribbean soldiers during world war 2. Neil fought for this country and was willing to lay down his life for it. The room showed Neil how much he was appreciated by giving him a standing ovation, he deserved it. Neil was touched by the gesture; people thanking him for his contribution to making the world a safer place and openly and loudly valuing his contribution. Appreciation was shown to all the award winners for their efforts, for their commitment to the NHS and to the patients that we serve.

Appreciating and valuing people is key to building their self-esteem their self-confidence, it makes people stand taller and want to do more when people say we value you and your efforts.

On the whole people from black backgrounds are not valued or appreciated, surely that has to change if we are to have true allyship. Which reminds me, someone told me that we don’t need allys in the fight for inclusion and acceptance we need accomplices, on second thoughts perhaps I need to add two

more A’s to the model making it the 9 A’s of Authentic Allyship.

This blog would not have been written if Donna Mighty, Sandwell & West Birmingham NHS Trust and Sabrina Richards, Walsall Healthcare NHS Trust both WRES Experts and fabulous human beings had not invited me to speak at the Black Country and West Birmingham Trusts black history month awards ceremony and by way of this blog I want them to know how very much I appreciate them.  

Appreciation is the 8th A of Authentic Allyship

Maybe it’s because of the trauma, the humiliation and cruelty that we as black people have had to endure for centuries that we know how to celebrate, how to party and really enjoy ourselves. Anyone that has been to a Caribbean or African wedding will know that celebrating and partying is something we do really well, that and the making and eating of the fabulous food that goes with it of course. This thought came to me on Friday 29th October at the Black Country and West Birmingham NHS Trusts black history month awards event. It was an outstanding evening and what was even more uplifting to see was how the joy and delight overflowed and infected the white colleagues that were there too. The atmosphere and perhaps a few glasses of wine made many of them relax and find their way onto the dance floor. I was impressed to see them dancing to ‘Jerusalema’ and my favourite, ‘the candy’.

So here we are at the end of another black history month, 31 days when the country sits up and takes notice of the contribution of people of African descent to this country. That contribution has not been inconsequential and lot of it has been accompanied by blood, sweat and tears. 2 years ago, after a number of white leaders in the NHS asked me how they could practically and demonstrably support people from black Asian and minority ethnic backgrounds, how they could become true allys, I wrote the 7 A’s of Authentic Allyship. The model was designed specifically to support white colleagues in how they could become authentic ally’s and support the cause for racial
equality in a practical and positive way. I am delighted that the 7 A’s has been widely circulated in the NHS with many people using it to develop training modules on allyship, like Candace Bedu- Mensah at Lancashire and South Cumbria NHS FT.

On Friday evening amidst the celebrations at the Birmingham and Black Country awards ceremony, it came to me that another A needs to be added to the model. That A being Appreciation. True, wholehearted and genuine appreciation of the contribution of black people to society and the world at large is sadly lacking, apart from during black history month that is. The truth of the matter is that black and white history are inextricably linked and without black history there is no white history, the stories of each group are interconnected and should be told together. Over the years this has not been done, we hear stories about white heroes and heroines, over and over again,
they are deeply embedded in our minds, we know their names and what they do or have done off by heart, however we know little of black people that have also made significant contributions not to mention sacrifices in the world. Yes the names of Nelson Mandela, Mary Seacole and Martin Luther King are well known but what about people that invented household items, things we use every day, a black man called
Thomas Stewart that invented the mop, Sarah Boone, a black woman, the ironing board, and Thomas Ray another black man, the dustpan. Black people have been ground breaking scientists and mathematician’s like Mary W. Jackson, Katherine Johnson and Dorothy Vaughan the three amazing black women that helped put rockets into space at NASA. We need to show a genuine and heartfelt appreciation of what people with African heritage have brought to this country and the world at large over centuries. Black people have contributed in sport, politics and the arts, too
many people to name here, sadly appreciation of their contributions and achievements are muted, whitewashed or not celebrated at all.


Appreciation does several things, it makes people feel valued, lifts their confidence and self-esteem. It makes you feel valued and worthwhile, it gives you that extra spring in your step when people appreciate and value what you have done. Appreciating people comes in different forms, it comes in saying thank you, in bothering to take an interest, it comes from valuing the contribution of the individual and the communities they come from. This A is essential if we are to really get to grips with being authentic allys.

On Friday night at the awards ceremony, appreciation was shown in so many ways, and you could actually feel the energy in the room go up, energy that could be harnessed to ensure patients receive a high-quality service from valued and appreciated staff, particularly at this difficult time for so many in the service.

At the event, 93-year-old Jamaican born, Neil Flanigan was in the room. Neil came to the UK in 1943 and fought alongside other Caribbean soldiers during world war 2. Neil fought for this country and was willing to lay down his life for it. The room showed Neil how much he was appreciated by giving him a standing ovation, he very much deserved it. Neil was touched by the gesture; people thanking him for his contribution to making the world a safer place and openly and loudly valuing his contribution. Appreciation
was shown to all the award winners for their efforts, for their commitment to the NHS and to the patients that they served.


Appreciating and valuing people is key to building their self-esteem their self-confidence, it makes people stand taller and want to do more when people say we value you and your efforts.
On the whole people from black backgrounds are not valued or appreciated, surely that has to change if we are to have true allyship, which reminds me, someone told me that we don’t need allys in the fight for inclusion and acceptance we need accomplices. On second thoughts perhaps I need to add two more A’s to the model making it the 9 A’s of Authentic Allyship.


This blog would not have been written if Donna Mighty, Sandwell & West Birmingham NHS Trust and Sabrina Richards, Walsall Healthcare NHS Trust both WRES Experts and fabulous human beings had not invited me to speak at the Black Country and West Birmingham Trusts black history month awards ceremony and by way of this blog I want them to know how very much I appreciate them.

Black History Month 2020

So here we are again, Black History Month (BHM) it’s the first time in 43 years that I have not been an employee of the NHS. What retirement gives you, in between watching daytime TV, is the time to reflect, to think about your accomplishments as well as the things you wish you’d have done differently. During this month, people from black backgrounds openly celebrate their history; they talk about remember and celebrate famous black people, their achievements and how, to all intents and purposes, many of their accomplishments have largely been omitted from our history books. Thankfully the list of people we celebrate is growing from when BHM first arrived in this country in 1986, imported from the USA. Back then, we used to laud and applaud Martin Luther King Jr. Nelson Mandela, Muhammad Ali, Rosa Parks, Maya Angelou, later we began to venerate and give thanks for Barack Obama, Oprah Winfrey and other famous black Americans. Believe it or not the list of black people and their achievements is actually quite a long one, and way too many to cite here; it simply needs the appetite and a few minutes of time typing ‘black inventors’ into Google to see what I mean. It got me thinking that black history isn’t black history at all, it is world history and without some of the famous black inventors like Dr Shirley Ann Jackson, who invented the touch tone phone or Gladys Mae West who helped to invent the GPS, the worlds history would be very different. These amazing people’s lives should be taught in all schools to everybody and not just in Black Saturday school to the few lucky children like Akala who was lucky enough to attend one. We should all know about the accomplishments of these very special people because without them the world would be a very different place. The fact that we only spend one month of the year thinking about black history, says an awful lot about the society we live in and what is seen as real history as opposed to black history. It begs the question: ‘whose history are we celebrating during the other 11 months of the year?’ Over the annals of time, black history was not just made during the month of October. Last week an article was published by the HSJ with the headline ‘Equality Lead says race equality will not change in the NHS in the next 10 years’. I own up, I did say that to Nick Kituno, the HSJ reporter that I spoke to, however what I said needs to be put into the context in which I said it. I explained why I believed that 10 years was not a reasonable amount of time to see the changes that we all want to see in our society. The racial inequalities that we see in society today have evolved and developed over 400 years. Therefore, achieving fairness and equity across the board, closing the gaps on inequality, equal pay, differential attainment etc, will take a lot longer than 10 years. But of course when you speak to journalists, particularly HSJ journalists, they write what they want in order to sell their story and unfortunately people believe what they read. It’s often the case: because a journalist says it, it must be true. The truth is this – the system that we all live and work in, will take a lot longer than 10 years to change, and if we are to be brutally honest, with some of the leaders we currently have holding sway in our world, I personally don’t see a break through anytime soon. I suppose it’s a hard thing to acknowledge that, despite all the energy and effort we have put and are putting into closing the inequality gap, believing that we won’t be living in utopia in 10 years’ time is some admission, particularly from the now retired Workforce Race Equality Standard (WRES) director. Yes, the WRES has made, and continues to make, positive change on this challenging agenda (perhaps the most challenging of all agendas in the NHS). At the same time, we also know that more work needs to be done to really shift the dial of inequality. But let’s be very clear here – more work needs to be done by those implementing the strategy on the ground, not just those that are producing the strategy. After all, a strategy is only as good as those that are implementing it. Yes, we can at least agree that the pace of change for people of colour is often unhurried at best and positively snail like at worst. I suppose many people believe that as its BHM negative thoughts and views should be put to one side and there should be a positive air about things. These days, BHM for me, is more of a time to take stock and reflect as opposed to just celebrate. Race equality is a long-term project; I have been working in that space for many years and the pace of change is slow and initiatives and interventions need to change as society changes in order to make sure what we are doing will make a sustained difference. My departure, and that of the wonderful Dr Habib Naqvi, from the WRES team is the perfect time for the CPO and the new very senior managers (VSMs) for equality, diversity and inclusion, to take a look at the WRES programme, and perhaps revise it, improve it and make it fit for a changed and very different post-pandemic future, compared to the one we thought we would have before Covid-19 hit us hard. The WRES initiative set out to raise awareness of race inequalities and to help win hearts and minds in the NHS and beyond, I believe it has succeeded in doing that. However, all programmes and initiatives, no matter how successful, must be evaluated. The WRES programme is under the scrutiny of the independent evaluation being carried out by the University of Sheffield. It will be important for the new leadership on this agenda to take learning from that evaluation, and to implement it as appropriate. Finally, during this BHM I would like us all to remember and celebrate all non-white staff working in the NHS. These are people that, from its inception in 1948, have helped the organisation become one of the best healthcare systems in the world. I don’t need to rehearse the statistics here; people know without a doubt that in the absence of this group of staff, it would have been nigh on impossible for the service to have got through the last six months of the pandemic – perhaps the most difficult time we have ever known in the NHS’ seventy-two years. Today, as I write this blog, Covid-19 is on the rise again, and again we will need to look to those black and minority ethnic members of staff to help support the health and social care system. Clapping and cheering the NHS for a few weeks during the pandemic and perhaps raising a glass of wine to celebrate BHM is great, but I believe that by remembering the energy, sacrifice and toil that people of colour put into their work every day, can only be truly demonstrated if there is equity of access to services for patients and equal opportunities for staff all year round and not just during BHM.

RCN Presidential Elections

August 20th 2020

Dear colleagues,

Many of you will be wondering about the reasons for our decision to withdraw our candidacies for the election of President of the Royal College of Nursing (RCN). We owe it to you, the members, and the staff of the RCN to explain our decision.

You might have been aware that originally four people were proposed as candidates for the election for the position of RCN President and that shortly after the election commenced, two of the candidates were disqualified. This was nothing to do with either of us; we both have followed the rules of the election and were prepared for and looking forward to a positive and stimulating election process. A process that would put nursing and nurses in the spotlight.

Unfortunately, following the disqualification of the candidates, there has been a persistent and very negative campaign against us on Twitter. Our integrity, morals and values have been questioned; something that as professional nurses we have both found deeply offensive and very painful. Since the other candidates were disqualified, we have been subjected to the most horrendous and soul-destroying bullying and harassment on Twitter, a campaign run by a group of people that believe they have the right to intimidate us.

We have both had long, successful and productive careers in nursing and are held in high esteem nationally and internationally. We, in turn, hold our profession in high esteem and appreciate the hundreds and thousands of nurses of all grades, both inside and outside the NHS that have worked tirelessly throughout this pandemic. They deserve praise and to be valued, remunerated and recognised for their worth.

Being a nurse is important to us, as is the Royal College of Nursing, hence our joint decision to withdraw from this election process to stop further embarrassment for ourselves and the college. For us this has been a trying and very difficult time, our grateful thanks goes to those of you that have supported us, openly and behind closed doors. It has not been a pleasant experience or one that nurses should seek to do to each other.

Ultimately, our joint priority is to protect the reputation of the College, our General Secretary, some Council members and the members of staff that work at the RCN, which we believe is being damaged by this situation.

It is therefore with regret that we have decided to withdraw.

In our opinion nursing is the best profession in the world. We are held in high esteem by the public, who have every confidence in us as a professional body; neither of us are prepared to bear witness to or be part of anything that will ruin the reputation of nurses, nursing or our Royal College.

 

Yvonne Coghill, CBE, MSc, RGN, RMN, HV

Professor Julie Green, Professor of District Nursing. PhD, MSc, BSc (Hons), PGCert, RGN, BEd, SFHEA, Queen’s Nurse. 

 

Covid19 – Why inclusion is a verb.

C19 ethnicityNorthwood in North West London, is in my opinion very beautiful, leafy, green and with an abundance of magnificent and very large detached houses, many on plots of upwards ½ an acre. It came to me on one of my early morning walks as I ventured past some of these houses, that we are genuinely not all in this covid19 situation together. Let’s be honest, surviving lockdown in a one bedroomed flat, in a tower block, as a single parent with 2 children under 5 is a very different proposition to being in lockdown and living in one of the houses I walked past in Northwood.

We are now well into the third week of lockdown and what is becoming clearer is that some people are more at risk of getting the virus than others and indeed some people are more likely to die. Sobering and very scary thoughts. The current evidence shows that older people and men are more likely to succumb to the virus and black and minority ethnic (BME) people are also at higher risk.

Last week was an extremely difficult week for many of us, we began to hear of the deaths of our medical, nursing and social care colleagues, horrible at the best of times, made worse by knowing they died because they contracted the virus. I was particularly struck by the deaths of some of our black and minority ethnic (BME) colleagues, at the end of last week we had lost 5 BME doctors and several nurses, a midwife and care worker, today less than a week later we have lost a total of 10 doctors from BME backgrounds. This is a shocking and unprecedented figure. My thoughts and condolences are with their families and all families that have lost loved ones.

Over the weekend, the intensive care national audit and research centre (ICNARC) published some data from critical care units participating in the Case Mix Programme (all NHS adult, general intensive care and combined intensive care/high dependency units in England, Wales and Northern Ireland, plus some specialist and non-NHS critical care units) The report contained data on all confirmed COVID-19 cases reported to ICNARC up to midday on 03 April 2020. I was astonished to read that even though BME people only make up approximately 13% of the total population in the UK 2011 census 35% had contracted the virus and had ended up in intensive care.

C19 ethnicity

I did what I always do when I am unsure and worried about what data pertaining to race actually means, I contacted my friend and world expert on health and race Dr David R. Williams of Harvard University and as always, David was willing to give up his precious time to talk to me about these truly troubling statistics.

He said that the data was not surprising and that in the US and UK the patterns were strikingly similar. He shared a lot of information, research and findings with me, which only served to confirm my fears. He said that people from BME backgrounds acquiring the virus, becoming sick and dying at a higher rate than their white counterparts was as a consequence of the lives that many BME people live.

The facts are that BME people globally are more likely to acquire diseases and when they do they are more likely to die from them. Numerous studies have been done to try to understand this phenomenon, the most well known of these is the work done by Arline Geronimous on Biological Weathering. In short, she describes that age not only captures the time you have been alive but the experiences you’ve had in that time. Bad experiences, for example being discriminated against and having to live in a hostile environment for long periods of time impact on an individual’s psychological and physiological health, meaning they are more compromised and likely to become ill and even die at a younger age than their white counterparts. What I found particularly fascinating about her work was the fact that class, wealth and fame do not insulate BME people from being weathered and that middle class, well paid, professional people, like many of our doctors were just as likely to experience the outcomes of being weathered as poorer people.

When I give talks on race equality I try to ensure my audience understand what the consequences of living in a society that doesn’t always consider your needs does to individuals from BME groups and how inclusive behaviour helps to mitigate some of the risks associated with exclusion like stress, depression, low self-esteem and a lack of confidence.

In the UK people from BME backgrounds are more likely to be in lower paid jobs, so called gig economy work, live in poorer housing and have less access to open spaces and healthy lifestyles, the social distancing that is required at this time can be problematic for people that live in multiple occupancy buildings with high numbers of people living together.

About a month ago Sir Michael Marmot published a report about Life expectancy in the UK he stated that many people that were in poverty would have shorter life expectancies, he went on say, Some ethnic groups face much higher rates of poverty than others, particularly those from Black, Bangladeshi and Pakistani backgrounds where rates of poverty after housing costs are taken into consideration are as high as 50 percent”.

Together the findings from Sir Michael Marmots report, Dr Williams work on race and health and Arline Geronious’ work on biological weathering, tell us something about why people from BME backgrounds are possibly more susceptible to Covid19.

This evidence gives lie to the statement that we are all in this together, we certainly are not. It would seem that even though the virus does not discriminate, our Prime Minister, Matt Hancock and Prince Charles are testament to that, as consequence of the pervasiveness of discrimination across the globe, with some groups being ‘othered’ for centuries, their ability to respond strongly to a crisis such as the one we are currently going through is severely compromised.

Thankfully, the issue is beginning to be highlighted and discussed by people across the country and an article was written about it in The Guardian newspaper further illustrated and highlighted the situation. Inequality and particularly health inequality is an important issue and for those of us from BME backgrounds, a life or death one.

Covid19 highlights the importance of inclusion and compassion in our country. Many people that are on the front line are from BME backgrounds, doctors, nurses, bus drivers, cleaners, shop assistants, these people are in essential jobs and play key roles in keeping the country going. It is true that they are being valued and appreciated for their contributions to society at this time. However, we should value, respect and appreciate the contributions of these people in good times as well as bad. During this unprecedented time, it is an opportunity for all of us to reflect on what is of value and what is not. We should consider that everyone regardless of background deserves the opportunity to thrive, not just survive. I am told that I am unrealistic, idealistic even and the world which I describe and aspire to couldn’t exist and is called utopia, well maybe, but I believe the consequences of the health and social inequalities that human beings have created across the globe can be seen glaringly and most obviously during times of crisis like this and they are much too serious, damaging and devastating for us all to ignore for a minute longer.

For all the fallen heroes and heroines of the NHS that have given their lives in service of other people and the country. Forever in our memories.

Communities, Colour and the Corona Virus

I started to write this blog last week and must admit it’s been a struggle. I have not been able to find the words that have enabled me to express the feelings I am having about the challenges we are facing as a consequence of Covid19. At the weekend I saw a video tweet from comedienne Gina Yashere.  The video reminded people of the contribution of staff from a diverse range of backgrounds but particularly people of colour (PoC) seeing it helped me to find the words to write this piece.

Getting the balance right in demonstrating care and compassion for all staff in our NHS but also making sure the work we have been doing in the Workforce Race Equality Standard (WRES) team for the last 5 years isn’t completely forgotten is a real challenge.

I find myself thinking a lot about the members of staff working on the front-line in the NHS, regardless of background or banding, I know how hard, frightening and difficult it must be for you and your families. As a nurse myself, I know first-hand how hard it is to be surrounded by very sick people.  It’s easy for people to say, “we’re all in this together” from the safety of their homes, not so easy when you are in the thick of it. Basically, what front-line staff are doing every single day, during every shift, is laying their lives on the line and for that they deserve the countries unreserved gratitude and praise. My respect and thanks go to them all but particularly to the families of the three doctors that gave their lives fighting this virus.

  • Dr Amged el-Hawrani
  • Dr Adel el Tayar
  • Dr Habib Zaidi

It seems to me that globally we were poorly prepared to deal with this kind of threat, an unseen and deadly enemy that does not discriminate between people,  Covid19, does not care if you are black or white, rich or poor, gay or straight, able bodied or with a disability, it affects people from every class and every background, that much we  know. We also know that because of the inequity and inequality in our world, some people will be more adversely affected by this disaster than others.  As I looked at the faces of some of the poorest people in South Africa on TV, all black, It became glaringly obvious to me that though the virus doesn’t discriminate, Boris Johnson and Matt Hancock can attest to that, as human beings we do, which means the impact of this pandemic will be so much worse for some communities than others, many of the communities most affected by this virus worldwide will be people of colour who happen to be amongsthe poorest most disadvantaged people in the world.

I live in London, one of the biggest and in my opinion one of the best capital cities in the world. There are 10 million people living and working here, it is a vibrant, busy, cosmopolitan city and approximately 45% of people living and working here come from backgrounds other than white British.

The underground system is used by more than 2 million people a day, overground train hubs, like Euston, Kings Cross and Waterloo bring many more people into the capital on a daily basis. Along with the people that live and work in London, the capital welcomes 30 million visitors a year.

It is therefore not surprising that during this current Covid19 crisis that London has become the epicenter of the outbreak in the UK. More people are contracting the disease, becoming sick and dying here than anywhere else in the country.

According to data published by the Royal College of Nursing (RCN) in October 2018, there are now more nurses from a black and minority ethnic (BME) background than white nurses in London.  The research shows that in London’s NHS there are now 27,982 nurses from a BME background with 24,847 nurses identifying as white, Overall 44.9% (92,487) of all staff working across London trusts are from BME backgrounds.

chart.png

The chart shows the numbers of BME nurses in London at band 5 in 2019. The majority of them are from backgrounds other than white, which means that many nurses from these backgrounds are on the front line. The evidence is that staff from BME backgrounds in our NHS and particularly in London, have a poorer experience in the workplace than their white counterparts. The inequalities manifest themselves in many different ways, but through the WRES we measure them in the number of people that are appointed from shortlisting, the number of people going through formal disciplinary processes and from the staff survey questions on bullying and harassment.  The importance of compassionate, thoughtful and inclusive leadership at this time cannot be underestimated. For too many years people from BME backgrounds have not been treated fairly or equitably in our NHS, yet  we are relying on nearly half the medical workforce as well as 1 in 5 nurses and midwives from these backgrounds to step up and do their duty and maybe like the afore mentioned doctors, pay the ultimate price.

No doubt we will learn from the experiences we are having during this time, be they good or bad we will learn a lot about ourselves and others, about the society we live in and perhaps the kind of society we’d like to live in. When a woman, a stranger paid for my bread at the weekend because I didn’t my debit card with me and told me to pass on the kindness when I tried to give her the money, I was deeply touched, no one has ever done anything like that for me before, it was an outstanding act of kindness during these dark times that I will never forget and I will indeed pass on that kindness.

The praise and gratitude that was expressed for our NHS on Thursday 26th March when the nation “clapped for carers” was wonderful, it was not segregated or filtered, it was wholehearted and genuine support for all members of staff. I suppose what I am saying, is that we continue to show how much we value all members of staff that work in the NHS, regardless of background or status and that the society we live in stays kind and thoughtful when this is all over. We must never forget the sacrifices being made by our staff and their families.

Whilst this unprecedented and unusual situation continues, make no mistake it will become harder and more testing for us all, it will become increasingly important that we acknowledge each other’s contributions and commitment to the NHS and wider society. As humans’ beings, we are bound by common cause and purpose, we are interconnected and interdependent, even when we try not to be. We are more alike than we are different, no matter our colour.  I believe many people in Britain are now learning the true meaning of the South African saying Ubuntu, which roughly translated means ‘I am because we are’

 

 

For Caroline, Megan and me.

When Megan Markle and Prince Harry got married on the 19th March 2018 at Windsor Castle, like millions of other people I watched the event on TV with an overwhelming sense of pride and joy. Pride that a member of the British Royal family, someone at the pinnacle of the British establishment had chosen to marry a divorced woman of mixed heritage. The joy was that in arranging and planning her wedding, Megan did not shy away from her African roots, indeed the opposite was true, she embraced them, from the brilliant Kingdom Gospel Choir, to the multitalented Sheku Kanneh Mason and who could ever forget the awe inspiring Bishop Michael Curry’s sermon. Megan was clearly a woman proud of who she was and strong enough to say to the world, “this is me”. I loved her for that. That was less than two years ago. It took less than two years for the joy and happiness of that day to turn into something entirely different, the absolute opposite of what we all felt on the day of the wedding, to the point where the Duke and Duchess of Sussex announced on January 8th 2020 that they were leaving this country and their Royal duties and to live in Canada.

What followed that announcement was a flurry of commentary from people about the rights and wrongs of the said departure. What was really unnerving though was the amount of vitriol and bile that was being spewed about the Duchess, when less than two years ago, she was hailed as the fresh new and inspiring addition to the royal family and our society.

As the news began to sink into a shocked and amazed country, several well-known commentators decided to join in the ‘lets knock Megan’ club. I was appalled by some of the things that were said, Eamonn Holmes , openly talking about the fact that he had never met her but he just didn’t like her, then of course Piers Morgan, making unpleasant and derogatory comments about her. All of this was too much for me to bear, so like many other people, I took to twitter to voice my opinion. What followed was an experience that I will never forget.

My tweet on January 16th was in response to some very negative social activity about Megan, particularly from certain high-profile men in the media and was in response to some horrible things being said about the Duchess.

My tweet said, “Recognise a pattern here? Ignorant, arrogant, older white media men @Schofe @piersmorgan @EamonnHolmes using their privileged positions on the airwaves to question the reality of an unfair and inequitable UK society. #RacismStillAlive

I am guessing that many people reading the tweet would say that it was a bit rash and foolish for me to write that , I accept that and on reflection I would agree that perhaps i could ahve worded my tweet differently, however what happened next really shocked me. Piers Morgan responded to my tweet with four words,

“Don’t be so Racist”

That’s when the online abuse started. The comments I received following his response were astonishing. I am not someone that is easily shaken or upset, but the vitriol and unpleasantness being heaped upon me from around the world took me completely by surprise. It was not a pleasant experience.

The experience made me reflect on the experiences of other women, women like the Duchess of Sussex,  Diane Abbott MP and of course the late Caroline Flack all of whom experienced something similar but for much longer periods of time. The amount and kind of abuse that I endured for 48 hours, (with the likes and retweets) was enough to leave me feeling shaken and upset, however to receive such unpleasant and cruel remarks on a daily basis would surely affect your mental health, sense of self and wellbeing.

I dealt with the experience by telling myself that those people didn’t know me, rationalising and talking myself up was my way of coping with the onslaught. That said, there can be no mistake, being trolled is an unsettling and anxiety provoking experience.

The people writing the tweets, the so-called keyboard warriors, seem not to know or care about the consequences of their actions and seek to heap maximum distress, hurt and pain on their hapless victims, there then becomes what can only be described as a feeding frenzy where the trolls seek to outdo each other with the levels of unpleasantness they can generate, safe in the knowledge that the messages are anonymous and there will be no repercussions.

When Caroline Flack, tragically died on the 15th February, it made me really think about the tweets I had received in January, the tweets and comments the Duchess and others receive on a daily basis and how low it makes you feels. The fact that these people not only receive these comments on twitter, in the newspapers, on the radio as well as by letters and email is terrible, the distress they must feel incalculable. I can imagine depression and anxiety would descend on the individual very quickly, with nowhere to turn and no way to turn the tap of vitriol off I am not surprised, Megan decided to leave the UK and sadly Caroline took the ultimate and irreversible way out.

Recently, a colleague told me that they too had experienced online trolling and how frightening it was, she was shaken up by it and so was her teenage son.

Being trolled was definitely one of the worst experiences I’ve ever had, it truly was nasty.

Caroline Flack posted a tweet a while ago which her friends retweeted after her death. Its poignant and oh so true.

In a world where you can be anything, be kind.

The WRES is working

Yvonne Coghill

February 14 2019

As expected, the first calls I got today, were from well-meaning folk wanting to share with me that the word on the street was that the Workforce Race Equality Standard (WRES) wasn’t working; thanks, I needed that! The WRES 2019 Data Report for NHS trusts was published on 13 February and to be honest, the news wasn’t overwhelmingly positive in all areas.

So, let me explain what the WRES is.

The WRES was developed in 2015, and if you read the literature it makes it clear that the WRES is an initiative by which we compare the experiences between white staff and black and minority ethnic (BME) staff in the NHS. This is done by using 9 indicators.

Nowhere in the documentation does it say, that the WRESimplementation team are responsible for changing the culture of organisations in the NHS to make them more equitable for everyone, and to do that within 5 years; and in all honestly, I don’t believe that anyone thinks the WRES was designed to do that. 

Understanding race equality and how it manifests itself is key to understanding why the WRES is actually working. The WRES is raising awareness of race inequality in our NHS. Lets face it,  race is one of the most difficult and complex issues of our time. People being judged, classified and treated differently based on the amount of melanin they have in their skin is an age-old and quite frankly horrible problem. The issue is a global one and has been in the making for over 400 years. Systems across the world have been developed with this in mind, and the same phenomena that we see in the UK is also evident in the US, Canada, Australia and Europe. People of colour have a worse experience across the board than their white counterparts. This is distressing and shocking for some but it’s the lived experience of many others. Thisimage below highlights an issue faced by black women in this country. There is a mountain of data that shows that in health, wealth, education and the judiciary, people of colour,experience poorer treatment and often poorer outcomes for them and their families. 

What the WRES seeks to do is draw attention to these inequities in our NHS in the hope that organisations will recognise the issue as being unfair and, with expert support, seek to do something about closing the inequality gaps. The WRES has created a social movement on the agenda; it is creating psychologically safe spaces for people to raise concerns (some of which we see reflected in the latest WRES data). From that perspective the WRES is a success. I would argue that most people in the NHS know what the WRES is and people are beginning to develop strategies to improve the experiences of its staff. I believe the NHS is much further down the road of acknowledging and working with the thorny issue of racial inequality than many other public sector organisations. I would go as far as to say that it is better than many private sector organisations too. It was only this week that it was announced that a third of FTSE 100 Companies would miss the target to have at least one member of the board from a BME background by 2021. My message to everyone reading the latest WRES data report for NHS trusts is, don’t shoot the messenger, acknowledge the issues and seek to understand them, then work tireless to ensure you develop a fair and just culture, which would benefit all of your staff but ultimately benefit all our patients regardless of background.

Internalised Racism

Like most people, there are little things that irritate me; people dropping litter on the pavement or putting their feet up on the seats in trains, chewing gum loudly, these minor irritations pale into insignificance when I think about the issue that irritates me the most and it’s when black and ethnic (BME) people try to explain away and/or justify some behaviours of white people to other BME people by denying or questioningthe data or trying to explain away the everyday experiences of their fellow BME colleagues by saying, “Well I have never experienced discrimination”, or “They didn’t mean it, they were only joking”.

As I have become more knowledgeable about race and it’s deeply complex and difficult nature, I have had to come to terms with some very hard truths about myself and others and have tried my best to be reflective and thoughtful in order tounderstand the many different aspects, facets and componentsof the thing called race inequality, and believe me there are many.

The phenomenon where the BME person will say, we don’t need a BME network because it’s not fair to our white colleagues or its divisive and unhelpful to have BME only programmes simply shows how far we have to go with our colleagues, black and white to finally achieve equity. A lack of understanding and ignorance about the issue of race is widespread amongst BME as well as white people. I have had BME people argue with me about the unfairness of ringfencing posts for BME senior leaders, even though history shows they are often more at risk of losing their jobs during reorganisations than their white counterparts.

As the director for WRES I am privileged enough to travel across the country meeting people in many different organisations. Over the last few years I have witnessed this behaviour on numerous occasions. Letters of complaints from BME staff written to CEOs complaining that development programmes had been offered to them and not their white colleague and how unfair it was for their white colleagues. I have had people say, “What about other white people that are foreign, Eastern Europeans for instance, you should include them in your work too as its not fair to exclude them” This is often said with little understanding that whatever the nationality of the individual white skin affords them more privileges in society than BME people. I agree that all discrimination is wrong but the fact is that some people experience more discrimination than others and this is often based on ethnicity and skin colour. Many BME people say, “I don’t want special treatment, I just want to be treated like everyone else and seen for my skills and talents not my colour” Unfortunately the data and evidence shows that BME people are treated less favourably than others and in order for there to be equity, we need to use positive action programmes and other initiatives like a Model Employer in order for BME people to catch up.

I know these statements are made with every sincerity and that people are saying what they believe to be true, nevertheless...

The research shows that 2/3rds of white people have deeply entrenched racial biases and attitudes but even more interestingly is that Dr Jerome Taylor of Pittsburg University found that a 1/3rd of blacks in his US studies scored high on internalised racism, this means they have bought into the myth that black people are just not good enough. This comes from years of hearing and seeing negative portrayals of black people. Dr Yin Paradies at the Deaking University in Australia also found that one third of Australian Aboriginals score high on internalised racism. The Implicit Association Test (IAT) found that 70% of Americans (all professional groups, all racial/ethnic groups, with one exception) score highly on having an anti-black bias. It also found that 30% of all blacks also have an anti-black bias, that’s one in three black people believe in the negative stereotypes about their own race.

I remember Harvard Dr David Williams giving me a live example of me how this phenomenon works. He pointed out that a black republican and ex surgeon by the name of Dr Ben Carson in the US was more disrespectful and rude about President Obama than many white people had been. His verbal tirade against Obama was welcomed by fellow republicans giving him status and a level support he had not had before from his white peers. His offensive comments about Barack Obama were part of Carson’s appeal to conservatives who detested the President during his six-plus years in office.

Racism is a well organised and deeply engrained social system in which the dominant racial group, based on an ideology of inferiority, categorises and ranks people into social groups called “races” and uses its power to devalue, disempower, and differentially allocate valued societal resources and opportunities to groups defined as inferior. Internalised racism occurs when BME people buy into this ideology about their own people and in order to win favour with the dominant group will say and do things which might negatively impact on themselves and other people of colour.

Part of my role as Director of the WRES is to inform people,about the deeply complex nature of race inequality, how it manifests itself and to help people BME and white understand that the concept of race is based on power structures, highlighting who has power and who has not and in doing so enabling people to realise that additional help and support for the group that has fared poorly for generations does not take away benefits and privileges of the group that has done better but like proportionate universalism, lifts us all up.