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NHS London

Black midwives disproportionately disciplined, claims RCM

Black midwives in London make up a disproportionate number of those facing disciplinary proceedings.

A report by the Royal College of Midwives has exposed what it has called a “very serious issue” and has called for an investigation and closer working among authorities in the capital.

The RCM has obtained figures from NHS trusts in London showing that while black and black British midwives make up only 32% of the workforce in London, they accounted for 60% of those facing disciplinary proceedings in the 12 months to June 2011.

In a report published this week, the RCM said it carried out the study after research and anecdotal reports suggested there was a problem in London.

The report, Midwives and Disciplinary Proceedings in London, also found harsher penalties for ethnic minorities. There were 10 midwives dismissed in the 12 months up to June 2011, all of them black.

Around 15% of these midwives who were investigated were subsequently dismissed. Around a third of black and ethnic minority midwives were suspended compared with 17% of white midwives.

There were a total of 4,217 midwives in London during the 12 months with 108 facing disciplinary procedures. A total of 65 black or black British were investigated compared to 29 white midwives.

Cathy Warwick, chief executive of the RCM, said: “These results and the other research in this area are a real cause for concern. The first step is knowing it is happening and we have the evidence for that.

“The pressing need now is to work with the trusts to find out why this is happening and find solutions.”

Shadow health minister Diane Abbot said: “These findings are very worrying and we need to find out why it’s happening. There needs to be an investigation.”

A spokesman for NHS London said it welcomed the report and would be “looking very closely at the data collated.”

They added: “NHS London had been in discussions with the RCM before this report to look at anecdotal evidence about the number of midwives from a BME background that were subject to disciplinary processes. We will be continuing to work with the RCM.”

The disproportionate involvement of ethnic minorities in NHS disciplinary proceedings was highlighted in March 2010 by the University of Bradford.

It found that black and minority ethnic staff were almost twice as likely to be disciplined in comparison with their white counterparts.

Readers' comments (15)

  • Not surprised at all. I have worked in the NHS for 35 years and have seen and experienced this type of discrimination all my working life. In order to work as an ethnic minority nurse within the NHS you need to be 10 times better then your white colleagues and be prepared to have fingers pointed at you by not only the patients and their families but also by your white co workers with little support from management or the unions. I am happily retired now all that stress behind me!!!

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  • Well done Cathy Warwick and the RCM.

    This confirms other research done on disciplinary action in the NHS - and work I am currently coimpleteling in local government.

    It is unfortunately the other side of the coin of the systematic discrimination black staff receive in terms of recruitment and promotion in far too many NHS organisations.

    It comes soon after the NHS Commissiong Board suddenly discovered a complete absencxe of BME people within the organisation - whatever happened to that issue.

    I am white and am ashamed this happens in my name

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  • A lot of unknown unknowns on this, to the first glance it looks discriminatory, but stats have the ability to do that. Lumping black and black british nurses together does not help.
    Be interesting to know the breakdown between demographics on this. Are foreign born nurses more prone to disciplinary action than native born nurses ( irrespective of colour of either group), and what are the breakdown on the offenses that have happened? If white eastern European nurses are disciplined more than black british nurses then the problem we have is xenophobia, not necessarily racism due to colour.

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  • If it is necessary to discipline or dismiss a midwife because of their performance or professional conduct then the colour of their skin is irrelevant. Keeping service users safe is the main priority, not making statistics equal based on skin colour.

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  • A quick look at the names of nurses and midwives appearing before fitness to practise hearings would suggest that those from a non-British background make up a significant number of practitioners being reported to the NMC. The NMC needs to look at this and ask if it represents discrimination or some other failure in the way we deal with issues of professional conduct.

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  • There should be an investigation that starts with the College. If stewards/regional officers had fulfilled their roles perhaps the public would not have to read such sickening statistics in 2012.

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  • The Local Supervising Authority (LSA) audit maternity departments so why didn't they pick up on the 'discrepancy'.


    Look carefully at those involved in the RCM, Supervision of midwives, NMC and the trust midwifery managers, you will see that they are all interlinked - its longstanding. How transparent would any investigation be if it they had a hand in it, it would be just another cover up.


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  • The institutional racism that exists in British society is to blame , what is ok for a WASP midwife is not ok for a person of colour and is reported, due to the clicks that exist , instead of fixing problems and views management reports to the nmc as a form of punishment and at the trbunal it looks so much worse than it really was

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  • The research does not include those BME midwives who were constructively dismissed.

    Unions like the RCM 'might want to consider reviewing their own support mechanisms for BME staff being disciplined' and then produce transparent findings.

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  • Who will do the research ?, hopefully it will be independant from the RCM and other authorities.

    If BME midwives are treated so unfairly what about the patients - is that the reason why the RCM don't want to name Trust - there maybe links?

    Also, no figures on outcomes of NMC referrals or Tribunals so that information can be put into perspective. What happens at Trust level when unfair treatment is proven, I'm sure there must be cases. If so, are those responsible facing disciplinary or promotion, would be interested to know because that would show how serious this matter is really being taken or not by both Trust and unions.

    What happened in the years up to 2011, a one off year is not sufficent to draw conclusion.

    I know Ms Warwick is being congratulated but I think this research is just a token offering, any good union worth there salt would have picked and done something about this major issue before now, anecdotal evidence should have been looked at,it's serious .

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  • What is not clear is whether BME midwives are unfairly disciplined for different, lesser offences than non-BME staff, or, are the offences the same and BME midwives more likely to commit them. Both issues need to be addressed, but without this information it is not sensible to draw conclusions. As Redpaddys says, we need more information. And must not use the headline to prop up any sort of racist agenda whether we are white or black.

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  • The RCM have published the results of FOI responses that's all.

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  • Not too sure why Cathy Warwick needs to be congratulated as the RCM has been aware of this information for a very long time and chose not to do anything about it.

    They have had this information in their possession for more than 6 months, maybe a year and it was not even discussed at the recent RCM conference.

    The question should be asked to the RCM of how many Black midwives they have represented at the NMC in comparison to their white counterparts in recent years.

    They have all the stats so why did they not just do the maths.

    Black midwives have raised concerns to the RCM in the past have been told "to grin and bear it"

    It was not that long ago that the RCM were questioning why Black midwives were not joining the RCM.

    The results of their report were never published.

    I wonder why?

    I suspect they found out that these midwives felt that they would be better supported from other unions or from employment solicitors or specialists.

    Clearly the fact that a significant proportion of the workforce in the maternity services (in London and probably the rest of the country) is treated unfairly on a regular basis and have maybe lost their jobs is not of any importance whatsoever.

    Not to the RCM anyway

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  • I must say that I have to support the above in that. Even when the RCM represent the members at the NMC the outcome is not good, the evidence is there, you just need to read.

    There are specific trusts in London that have a track record for treating black midwives badly, again the RCM have the details but want to keep it hidden.

    Transparent- I don't think so

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  • Surely if a midwife has practiced at a level thought necessary to warrant disciplinary action the colour of her/his skin is not brought into the equation. Why do we immediately jump to racial discrimination? By doing this are we suggesting the panel are racist too? I would think they would throw out any disciplinary action brought that did not require investigation.

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