Letters - 31 May 1997

Editor—Five years ago, when we published our research on the discrimination faced by ethnic minority doctors applying for posts as senior house officers, the Department of Health considered using our methodology to monitor progress in tackling discrimination. At a recent BMA conference to discuss racial discrimination in the medical profession several speakers pointed out that racial discrimination was still endemic in the NHS and that direct policy initiatives to tackle specific examples of discrimination—for example, in the shortlisting of job applications for hospital posts—were lacking. We therefore assessed whether the discrimination that we highlighted in 1992 was still prevalent because it would have serious implications for the implementation and assessment of anti-discrimination policies by the General Medical Council and the NHS Management Executive. We repeated our survey in March and April of this year, using exactly the same methods as in 1992, to see whether British trained doctors with Asian names were less likely to be shortlisted for posts as a senior house officer. Matched pairs of applications were sent for 50 advertised posts covering the specialties of paediatrics, general medicine, geriatrics, psychiatry, obstetrics and gynaecology, general surgery, orthopaedics, and vocational training schemes. Table 1 shows the results of the survey. There was again evidence that a lower proportion of Asian than English candidates were shortlisted: 36% v 52% (difference 16%; 95% confidence interval -0.4% to 25%). Our results show that discrimination against ethnic minority candidates is still prevalent five years after we first highlighted the problem and despite numerous public commitments by the profession’s leaders and employers to deal with it. The discrimination is being practised by consultants, who are responsible for shortlisting for junior posts. These consultants have a responsibility to maintain the highest ethical and moral standards, and their employers have the added responsibility to ensure that equal opportunity policies are being implemented and monitored. Although the NHS Management Executive specifically requires employing authorities to carry out ethnic monitoring, only five trusts out of 50 sent equal opportunity monitoring forms to our sample. Five years ago we suggested several mechanisms, including standard and anonymised application forms together with strict enforcement and publication of the results of equal opportunity monitoring, as a means of reducing the possibility of discrimination. Sadly, little seems to have changed, and it is an indictment of our profession that we still seem to tolerate a situation in which people’s careers and livelihoods are jeopardised simply because they have the wrong name (and hence the wrong colour of skin).