Nurses from overseas are 'held back by NHS racism'

Institutional racism in the NHS is stopping many foreign nurses gaining promotion and could threaten government promises to improve the health service, a study shows. Britain's dependence on overseas nurses means almost half of all recruits over the past three years came from abroad.

Institutional racism in the NHS is stopping many foreign nurses gaining promotion and could threaten government promises to improve the health service, a study shows. Britain's dependence on overseas nurses means almost half of all recruits over the past three years came from abroad.

Research by the health policy think-tank the King's Fund has found that internationally recruited nurses are being denied full careers. A separate study by the Royal College of Nursing (RCN) shows that black and minority ethnic (BME) nurses from Britain and abroad are far less likely to win promotion than whites, but are twice as likely to be given extra responsibilities that are unpaid.

One in five BME nurses is doing the job a grade above the one he or she is being paid for, compared with one in 10 of white nurses.

More than half of Afro-Caribbean nurses have a second job, compared to 26 per cent of white nurses. And only a quarter of BME staff feel they are graded appropriately, compared with half of white nurses.

Howard Caton, national officer at the RCN, said: "It is very difficult to come to any conclusion, other than that there is institutional racism within the NHS. That is causing massive problems and could cause more problems, unless it is tackled.

"I think it permeates the whole health service and it makes it difficult for BME nurses to progress. It is not just what that culture does to nurses; it can affect society because it means people are being treated by an NHS which does not reflect the cultural mix of Britain."

Massive reform of NHS careers and pay structures, called Agenda for Change, is due by the end of the year to give nurses more responsibilities, qualifications and pay. Many government pledges on cutting waiting times and improving the NHS rely on experienced nursing staff taking on duties previously performed by doctors. But the King's Fund study found that progress on Agenda for Change was being slowed by a "bunching" of nurses around the lowest D and E grades, with too few staff at the higher levels. This created a bottleneck which prevented newly qualified, home-grown nurses from getting jobs.

Pippa Gough, who researched the study, said: "We have had a huge influx of internationally recruited nurses over the past few years and the NHS is now increasingly dependent on them to plug its staffing problems. But these nurses are finding it very difficult to progress up the career ladder.

"If we do not do something about this, these foreign nurses are going to be lured to other countries, such as America, and the NHS will be left unable to attract and retain international staff. That could be disastrous."

The King's Fund has started a survey of internationally recruited nurses' experiences of working in Britain. One in four nurses in some NHS hospitals have been recruited from abroad, leaving countries such as South Africa and India suffering from staff shortages. The Department of Health has an "ethical list" of countries from which trusts should not recruit, but many foreign nurses sidestep this by signing up with private agencies and then applying for NHS jobs.