Inequality is embedded in medicine throughout a doctor’s career, from the earliest days of education and training to the leadership positions of latter years, Charlie Massey, Chief Executive of the General Medical Council (GMC) warns in a new report.
He says there needs to be a cultural upheaval, and a focus on longer-term systemic issues, across UK healthcare, if inequalities are to be eradicated. His comments come as the regulator posts its annual update on work to tackle discrimination and inequality in medicine and progress against its commitment to eliminate discrimination, disadvantage and unfairness in medical education and training.
This year’s update shows promising signs of progress. The disparity in fitness to practise referrals in relation to a doctor’s ethnicity or place of qualification has continued to reduce. Since the initial benchmark three years ago there has now been a reduction of 43% - from 5.6% down to 3.2% - in the proportion of employers where data suggests excess referrals of non-UK or ethnic minority doctors.
Differences in overall rates of referrals between ethnic minority and white doctors, and between UK-qualified and non-UK qualified doctors, have also fallen, over the same period, by 54% and 62% respectively.
The GMC has committed to eliminating disproportionality in referrals by 2026 and forecasts now show that, in principle, key indicators can be reduced towards that target. Attainment gaps in specialty training between white and ethnic minority doctors, which the GMC has committed to eradicating by 2031, are also narrowing, thanks to an increasing number of initiatives.
Educational organisations, including medical schools, royal colleges and faculties, are now required to report their actions to address issues to the GMC each year. Enhanced induction programmes for doctors new to the UK, tailored support for doctors ahead of important assessments, and mentoring programmes and support for educators are all being rolled out more widely and are having positive impacts, particularly for overseas-qualified doctors.
The latest data shows the gap in attainment in postgraduate specialty exams, for international medical graduates compared to UK-qualified white doctors, has narrowed from 30.8% in 2020 to 22.1% in 2023.
Charlie Massey said: "Efforts to foster equality are not a nice-to-have – they lie at the heart of sustainable health services. Inclusive and supportive workplaces and training environments are vital to high-quality patient care – a valued and supported doctor performs at their best.
"When pressure hits our system, this commitment can’t be downgraded. We must maintain our focus on this work. This report provides valuable insights into how we can work together as effectively as possible."
The GMC has also updated on progress to mitigate bias and promote fairness across its own functions. Work includes an updated set of decision-making principles for teams responsible for making regulatory decisions, for example those involved in assessing concerns about a doctor’s practise, or when considering applications for registration.
It is also set to meet its target in attracting more ethnic minority candidates to roles a year ahead of schedule, in 2025 rather than 2026. However, targets on increasing representation among senior management have not yet been met.
Mr Massey continued: "When diversity is harnessed, it can be transformational. There is huge potential in embracing many viewpoints and experiences, and the improved decision-making this brings. There is real will across the system to deliver meaningful change. And, as this report shows, efforts are bearing fruit. But, although we’re positive about the improvements we have seen, there is more to do. A fairer system is a stronger system, and it is in all our interests to deliver it."
View the ful report at:Annual equality, diversity, and inclusion (ED&I) progress update 2024.
