White managers failing BME doctors, says GMC review head

Doctors from BME (black and minority ethnic) backgrounds were more likely to be disciplined as ‘some white managers’ struggled to resolve concerns informally, Roger Kline has said – the head of a review into fitness-to-practise referrals.

Dr Kline is working alongside Doyin Atewologun, another respected academic, to examine why some groups of doctors are referred to the GMC more than others.

‘We know there are a number of reasons why there are high levels of disciplinary action and we know in particular why there is a disproportionate entry of BME staff in disciplinary processes,’ he told the BMA staff, associate specialist and specialty doctors committee conference last week.

‘The biggest single reason is the inability of some managers to informally discuss with staff when mistakes are made, behaviour is inappropriate, or when things go wrong.

‘Some white managers find it difficult to have the same informal conversations with their BME staff which they would expect to have with other staff.

‘Instead of having those informal conversations which are focused on what happened, what went wrong, how can we prevent it happening again, they go down the “who did it”, “who is to blame” route; we end up in disciplinary action and we end up in referrals.’

For some BME staff, raising concerns about discrimination had become ‘equivalent to advancing your own P45’ as they risked ‘being seen as a troublemaker’, he added.

Levels of bullying were rising in the NHS as the likelihood of reporting it had fallen, according to official figures which Dr Kline called an ‘understatement’.

‘They don’t take account of the impact of witnessing bullying and the impact on those who suffer from incivility and stress,’ he said.

‘We know that bullying of staff, witnessing bullying and rudeness increases the turnover of staff, increases absenteeism and “presenteeism” – where people are at work when they shouldn’t be because they are afraid not to work.’

The GMC review has been prompted by the case of Hadiza Bawa-Garba, a paediatrics trainee, who was convicted of gross negligence manslaughter in 2015 and suspended from the medical register for 12 months by the Medical Practitioners Tribunal Service last June.

The GMC successfully appealed the decision to the high court, and in January she was erased from the medical register. She has been granted permission to appeal the erasure.