The NHS needs to undertake radical reform if it is to meet the needs of Black and Asian communities or the aspirations of its diverse staff, argue Health Secretary, John Reid, and Chair of the Commission for Racial Equality, Trevor Phillips, in a new Fabian Society pamphlet: The Best Intentions? Race, Equity and Delivering Today's NHS, published on Wednesday July 14 2004.

Without the contribution of immigrant doctors, nurses and other health service workers, it would not have been possible for the NHS to have become an important practical symbol of the meaning of fairness and equality in modern Britain. Yet the NHS continues to be snowcapped, with a disproportionate number of white managers filling the highest posts. This leads to a failure to meet the health requirements of an ethnically diverse population.

Reid and Phillips set out the reform agenda necessary to make the NHS reflect Britain's ethnic diversity more positively, to meet the needs of the population more comprehensively and to combat its own institutional racism.

Representation

The NHS will need to build race equality into the new regime for setting standards, ensuring that this is nationally part of the new inspection model and locally part of the performance management system.

'The moment a diverse NHS realised that a much higher proportion of Afro-Caribbean men were being sectioned than their population proportion merited, it would have automatically begun correcting activity. Yet it did not.'

Choice

Although controversial with many, Reid and Phillips argue that choice is necessary to enable the system to meet the needs of all its patients:

'All the evidence shows that black and minority ethnic people want the opportunity to choose. Their experience of bureaucracies making decisions for them, of telling them what is best for them, has not delivered them equity. They want the right to play a role and direct, through their preferences, the way in which services are delivered.'

Mentoring

The NHS should implement a mentoring strategy:

'In other organisations, senior staff mentoring black and minority ethnic staff has had an impact and we expect that all senior leaders in the Department and in the NHS will mentor staff. Equally, to immediately focus their attention, all senior leaders should include in their personal objectives for next year a personal stretch target on race equality.'