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Black nurses tell of double hit from pay discrimination and cost of living

Institutional racism has led to Black nurses being stuck in low pay bands and left with no choice but to take second jobs

Adam Bychawski
15 November 2022, 3.15pm

Black NHS nurses are overrepresented in lower pay bands and less likely to be promoted.

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Anna Watson / Alamy Stock Photo

Black nurses in the UK are “doubly affected” by stagnant wages and spiralling living costs because of the pay discrimination they face at work, a campaign group has warned.

Some Black nurses told openDemocracy that they have been forced to take on second jobs to make ends meet and that food bank usage is rife among their colleagues.

Nurses in England have taken a real-terms pay cut of more than 10% since 2010, as wages have failed to keep pace with inflation. Neomi Bennett, the founder of campaign group Equality 4 Black Nurses, said poor pay is “compounded” by racial discrimination, which means Black nurses are less likely to be promoted than white colleagues.

“Black and Brown nurses are doubly affected, because not only are we dealing with not being paid well, we’re also treated worse,” she told openDemocracy.

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The NHS reported a 7.8% ethnicity pay gap last year, meaning that for every £1 earned by a white employee, a Black, Asian and minority ethnic employee earned £0.92. Black, Asian and minority ethnic colleagues are also disproportionately overrepresented within lower pay bands. 

Sam, a Black NHS nurse who works in an intensive care unit, told openDemocracy she has to take on additional agency work because her pay is so low. 

“I’ve been qualified for 13 years and I’ve always had to have a second job as an agency nurse. I work 36 hours for the NHS but I work extra shifts – up to 60 hours in total – in order to meet my needs at home. And I pay an agency £120 a year for that privilege.

“If you’re trying to supplement your income you are frowned upon as overworking or money-grabbing by other white colleagues. I remember one colleague asking me: ‘Are you feeding a village in Africa?’ 

“I’m a single mum and I’ve got two kids. My childcare costs are £800 alone. I just couldn’t make ends meet, I ended up living on credit cards.”

Last year, the NHS reported that 16.7% of Black and minority ethnic (BME) staff had personally experienced discrimination at work from a manager, team leader or other colleagues in 2020; the highest level since 2015 (14%).

A number of Black NHS nurses told openDemocracy they had been repeatedly refused promotions and seen less experienced white colleagues promoted more quickly. White nurses are twice as likely to be promoted than Black colleagues, according to research published by the Royal College of Nursing (RCN) in June.

Brooke, a former nurse, is currently pursuing a discrimination case against the NHS in an employment tribunal after he says he was repeatedly refused promotion. Asked for comment, NHS England directed openDemocracy to the Department of Health and Social Care, which had not responded by our deadline.

“If you walk to any ward, you’ll see 90% of the managers, who are in [pay] bands eight and seven, are white nurses. And the rest of us are band five and six. When I say the rest of us, I mean the band five and six posts are disproportionately filled by Black and Asian nurses,” he told openDemocracy.

“So you have a racial hierarchy, which obviously affects us in terms of health inequalities, pay inequalities, and everybody’s aware of this, that nothing actually gets done.”

Brooke added: “When the NHS was formed in 1948, they brought in Caribbeans to be nurses. We still haven’t moved from 1948: we’re still only working by the bedside because they think Black is brawn and white is brain.”

Nurses will walk out before the end of year after the RCN, which represents about two-thirds of nurses in the NHS, voted to strike over pay.

Last week, openDemocracy revealed that the UK has recruited a quarter of its nurses from poorer countries with more severe staffing shortages. 

Dr Habib Naqvi, director of the NHS Race and Health Observatory, said: “Black nurses working in the NHS face challenges in the workplace, and yet their contributions are vital for the healthcare system to rebuild its workforce and resources.

Tackling race inequality in the NHS workplace is not only the right thing to do, but will also lead to better patient outcomes and save the healthcare system money. Amidst the current cost of living crisis, and stark inequalities exposed by the Covid-19 pandemic, now is the time for the NHS to take targeted action to address discrimination in the workplace and avoid losing key healthcare workers.”

A Department of Health and Social Care spokesperson said: “Respect, equality and diversity are central to the culture of the NHS, and the NHS has overhauled recruitment and promotion practices to ensure staffing reflects the diversity of the community.

We are giving over one million NHS workers, including nurses, a pay rise of at least £1,400 this year as recommended by the independent NHS Pay Review Body, on top of 3% last year when pay was frozen in the public sector, and wider government support with cost of living.”

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