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Are unions failing to support Black NHS workers?

As strikes continue nationwide, openDemocracy asks whether Black people are properly represented in the labour movement

Beauty Dhlamini
12 January 2023, 12.04pm
Black healthcare workers are among the hardest hit by problems within the NHS
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Anna Watson / Alamy Stock Photo

“I support the strikes and unions 100%, but it’s really difficult to see how they are benefiting minority populations,” said Charlie*, a mixed Black man working as an assistant psychologist on a mental health ward in the Midlands.

Charlie spoke to openDemocracy as the NHS crisis collided with the cost of living crisis, the housing crisis and a decade of the hostile environment.

Together, these crises have breathed new life into Britain’s unions, which are seeing new opportunities for growth after decades of having their powers curtailed by successive governments.

But despite rising public support, union membership remains low. And while Black workers are overrepresented in them, unions’ governance and public faces still appear wedded to the labour movement’s historical beginnings of older white men ‘leading’ workers to victory.

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Emeka Forbes, an independent campaigner, strategist and activist focusing on anti-racism and poverty alleviation, thinks this is largely due to the UK’s chronic racism issue.

“Trade unions have a huge role to play in workers’ rights, but they aren’t perfect institutions and have had their own problematic legacies with white supremacy, racism and, consequentially, representation across the unions but especially in senior roles,” Forbes said. “This has often resulted in unions failing to represent the needs of people that look like me.”

Joshua*, a Black doctor working in London, believes this is the case for unions supporting NHS workers. “Unions such as the BMA [British Medical Association] are the most progressive they have been but you still do not see real genuine representation entrusted to minoritised groups,” he said. “Unfortunately, you have to be a palatable face of blackness to be seen or even rise ranks in the union movement.”

He added: “Unions are happy to cause trouble but do not want ‘Black people trouble’, which, alongside fighting for better pay and working conditions, means making a real commitment against anti-racism, discrimination and dismantling white supremacy. Unfortunately, people in the union aren’t ready for the uncomfortable truths that will come with Black people.”

This is particularly worrying because some Black NHS staff have reported being discriminated against at work. In November, openDemocracy reported that Black nurses are being “doubly affected” by stagnant wages and spiralling living costs because of the pay discrimination they face. Similarly, during the pandemic’s peak, many Black workers – including those in the NHS – reported an expectation for them to work on the frontlines and had a higher mortality rate as a result.

Such problems are not unique to the health service. A 2022 study by the Trade Union Congress found that 41% of minoritised workers have “faced racism at work in the last five years”. This is unsurprising, given Black, Asian and other racialised minorities are twice as likely to be on zero-hours contracts, with more than a decade of austerity leaving young Black people in the least secure and lowest-paid jobs.

Unions are happy to cause trouble but do not want ‘Black people trouble’

Forbes believes the government’s failure to commit to negotiation talks with unions, especially healthcare unions, has a racial dynamic to it.

“Sectors of the economy where Black people are less likely to be employed – finance, banking – are more likely to be offered a pay rise in line with inflation,” he explained. “But we’re underrepresented in these sectors, and by extension do not have the same protections.”

Forbes also pointed out that “porters, hospitality and domestic staff are not prioritised when we speak about the NHS crisis”, which he said “comes down to their social capital”. He added: “Unfortunately, they are not romanticised in the same way as doctors or nurses, but they are essential to these strikes too.

We need Black people at the table

Black communities’ organising is rooted in a long radical tradition. In former British colonies, many communities practised trade unionism by fighting the exploitation of labour and resources by their occupiers.

This method of collectivism was passed down through successive generations of migration. It led to the formation of the first African Students Union in 1916, The Coloured Seamen’s Union in 1936 fighting racism and segregation, and to Bill Morris becoming the first Black leader of a major British trade union, the Transport and General Workers’ Union, in 1992.

But Gloria*, a 50-year-old domestic worker who has been “in and out of the union movement for nearly 20 years”, told openDemocracy that many unions still don’t understand the problems facing Black workers.

“Yes, they do some good work which has helped me, but they’ve never done anything specifically for me,” she said. “There are so many layers to being Black and, in this country, and by extension, being a Black union member. A lot of unions don’t get that.

“I was a migrant when I came to this country and couldn’t participate in any strike action we agreed on because I feared I would lose my visa – many organisers will see that as me scabbing but they cannot even begin to imagine how much I sacrificed to be in this country.”

It’s clear that despite disappointment that unions are not appropriately representing them, Black people still consider the labour movement a way to protect their interests at work, to fight for higher wages, better benefits, and as a central point of organising – this is especially true for those in low-wage jobs.

I couldn’t strike because I feared I’d lose my visa. Organisers see that as scabbing but they cannot imagine what I sacrificed to be in the UK

As Charlie, the assistant psychologist from the Midlands, told openDemocracy: “I would encourage anyone who looks like me to join a union – mainly to protect themselves. As healthcare workers, we know how quickly the sanctions come so having protection there, no matter how small, is imperative.”

He added: “We have to be really careful about eroding the power of unions because that’s what the government wants, but if you don’t have Black people at the table and in higher positions, then you cannot understand their needs.”

Charlie is right: Black people’s needs must be amplified – rather than an afterthought – when it comes to collective bargaining. Often, Black union members feel their self-determination and collectivism are seen as a hindrance to wider class struggle, when they are an integral part of it.

Forbes added: “There are two questions in whether Black healthcare workers should be joining a union right now: why is it important to be in a union and does a union have your interests at the heart of their work? For a lot of Black workers, these questions reveal conflicting answers.

“Unions are the best vehicles for organising and I really do think we should invest in the union model. But we need to address archaic ways of organising within it, and barriers that stop it being an authentic collectivism”.

Joshua agreed, saying he would encourage other Black doctors to join a union right now.

“I believe collective bargaining is important but you have to find your people for it to truly work. I know the trade union space hasn’t been designed for me and ultimately true change for Black people won’t come from these spaces, but we have to try.”


*Names have been changed to protect identities

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