A review has called for “immediate action” to address gaps in data on how health inequalities affect ethnic minorities in Scotland.

The expert group, set up by the Scottish government, concluded that overt racism was rare but said evidence of institutional discrimination in the health service workforce had built up during the pandemic.

Initial attempts to understand how covid-19 was affecting Black, Asian and minority ethnic groups in Scotland were hampered by information shortages.

Subsequent analysis suggested South Asian Scots were almost twice as likely to die with covid-19 than others, after linking death records with ethnicity information from the 2011 census.

However, there was insufficient data to draw conclusions for groups such as Black and Chinese people.

Anas Sarwar, Labour MSP for Glasgow and chair of Holyrood’s Cross-Party Group on Tackling Islamophobia, told healthandcare.scot the expert group’s report should act as a “wake-up call”.

He said the Scottish government had been “far too slow” to analyse the impact of covid-19 on minorities.

The Scottish government says it is implementing the report’s recommendations and working to improve diversity in the health service.

The expert group’s recommendations on data were published alongside a wide-ranging document calling for changes to education, museums and public bodies.

The data review criticised a ‘longstanding’ lack of ongoing monitoring of ethnic inequalities in health.

It said recording by the health service was often ‘too poor to allow meaningful analysis’ and improvements were not sustained.

The percentage of acute inpatient and day-case patients whose ethnic group is recorded ranges from 96% in Dumfries and Galloway to 50% in neighbouring Borders. The average across Scotland is 82%.

More broadly, the review said the existing practice of relying on information from censuses every ten years was leading to out-of-date data.

Issues also extend to social care, where figures on workers’ ethnicity are not collated centrally and information on service users ‘highly varied’.

This is particularly concerning given the proportion of older people from BAME backgrounds and needing social care is set to rise substantially, according to the review.

Mr Sarwar, who has previously called for more protection for BAME health workers in frontline roles, said: “The pandemic has highlighted the lack of adequate data, but as the report states, this is a much wider problem.

“The recommendation for immediate action to improve data collection must be followed urgently.

“The additional findings about institutional discrimination are deeply concerning. Discrimination is more than just abuse or threats, it also impacts on life chances and outcomes including people not getting jobs or missing out on promotion.

“This report must act as a wake-up call for the Scottish government.”

A Scottish government spokesperson said: “We established the expert reference group on covid-19 and ethnicity in response to UK-wide and international reports that covid-19 was disproportionally impacting on some minority ethnic groups and we welcome their in-depth work.

“The group has already played a vital role in informing the Scottish government response to covid-19 and some of their initial advice and recommendation were reflected in our Programme for Government including that we will make ethnicity a mandatory field for health databases, develop a link to the census, and embed the process of ethnicity data collection in the culture of the NHS in Scotland.

“We will also aim to increase the numbers of minority ethnic staff in senior executive team roles in health and social care, while ensuring staff at all levels have a voice and influence to help drive change.”

 

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