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Is racism really a problem in our profession?

The views expressed in this letter are those of the author’s. If you would like to submit a letter to The Pharmaceutical Journal, please click here.

I must comment on the perceptions of Elsy Gomez Campos, president of the UK Black Pharmacist Association, and Nigel Praities, who interviewed her for ‘There are too many excuses justifying the unjustifiable’, published in the August issue of The Pharmaceutical Journal.

Praities says the Black Lives Matter marches in the UK have led to “much soul-searching over the discrimination black people face in society”. Most people I talk to are dismayed at the associated lawlessness, including attacks on police and damage to buildings and statues.

He also implies that black, Asian and minority ethnic (BAME) people are more susceptible to COVID-19 owing to inequality caused by societal discrimination. This is not the case; for example, some Asian groups are more prone to diabetes and some African groups to sickle cell anaemia.

Praities also implies that the General Pharmaceutical Council (GPhC) is biased against BAME pharmacists in fitness-to-practise investigations. And surely students fail the preregistration exam because they didn’t meet the required standard, not because of the GPhC’s bias.

Gomez Campos is concerned that BAME candidates are excluded from achieving office, but there have been many Asian presidents of the Royal Pharmaceutical Society (RPS). If BAME candidates apply and are not appointed, there must have been a stronger candidate.

Gomez Campos makes several sweeping statements such as “discrimination, isolation and inequality is happening daily”; “people [… are being] isolated, physically attacked and [having] their reputations destroyed”; and “serious problem in pharmacy.” How can these comments be substantiated?

She also states that some black people are at a disadvantage because they have no family support networks here in the UK. Has she thought of overseas students who are here coping with the same issue?

The pharmacy culture she alludes to does not reflect my experience. I have never come across any discrimination. I have worked with black, white and Asian pharmacists in harmony. How can there be institutional racism when a substantial proportion of pharmacists seem to be Asian?

In the UK, I have appointed black candidates to senior positions. My workforce was mostly black when I worked in Africa. I did not discriminate against them; neither did they give me a hard time because I was English.

Gomez Campos says she does not want tokenism, but she seems to want preferential support for BAME students. She appears to pressure the RPS, the GPhC and pharmacy schools to tilt the slope of the playing field in their favour.

Looking for problems (particularly around race and gender) where they do not exist is common. Often this can attract the law of unintended consequences.

David Norris, Fellow, Royal Pharmaceutical Society

Dear David,

Thank you for your letter. I am glad that in your personal experience you have not witnessed any of your colleagues being subject to the discrimination described by Elsy in her interview, and it is good to hear about your fair approach as a manager. However, that does not mean that what Elsy describes does not exist or that her experience is not representative or valid for reporting in the journal.

Specifically, you question the mention of the impact of COVID-19 on BAME communities, but a recent review from Public Health England says that this may be explained by factors including “social and economic inequalities, racism, discrimination and stigma”.

Of course, the overrepresentation of members of BAME pharmacists in fitness-to-practise proceedings, and the ongoing differential in pass rates for the preregistration exam for black African candidates, are complicated issues, but the latter was subject of a report commissioned by the General Pharmaceutical Council in 2016, which said there were reports of “explicit prejudice and perceptions of implicit bias” against black students.

It is right that we continue to highlight both these issues in the journal, even if it sometimes makes for uncomfortable reading.

Best wishes,

Nigel Praities, executive editor, The Pharmaceutical Journal

 

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2020.20208414

Readers' comments (7)

  • Dear Editor,

    I was dismayed to read the letter entitled ‘Is racism really a problem in our profession?’ and note that the author states that they are a Fellow of the Royal Pharmaceutical Society. A Fellowship of the Royal Pharmaceutical Society ‘recognises those individuals who have attained distinction in their pharmacy career .’ Whilst Fellows may have been recognised for their past achievements, it does not mean that their opinions represent the opinions of the society, nor other members of the society.

    The letter demonstrates a lack of understanding and empathy. As pharmacists, and as healthcare professionals I believe it is part of our role to understand the views and perspectives of others. Just because you yourself have not experienced racism or sexism does not mean that they do not exist. In my own experience as a young female pharmacist I have been bypassed by patients to speak to the male in the pharmacy team whom they presumed was the pharmacist. Even if I had not had this personal experience, I would not dismiss that it had happened, or could happen to my fellow pharmacy colleagues.

    Just because you personally have not experienced discrimination does not mean that it does not exist.

    The author writes that there have been many ‘Asian presidents of the Royal Pharmaceutical Society.’ This is a problem with the BAME label, it lumps so many diverse backgrounds under one bland label. I note a comment from one young black pharmacist recently, who said what we really need is young black pharmacists to see a fellow black pharmacist on the National Boards. They need to see someone like them succeed. If the profession is going to be the best it can be, we have to take the whole profession along with us. The onus is on the privileged to make the effort.

    Finally the author writes; ‘Looking for problems (particularly around race and gender) where they do not exist is common.’ We have a Duty of Candour as regulated healthcare professionals. This includes a duty to be open and honest with colleagues, employers and any other relevant organisations, including the GPhC, and to raise concerns as appropriate.

    It is not a problem to share if you have experienced discrimination, you are not a problem.

    I end this letter encouraging more individuals to stand in the Society elections next year. You never know who you might encourage to stand.

    Together we rise,

    Thorrun Govind
    @pharmthorrun

    This letter is my own personal view.
    Board Member- English Pharmacy Board
    Assembly Member-Royal Pharmaceutical Society


    https://www.rpharms.com/rps-membership/fellows
    https://www.pharmacyregulation.org/news/professional-duty-of-candour-joint-health-regulators-statement

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  • This opinion piece sounds a lot like the "I don't see colour" argument to me.

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  • This is not a debate.

    It’s a shame to see the views in this letter are still held amongst some members of our profession. It is particularly upsetting when Black pharmacists have their lived experience ignored and dismissed because that is a distinct and very troubling issue which Elsy and the UKBPA are working exceptionally hard on all our behalf to highlight. Those who have not had to face racism and bias should be using their privilege to listen, learn and help make things better. Reading this letter has strengthened my commitment to the priority RPS is placing on making the profession a fairer place for all and the tackling huge amount of work still to be done to eradicate racism and bias. Addressing race inequality will continue to be a priority for the RPS. If anyone reading this has been privileged enough to not experience racism and discrimination and is still thinking ‘racism doesn’t exist in pharmacy’ then we ask them to educate themselves on this topic.

    That racism and structural biases have a significant negative impact on individuals and communities both across our profession and in wider society is not up for debate. This is not an issue that needs more evidence or more data before we take action. I am ashamed that it has taken the events of this year including the death of George Floyd and the unequal impact of COVID-19 to really open my eyes to how unfair society and our profession is for too many people. I am grateful to all the people who have relived their experiences (at emotional cost to themselves) to me and my colleagues across RPS. This has helped us understand why we must work to make our profession one where everyone feels they belong and are valued and celebrated for their differences and uniqueness is so important. That not been racist is not good enough. That we must be (and should want to be) anti-racist.

    Robbie Turner, FRPharmS
    Director of Pharmacy and Member Experience, RPS

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  • High level of "whattaboutery" here. This letter is beyond disappointing, it is shameful.

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  • Dear Editor,

    Whilst the author of this letter may not have experienced racism/discrimination himself (for which there should be an appreciation of the privilege that is) being dismissive of the lived experience of someone else is not acceptable.

    Rather than reading the article by Elsy to understand the experiences of Black Pharmacists in the UK and the very real points being put across sadly the response in this letter is to say ‘well in my experience I’ve not come across discrimination…..’
    It is sad that someone who is an RPS fellow and who is/has been in positions of authority fells emboldened enough to write this, but it highlights the very real need for change within our profession.

    We cannot change as a profession if we stay in denial about our state. Change comes through acceptance that things are not ok for all members of the profession and then seek and implement solutions for the pharmacy profession now and for future generations yet to enter the profession.

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  • Dear Editor,

    I feel compelled to write to you in reply to Mr. Norris' letter recently published online. From what I have gathered from social media, when his letter was tweeted by the Journal, it has certainly angered several of my colleagues as well as myself.
    I wonder whether Mr. Norris has sought the feelings and experiences of colleagues from a minority background? I believe there are many of us who would be willing to discuss the experiences we have had throughout our lives. I am looking forward to his reply.
    Is Mr. Norris alluding to the fact that racism is less visible now than it was in the 1970s? My father emigrated to this country, invited by the British Government at the time to study, as he was born in a country once ruled by the British Empire. He has recounted many stories to me about his experiences in London in the 1970s. People used to verbally abuse him whilst he was walking down the street in London, and has been assaulted purely based on the colour of his skin,
    Being a teenager at the time when I was told these stories, I truly believed that that type of racism had died out. I remember arguing with my father at the time as to whether racism was still present in society. I grew up in a predominantly white area, with only 3 or 4 other asian families in my town. I did not feel at any point during my childhood that I had been the subject of racial discrimination.
    It is only as I have experienced more of life, have I discovered that the way in which racism occurs in this country has changed in 50 years. It is no longer visible, and in your face. I managed to achieve the age of 25 before I was verbally abused in the street, and called "a f****** P***" openly in the street. At the time I was so shocked that I did not know what to do. Thankfully, I have never had to experience this again. I remember the initial shock, and following anger to this very day. I doubt it will ever leave me.
    As I have matured I have realised that racism in this country certainly still exists. It is no longer as visible with verbal or physical abuse occurring in the street or the supermarket, but it is now structural and inherent in society's systems.
    Managers and commissioners need to be acutely aware that due to cultural differences there may be a reason why a specific pathway into a service cannot be followed. For example, for those coming from countries where there is a private healthcare system, patients may not understand the need to be referred and recalled once an initial assessment has been made by a specialist. For example, some patients may attend a hospital appointment expecting to be operated on that day, rather than to attend a pre-operative assessment clinic. The assumption the healthcare system operates in the same way is not unreasonable.
    Whilst I do not believe that the people responsible for those systems are racist and have designed the intricacies of their service deliberately to obfuscate access by certain parts of the population, I believe the lack of diversity at a senior level in many organisations leads to obvious obstructions being overlooked. You do not have to look very far to see that our own regulator chose to schedule the pre-registration exam on a Friday in the period of Ramadan.
    The lack of consideration of this, I believe, was not deliberate, but a consequence of diversity in our profession's leadership. It would have been obvious to a Muslim that scheduling the exam on a Friday would be difficult for many trainees, just as a Christian would recognise that scheduling the exam on Christmas Day would be inappropriate.
    In a similar fashion I believe the discrepancy in pass rates at both undergraduate and for the pre-registration assessment are being considered, not because the assessment itself is biased, but perhaps there are other issues around this style of assessment that need to be considered and investigated; issues that may not have been considered by previous persons in charge of the assessment.
    I believe racism today is much more subtle. The way in which the NHS recruits is through utilisation of person specification and a set of qualities. Could the person writing these documents and assessments be unconsciously biased? I believe so. The same can be true of disciplinary procedures in NHS workplaces. The NHS has not done much to address the "Snowy White Peaks" report published in 2014.
    There are remedies to these problems which require some drastic change in thinking. I believe that current managerial practice throughout the NHS encourages "group think" and "yes people." More should be done to encourage those from different backgrounds into leadership and management positions. I do not believe the argument that "there must have been a stronger candidate." Interviews will only select those that are good at interviews. Perhaps we need to lose the check-box approach to appointments in the NHS? Is this system really the right way to appoint leaders? Perhaps a much better approach would be to speak to the staff in junior positions below that candidate to see what their opinion of them is? Perhaps this could be objectively scored somehow? Or a more practical OSCE based assessment?
    Those in leadership positions should choose a team, not one that they agree with all the time, but one which will bring a variety of thought patterns, and one encouraged to challenge that leader and effectively hold them to account. If I were in such a position I would want my team to challenge me so that I knew I was making the right decision. Healthy debate should be encouraged, even if sometimes it is merely an exercise playing devil's advocate. A true leader at the end of a heated argument should be able to say “thank you, you’ve helped me make sure I’ve considered different points of view.”
    Those from a different background may not even realise racism is occurring. Racism today may not be what I experienced several years ago. I believe racism today can sound more like: "You didn't have the right skills." "The other candidate had more experience than you." "We think the other person will be a better fit for the team." These all may be true, but once a BAME candidate keeps hearing these repeated in an organisation it soon becomes clear what the hidden meaning is.

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  • As a Pharmacist who has been on the Register for over 50 years and who has been able to observe the many changes and progress in Pharmacy, I would like to support David Norris's legitimate right to comment on the somewhat challenging article by the President of the Black Pharmacist's Association without being belittled by a senior executive of the Society.
    Accepting that the latter's brief is to reflect Member's experience, he might also have commented on the fact that there are many Black and Asian pharmacists, who through their talents, qualities and efforts have been able to achieve considerable success in the Profession.

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