The UK’s healthcare system faces a deep-rooted racism issue, particularly impacting Black nurses, midwives and healthcare assistants. Despite “equality initiatives,” these workers still face subtle yet systematic tactics like gaslighting, tone policing, racial stereotyping, disproportionate discipline, and punitive NMC referrals, all of which serve to discredit and silence them. The harsh reality? Equality initiatives are primarily useless and redundant, no matter how many workshops or posters they entail. They don’t address the real issue: a system that is designed to maintain racial hierarchies and silence Black voices. What we need instead is equity: a reimagining of healthcare practices that truly levels the playing field supports Black professionals, and actively dismantles racial bias at every level.
Equality initiatives may sound promising, but they’re little more than lip service in a system designed to perpetuate inequality. Equality promises to treat everyone the same, but how can equal treatment make a difference when Black healthcare workers are starting from a place of disadvantage, facing additional barriers like tone policing, racial stereotyping, and unfair disciplinary measures?
On the other hand, equity acknowledges these systemic barriers and strives to create environments where Black Nurses have the support, resources, and protection they need to thrive. Without equity, “equality” becomes hollow, offering no meaningful change.
Labelling Black Staff as “Aggressive” Lazy" or “Emotional”
Black nurses, midwives and healthcare assistants who raise concerns about racism are often labelled as “aggressive” "lazy"or “too emotional”, stereotypes that serve to discredit their legitimate grievances. These labels feed into tone policing, where Black healthcare professionals are expected to self-censor and downplay their emotions to be heard. Under the guise of “equality,” they’re asked to adopt the same “professionalism” standards, all while being scrutinised more harshly than their white colleagues.
Racial stereotypes of incompetence and unreliability place Black healthcare workers under a microscope. Minor mistakes or misunderstandings are exaggerated, and Black staff often face formal disciplinary actions or are reported to the NMC, while white colleagues are handled more informally and leniently. Equality initiatives don’t address the unequal expectations placed on Black healthcare workers; equity, however, would require organisations to examine and adjust these biases, ensuring everyone is assessed fairly and judged on merit.
Disproportionate Disciplinary Actions Rooted in Racial Bias
Black nurses, midwives and healthcare assistants often face disproportionate discipline, driven by racial stereotypes that they are “unprofessional” or “difficult.” Instead of focusing on equal treatment, an equity approach would demand that organisations recognise and rectify these racialised disciplinary patterns. Equity would ensure Black healthcare workers are held to the same standards as their white colleagues without additional scrutiny or harsher punishments simply for speaking up.
Using NMC Referrals as Covert Punishment
The Nursing and Midwifery Council (NMC), originally intended to maintain professional standards, is too often wielded as a covert punishment for Black nurses and midwives. While minor issues for white colleagues are dealt with internally, Black professionals frequently face NMC referrals that jeopardise their careers and reputations. Equality initiatives, which promise equal standards, do little to stop this; an equity-based approach would mandate reviewing these practices and protect Black nurses from being targeted by unfair referrals.
The Cycle of Racial Stereotyping and Its Lasting Impact
Racial stereotyping and tone policing reinforce a vicious cycle that traps Black healthcare workers at a disadvantage. Equality initiatives don’t address the systemic nature of these issues, leaving Black professionals to face repeated, cumulative harm. Here’s how the cycle perpetuates racism:
Silencing Black Voices: Tone policing and racial stereotypes ensure Black healthcare workers must constantly monitor their words and expressions, fearing that any emotional reaction will be seen as aggression. An equity-focused approach would protect these workers from misinterpretation, allowing them to advocate for themselves without consequence.
Damaging Self-Confidence and Increasing Isolation: Constantly being told they are “too aggressive” or “unfit” takes a psychological toll on Black healthcare workers, causing self-doubt and burnout. Equality initiatives fall short because they do not address these psychological impacts; equity would mandate support systems and resources to help Black staff maintain their confidence and resilience.
Blocking Career Advancement: Racial stereotypes and unfair disciplinary actions keep Black healthcare workers from advancing. They are often excluded from opportunities for growth or promotion due to labels that stem from racial bias. Equity initiatives would aim to break down these barriers, giving Black professionals equal access to career development without the fear of unjust repercussions.
For meaningful change, healthcare must pivot from empty “equality” promises to tangible equity measures. Here’s what that looks like:
Implement Anti-Black, Anti-Stereotyping, Anti-Tone Policing, and Anti-Gaslighting Policies: Healthcare institutions should go beyond “equal” policies and enact standards that protect Black workers from harmful stereotypes and unfair scrutiny. Equity-based policies would ensure accountability for anyone engaging in tone policing or racial stereotyping, protecting Black staff from being marginalised.
Equitable Disciplinary Practices and NMC Referral Standards: An equity approach would create safeguards so that Black healthcare workers aren’t disproportionately disciplined or referred to the NMC. Equity means recognising and adjusting for systemic bias, ensuring that all staff face fair, unbiased standards.
Gaslighting, tone policing, racial stereotyping, disproportionate disciplinary measures, and NMC referrals are not just unfortunate by-products; they are tools used to silence and control Black nurses, midwives and healthcare assistants. The problem is exacerbated by equality initiatives that focus on treating everyone the same without acknowledging the additional barriers Black healthcare workers face.
Equality is insufficient when it ignores the reality of systemic disadvantage; only equity addresses the root causes of these disparities and offers meaningful support.
The path forward is clear: healthcare must abandon redundant equality initiatives and embrace equity. Black healthcare workers deserve to work in environments that value their voices, respect their contributions, and protect them from unjust punishments. Only through accurate equity can healthcare institutions hope to dismantle the deeply embedded racism that holds back the progress and well-being of Black professionals
To every Black nurse, midwife, support worker, and healthcare assistant enduring these challenges daily, your resilience and dedication are truly inspiring. Despite the weight of systemic obstacles, you continue to serve with strength, compassion, and unwavering commitment to quality care. We see you, and we appreciate all that you do.
If anything in this article resonates with you, remember you’re not alone. Equality 4 Black Nurses is here to provide support, solidarity, and advocacy. Don’t hesitate to reach out at 0208 050 2598. We are here to listen, stand by you, and fight alongside you for a truly equitable healthcare system.
Excellent & factual article. What a sad & bitter pill for black nurse’s “One Day, we shall overcome"