Editors Picks Science & technology Social commentary

Content Moderators: The fire fighters of the internet

The Centre for Abuse and Trauma Studies (CATS) highlights the damaging impact that child sex abuse material can have on content moderators

            The dark corners of cyberspace can play host to the some of the most distressing images imaginable, including child sexual abuse material (CSAM), which is highly damaging not only to the children depicted in those images and videos, but also to those who review and remove such content. Unfortunately, the increase of digitalisation and online connectivity, has seen pressure on the tech industry, law enforcement agencies and other organisations to police the internet increase rapidly.

The growth in online sexual offending has had significant implications for those who are tasked with responding to such crimes. A recent online event hosted by the Centre for Abuse and Trauma Studies (CATS) at Middlesex University featured leading academics, practitioners and frontline responders, who all emphasised the  urgency in addressing the impact that exposure to CSAM and other potentially traumatic material has on the mental health of content moderators.

The aim was to share the preliminary findings of a project entitled ’Invisible Risks: Content Moderators and the Trauma of Child Sexual Abuse Materials’  which has been conducted by CATS over recent  years, with support and funding from the Tech Coalition and End Violence Safe Online Initiative.

In this blog, the event chair and Middlesex University criminologist Dr Elena Martellozzo, with criminologist Dr Paul Bleakley, University of New Haven, highlight some of the key points raised in the webinar and share insights that may contribute to improving well-being for content moderators, no matter what type of organisation they may work for.

The first speaker of the event was child psychiatrist Dr Richard Graham, who has worked to support positive mental health in children and young people, and those who work with them, for many years, and served as a consultant on the ‘Invisible Risks’ project. Dr Graham invited the audience to reflect on the meaning of  occupational health in the content moderation field and, particularly, the concept of burnout. Dr Graham suggested that many of the challenges experienced in content moderation are not entirely new. He referred back to the 1960s and 1970s when the swift growth of international travel meant air traffic controllers were suddenly faced with inadequate equipment, changing shift patterns, long shifts without breaks, stress and fatigue of those long shifts, the monotony of automated work, and the challenges arising from using new technology. Because of these rapid changes in working conditions, many felt burnt out and, tragically, this poor state of well-being even resulted in several mid-air collisions. Dr Graham urges that this scenario is “what we need to be thinking about is when we’re looking at harms in the online world.” He continued that “understanding the impact of the work upon content moderators may have come late, but it is not too late to make changes, because we need these professionals to be able to work well and flourish.”

The next speaker, Denton Howard, the CEO of The International Association of Internet Hotlines (INHOPE), referred to content moderators as “first digital responders who put out the fire that is CSAM.”  He argued that no matter how cutting-edge innovative technology might be, the human eye is still instrumental in assessing and making the final decisions when it comes to responding to potentially harmful online content. He stressed “while the perception is that we’re technology driven and there is lots of fancy machines that do that [content moderation], behind that [technology] are the people, and unless we take care of the people, the machines won’t work and we won’t achieve what we’re supposed to do.” Whilst artificial intelligence continues to develop, Howard said it is not yet at the stage where it can make clear distinctions during the assessment of an image, and what response is warranted to that material. 

However, there is substantial evidence which suggests that constant surveillance of traumatic images can affect content moderators’ wellbeing, mental health, and quality of life. It can also have knock-on impacts on their professional competence, satisfaction, and productivity.  These arguments were supported by panellist Andy Briercliffe, an online child safety specialist who has spent more than 20 years in British law enforcement undertaking investigations into various types of serious internet crime. Andy shared some of his personal experiences, and outlined the impact that viewing harmful content may have on content moderators’ lives including (but not limited to) burnout, secondary traumatic stress, compassion fatigue, and vicarious trauma. As Briercliffe noted, if we want content moderators to act as ‘fire fighters’ and ‘put out’ CSAM effectively, it is important that they are appropriately supported — that we understand their coping strategies and the organisational factors which may assist or hinder the efficacy of the coping mechanisms they utilise.

            Several of the same issues were raised by Dr Ruth Spence, a researcher in psychology at CATS who also served as the project manager of ‘Invisible Risks’. Following on from Briercliffe, Dr Spence presented some of the study’s preliminary results based on a survey conducted with 212 content moderators, and in-depth interviews with another 11. Dr Spence explained that more than a third of content moderators (34.6%) presented signs of experiencing moderate to severe psychological distress, which would ordinarily result in a referral for treatment and more than half (58.5%) showed signs of mild-to-low psychological distress, amounting to 93.1% of content moderators exhibiting indicators of distress on some level.

Dr Spence went on to observe that a high proportion of content moderators also experienced secondary trauma characterized by intrusive thoughts, avoidance, hyperarousal (e.g., sleep disturbance, hypervigilance), and other cognitive and/or emotional affects. Nonetheless, in spite of these profound challenges, Dr Spence also noted that content moderators seemed to cope relatively well with this distress, which the ‘Invisible Risks’ project seeks to explore further in order to determine appropriate intervention strategies.

            Paula Bradbury, a criminologist and senior researcher with CATS, presented the project’s findings on leadership in the content moderation industry, which highlighted the need for a leadership environment that is empathetic, shows appreciation for the work of content moderation, and an understanding of the challenges.

Ultimately, Paula said, content moderators did not want to be part of a profession that is hidden: they called for more networking opportunities which would allow the field to professionalise, more training opportunities, and more direct feedback on their job performance from leadership. She added content moderators also emphasised the importance of building “the right team” which they defined as one in which they could rely on teammates, and felt comfortable being open with them about their experiences, and concerns. Paula noted most content moderators interviewed referred to their professional colleagues as a “second family” that was bonded through the shared challenges faced in the course of their work. This second family was seen as essential to the coping strategies employed by moderators, and stands as an essential informal support system.

Professor Antonia Bifulco, co-founder and director of CATS, closed the event, highlighting that often when people hear about content moderation, they think that it is all dependent on complex technology, such as AI.

However, she continued, “this work is about people and it is important to ensure they are kept in the picture, as they are the people behind the technology that protects us from seeing disturbing content.”

As mentioned over the course of the event, practitioners are working with the material comparable to toxic waste, and Professor Bifulco added that “this work can involve moral injury. It’s about material that really offends your values and sense of what’s right and wrong.”

It is this type of material that content moderators are faced with on a daily basis and, as the early results of the ‘Invisible Risks’ project suggest, this may have a significant (and hidden) impact on their well-being and psychological health. With greater understanding of how the role of content moderator effects those performing said role, we will be better placed to offer evidence-based support to the industry, allowing content moderators perform their job effectively in a way that lessens the personal risk of harm.

About the authors

Dr Elena Martellozzo

Criminologist Dr Elena Martellozzo is an associate professor in Criminology at Middlesex University and the associate director of CATS, with extensive experience in researching subjects related to online harms and abuse against women and children. Elena has acted as an advisor on child protection to governments and practitioners in Lithuania, Italy and Bahrain to support the development of national child internet safety policy frameworks and led and co-led research project both in the United Kingdom and internationally.

Recognised as one of the world’s leading experts in criminology, she focuses primarily on online harms, online violence against children and women and online safety. She is an active member of the UK Centre for Internet Safety (UKCIS) and an expert advisor for EIGE on Cyber violence against Women and Girls, mapping national policies, research, data, and definitions on cyber violence against women and girls across the EU-27.

Elena delivers regularly expert training on online safety and prevention to professionals working in the online safety and sexual health area. As a published peer-reviewed author, she regular speaks in national TV and print media.

Twitter: @E_Martellozzo

Dr Paul Bleakley

Dr Paul Bleakley is an assistant professor in Criminal Justice at the University of New Haven in Connecticut, USA, with an expertise in policing, corruption and abuse studies. He has a particular focus on historical criminology, and especially the use of historical research methods to examine police corruption and cold case crimes. Dr Bleakley has written two books on this subject, Under a Bad Sun: Police, Politics and Corruption in Australia (2021) and Policing Child Sexual Abuse (2022). He has published his research in a range of leading journals such as Criminology & Criminal Justice, Critical Criminology, Deviant Behavior, Policing, and Criminal Justice Studies.

A former journalist, Dr Bleakley previously worked for Middlesex University.

Twitter: @DrBleaks

Editors Picks Health & wellbeing

Zero tolerance for bullying in healthcare?

Roger Kline, MDX Research Fellow, argues tackling bullying and harassment in healthcare must remain a priority and equal more than well-meaning statements of planned action

Five years ago, Duncan Lewis and myself estimated the bullying of NHS staff in England cost £2.3 billion per year – and this didn’t include the huge cost of presenteeism (working without being productive), incivility (rude behaviour), or the impact on bystanders. It took no account of primary care or national bodies and above all it did not include the immense cost to patient care. We were told “NHS bosses will be sacked if they fail to stamp out alarming bullying of hospital staff”. Since then the incidence of bullying, and the likelihood staff will report it, has remained at dangerous levels.

In the last NHS staff survey 11.6% staff reported at least one incident of bullying, harassment or abuse by a manager, whilst 18.7% reported at least one incident by another colleague.  Less than half (48.7%) said that they or a colleague even reported such incidents. Some groups of staff (disabled, LGBT and Black and Minority Ethnic staff) remain especially subjected to bullying, harassment and abuse whilst it is particularly high in some occupations, notably the ambulance service. We now also know how toxic rudeness is.

Bullying has been a key factor in patient care scandals driven by a cocktail of workload pressures, reorganisations, hierarchical cultures, and poor leadership which together create an organisational climate in which inappropriate and unacceptable behaviours become the “norm”. It is a serious problem for the NHS. It damages the health and wellbeing of staff.  It undermines organisational effectiveness, increases sickness absence, prompt presenteeism, and reduce discretionary staff effort and increasing turnover not only of those directly subjected to bullying and harassment but bystanders too.   It undermines effective team working, disrupts inclusive working, and negates psychological safety which in turn undermine the trust, collaboration and communication essential for good care.

If it is such a problem why have efforts to reduce it failed?

Almost seven years ago the NHS Call to Action on Bullying made little difference. NHS Employers bullying guidance (2006-2016) stated ‘employers can only address cases of bullying and harassment that are brought to their attention’.  This approach emphasised the importance of making it safe for staff to raise concerns, of having policies, procedures and training in place, often accompanied by leaders (and ministers) announcing “zero tolerance” of bullying.

But staff who are bullied and harassed are reluctant to formally complain because they either have no confidence it will make a difference or believe it will make things worse. I recall how, when visiting one NHS trust with poor staff survey bullying data, I was assured this data should be treated with a degree of scepticism as there were very few grievances lodged. I suggested this meant there was a further problem – staff saw little point in raising concerns or were afraid of the consequences of doing so.

Research finds the reliance on policies, procedures and training to be fundamentally flawed. An authoritative ACAS review concluded, for example

“while policies and training are doubtless essential components of effective strategies for addressing bullying in the workplace …….. research has generated no evidence that, in isolation, this approach can work to reduce the overall incidence of bullying in Britain’s workplaces.

The review added such an approach

“flies in the face of current research evidence about the limited effectiveness of using such individualised processes to resolve allegations of bullying and to prevent bullying behaviours.”

Organisational culture is shaped by formal organisational values and local policies; by values, behaviours and knowledge staff learn; and by how an organisation’s leaders behave. Culture is crucial in healthcare. Managing staff with respect and compassion correlates with improved patient satisfaction, infection and mortality rates, Care Quality Commission (CQC) ratings and financial performance.  

An inclusive climate (the antithesis of an inclusive one) is more likely to enable psychological safety and both are likely to positively influence speaking up and may be particularly helpful in the hierarchical environments common in healthcare where it may minimise the effect of status on psychological safety within teams and give legitimacy to voice. Inclusive teams treat relational intelligence (kindness, emotional intelligence) as being important as rational intelligence (regulation, measurement and efficiency) further enabling those benefits.

Using formal grievance procedures to tackle bullying is rarely effective. Employees who “win” often find they have to “move on” whilst employers find underlying causes are rarely addressed. My own field work suggests staff who do raise bullying concerns want bad behaviours to stop rather than to lodge formal grievances. Grievance, discipline and whistleblowing procedures which are often linked to bullying concerns risk a punitive and adversarial approach driven either by an eye on possible litigation – or the silencing of the person raising a concern.

There is an alternative, but no magic solution. The NHS has shown a growing interest in data-driven early informal intervention – a “public health” approach to toxic culture. The ‘professionalism pyramid’ developed by Vanderbilt University’s Center for Professionalism and Patient Advocacy, for example, emphasises discussing unprofessional behaviour at the first signs of it and providing support for the individual to change whilst emphasising the need for interventions to escalate if unprofessional behaviour persists or worsens. A review found the majority of professionals “self-regulate”. 

Such informal early action, appears to rely on managers, senior staff, HR and staff as a whole:

  • Being clear about the importance of responding to low intensity or one-off behaviours such as rudeness and interpersonal conflict;
  • Having the confidence, skills and time to make effective informal early interventions.
  • Having (and be seen to have) the active support of senior leadership modelling such behaviours

Without those preconditions being in place staff may fear becoming a target themselves, or making things worse. Early research on the impact of bystanders emphasised “the relevance of workplace relationships and managerial ideology in influencing bystander decisions, actions and outcomes. “

Another element of early intervention may be the use of mediation but ACAS advise caution against using mediation as a universal “fix” especially where there are stark power imbalances between the parties.

Research on whistleblowing (a frequent way of staff raising concerns about bullying and harassment) by Megan Reitz and colleagues concludes

“leaders…..are focusing their attention and efforts predominantly on those who feel silenced, urging them to ‘be brave’, ‘speak up’ and have the ‘courageous conversations’ that are required…….We need to stop trying to ‘fix the silenced’ and rather ‘fix the system’.”

Reitz then argues

“instigating whistleblowing lines and training employees to be braver or insisting that they speak up out of duty, will achieve little therefore, without leaders owning their status and hierarchy, stepping out of their internal monologue and engaging with the reality of others.”

In whistleblowing, in discrimination and in bullying (which often overlap) what leaders do, and don’t do, is what drives culture, not what they say. There certainly are some NHS leaders who behave like corporate psychopaths. But many others want to do the right thing but hesitate or struggle.

Accountability is crucial. The approach to workplace culture in Mersey Care NHS FT suggests some principles we might draw on, acting wherever early, informally, using data and soft intelligence to be preventative and proactive with an emphasis on learning not punishment. Recent resources from NHS England helpfully build on elements of that approach in tackling incivility and rudeness at work.

Finally, there is much talk about “allyship” in tackling discrimination. This approach applies equally to bullying and harassment. It should not (must not) be left to those who are bullied and harassed to have prime responsibility for tackling their abuse. It is for leaders to step up and for all of us as colleagues to do the same, early and informally wherever possible, robustly where that is not possible. Crucially, we must draw on the evidence relying primarily on policies, procedures and training is simply not good enough and, in isolation, simply will not work.

Roger Kline is Research Fellow at Middlesex University Business School

Editors Picks Law & politics Social commentary

Ideal Victimhood, Misogyny, and the Amber Heard Trial

Female Leading Interview With Journalists Outside (Unsplash)

MDX Criminology and Sociology lecturer Dr Daniel Sailofsky fears that the Amber Heard vs Johnny Depp trial will be a turning point for all the wrong reasons. Here he takes us through his views on why:

If you live in Europe or North America and have a working internet connection, you have probably heard of the Amber Heard – Johnny Depp defamation trial. This was not an accident. The Depp legal and PR team did everything in their power to make sure this case was as public as possible, including filing the case in the state of Virginia, ensuring that it could be recorded and live streamed.

Though Depp already lost a libel case in the UK – a jurisdiction where libel cases are more often successful than in the United States – he won the Virginia defamation case last week. Heard was charged to pay over 10 million dollars in damages, though Depp is also liable to pay two million dollars for his own defamation of Heard.

It should come as no surprise that Men’s Rights ‘activists’, the online ‘manosphere’, and the American political right latched onto this case as ‘proof’ that #MeToo has ‘gone too far’ (it hasn’t) and ‘ruins men’s lives’ (it doesn’t, if they’re talented enough), and that women lie about abuse all the time (90+% do not).

To be frank, I’m not concerned about these groups. I’m concerned about the rest of Depp’s supporters – or perhaps more aptly, those who grew to detest Heard as this case proceeded.

I’m concerned about society’s regression to victim blaming, victim hierarchies, and to unrealistic expectations of how victims of abuse are supposed to act.  

Feminist sociologists, criminologists and more specifically victimologists have long been concerned with how the public and the law treat different victims, especially victims of intimate partner violence. In the 1980s, Norwegian sociologist Nils Christie introduced the concept of the ‘ideal victim’, a crime victim who’s ‘ideal’ characteristics make them more likely to garner sympathy and justice in the courtroom, and perhaps most importantly, more likely to be believed when they recount their abuse.

Even those defending Amber Heard would admit that she is far from an ideal victim. The point, however, is that she shouldn’t have to be.

Christie’s original formulation of the ideal victim (in a courtroom setting) is someone old, weak and vulnerable. They are involved in respectable activities and employment, blameless in their victimization, and victimized by a “vicious” and “unknown” offender. Other characteristics have been added to this formulation over the years, including acting ‘rationally’ to escape victimization, presenting as sincere and thoughtful in court, and being young and naïve (rather than old). Those marginalized along racial, class, and/or sexuality lines are also less likely to benefit from privileges of ideal victimhood.

Heard is not an ‘ideal victim’; almost no one is. Intimate partner violence is messy, courtrooms are stressful, and the real world of violence, abuse, and (attempts at) justice is not a True Crime podcast. Depp, his lawyers, and a deluge of social media content creators presented Heard as a liar unable to tell a coherent narrative, a gold-digger, and responsible for her own victimization due to her behaviour and her own abuse towards Depp. The fact that a judge in another jurisdiction had found substantial proof for 12 of Depp’s alleged abuses, or that he has a history of substance abuse and mistreatment of those on movie sets mattered little, because Heard was not the right victim. She wasn’t a ‘real’ victim.

As sociologist Nicole Bedera explained, Depp’s legal team used a typical DARVO (deflect, attack, reverse victim and offender) playbook in this case, and to great effect. Punching down on someone with lower structural power – in terms of wealth as well as social and cultural capital (aka popularity) – Depp and his team engaged in a takedown of Heard’s character, ignoring and deflecting from years of documented evidence.

These DARVO strategies are common, and are often used in cases of sexual violence on college campuses. Following this highly public trial, they will only become more so. This case will not only push victims to avoid seeking justice from the criminal legal system, but it will silence them from even mentioning their abuse to friends, family, and the public if they have the slightest inkling that they won’t be received as a perfect victim.

Though she is a young, conventionally attractive white woman (more likely, according to some research to be considered an ideal and believable victim), Heard admitted to fighting back against Depp. She admitted that she did not leave right away after the first time she was threatened, or when Depp first behaved in abusive ways. She didn’t have bruises at the right times; she was out to get him; she brought this into the public eye; she deserves this trial and this public execution.

This case got such media traction because Heard was not simply framed as a non-ideal victim, but as a liar, a ‘crazy woman’, and an abuser herself. TikTok ‘investigators’ and social media sleuths showed a misogynistic bloodlust for her every misstep, mistimed facial expression, and any odd courtroom behaviour. Memes were made, including those attributing guilt or blame based on courtroom behaviour and facial expressions, and social media celebrity careers were launched.

Imbibing this never-ending stream of content, observers flipped back and forth from “she’s lying” to “she deserved it”. Those defending Heard were berated and mocked, with Depp supporters taking over social media channels like TikTok.

If the general public needs victims of intimate partner violence to fit a particular cookie-cutter image to be considered a ‘real’ victim, we have seemingly learned nothing about gender inequality, power, and the messy nature of interpersonal violence trials. If defamation cases and (social) media slander await victims of powerful abusers, any progress made on speaking out against this type of violence will come to a grinding halt.

I fear that we will look back at the Depp-Heard trial as a turning point, where Men’s Rights activists, misogynists, and those looking to thwart movement on gender inequality took the narrative and public opinion back. I hope I’m wrong.

Editors Picks Health & wellbeing Home Categories

Racism which impacts healthcare staff endangers patient care

Nurse Efe Obiakur, who says she has long faced discrimination and harassment working in the NHS. Credit: Matt Brealey/CNN

As well as a moral issue, tackling racism affecting NHS staff is a crucial part of improving patient safety and care, says MDX Research Fellow Roger Kline

There is finally a growing awareness of the impact of discrimination on Black and Minority Ethnic patients.

There is equally a growing awareness of the scale of race discrimination in all aspects of the lives of citizens of Black and Minority Ethnic heritage including the quarter of a million Black and Minority Ethnic staff working in the NHS.

Not so well known is the impact of race discrimination against health and social care staff on the care and safety of all patients and service users.

We have a wealth of data demonstrating that BME staff in health care are disadvantaged in recruitment and career progression, in whether staff are disciplined, bullied and harassed at work, and are treated worse if they raise concerns or admit mistakes.

Such treatment demoralises staff, wastes talent, affects turnover, costs money, and damages staff health. But crucially it also undermines team working, incentivises blame, not learning, and adversely impacts patient health and safety.

Risk one: There is a serious risk that recruitment and promotion data means that selection panels may be choosing “people like us” or who can best “fit in” rather than the best candidates, thus depriving patients of the best possible talent.

The NHS has an ethnicity gradient in which the more senior the post the less likely we are to see BME staff. It is still 1.61 times more likely that a White shortlisted candidate will be appointed compared to a Black and Minority Ethnic shortlisted candidate. It is not surprising therefore that it is twice as likely that BME staff do not believe there are equal opportunities for promotion and career progression.

Risk two: A culture of blame not learning is a risk to patient care and safety

NHS BME staff are more likely than White staff to be disciplined. They are more likely to be reported to their professional regulator by their employer (though interestingly, not by the public). BME staff are more likely to be bullied by managers and colleagues than White staff and are three times more likely to report being discriminated against than their White colleagues.

Literature demonstrates the risk of racial bias in investigations. In combination, such treatment means it is more likely that the mistakes we all make are seen through the lens of blame, not learning for BME staff, not least because of the difficulty some White managers have in having honest conversations with BME staff.

Risk three: Racialised patterns of work are a risk to staff health and adverse impact on staff health may have consequences for staffing absence, discretionary effort and staff turnover, any of which may impact on patient care and safety, especially at a time of pre-existing staff shortages

Racialised patterns of employment were highlighted during Covid. According to Public Health England researchers, almost 90% of staff infection was due to occupational exposure. BME staff were disproportionately impacted because:  

  • They work disproportionately in lower-graded patient facing roles
  • They had poorer access to appropriate PPE with the correct fit 
  • They were more reluctant to raise concerns 
  • They were disproportionately redeployed to riskier areas
  • Agency staff (more likely to be BME) may not have been reimbursed when self-isolating or had poorer access to PPE.

More generally, we know that race discrimination makes people ill. Two decades ago, in journal article Agency and structure: the impact of ethnic identity and racism on the health of ethnic minority people, Nazroo and Karlsen found that:

“Over and above socioeconomic effects, both experience of racial harassment and perceptions of racial discrimination make an independent contribution to health. For example, those who had been verbally harassed had a 50 per cent greater odds of reporting fair or poor health compared with those who reported no harassment”.

Race discrimination is positively associated with an extensive range of adverse conditions including coronary artery calcification, high blood pressure, lower birth weight, cognitive impairment, and mortality. Moreover, discrimination, like other stressors, can affect health through both actual exposure and the threat of exposure. 

Risk four: If BME staff are more likely to be bullied that will impact on their health and their working lives as well, placing patient care and safety at risk

BME staff are 21% of the NHS workforce. An astonishing 28% of them reported being bullied and harassed by managers and staff last year, significantly more than White staff reported themselves as being (23%).

The adverse impact of bullying on staff health has been well evidenced by Lever and others and in turn impacts on performance, career progression, engagement, retention and team effectiveness, as well as harming the safety and physical and mental well-being of staff.

American medic Lucien Leape describes how a culture of disrespect in medicine is a threat to patient safety because ”it inhibits collegiality and cooperation essential to teamwork, cuts off communication, undermines morale and inhibits compliance with and implementation of new practices”. Staff who are bullied are less likely to admit mistakes, raise concerns or work effectively in teams – all with consequences for patient care and safety.

Risk five: If staff are less likely to speak out and raise concerns that is likely to directly impact on patient care and safety

Robert Francis’ Speaking Up report (2015) drew on a survey of 20,000 NHS staff which found very significant differences between the experiences of White and BME staff who raised concerns.

It was 50% more likely that:

  • BME staff raising concerns would be satisfied with the response to their concern about suspected wrongdoing
  • BME staff felt they would be victimised by management after raising a concern
  • BME staff felt they had been victimised by co-workers after raising a concern
  • BME staff were 23% less likely than White staff to report a concern again if the staff suspected wrongdoing 
  • BME staff were 70% less likely than White staff to raise a concern about suspected wrongdoing, due to a fear of victimisation.

The NHS National staff survey 2020 reported a significant difference between White and BME staff views on raising concerns. It reported that staff from BME backgrounds are less likely (62.1%) to feel safe to speak up about any concerns than White staff (67.0%).

Risk six. Where staff of Black and Minority Ethnic heritage are not welcomed, their difference valued, and it is not a safe place for them to raise concerns, then patient care is likely to lose the benefit that improved representation can give.

Dawson (2009) found that

“the experience of black and minority ethnic (BME) NHS staff was a good barometer of the climate of respect and care for all within the NHS. Put simply, if BME staff feel engaged, motivated, valued and part of a team with a sense of belonging, patients were more likely to be satisfied with the service they received”.

Similarly West, M et al (2018) found that

“the % staff believing Trust provides equal opportunities for career progression or promotion… was a very important predictor of patient satisfaction in all three analyses (2014, 2015 and across the years). The more staff believe this to be the case, the more satisfied patients will be on average.”

Racism and bullying undermine psychological safety at work. This matters because as Carter and colleagues demonstrated, inclusive and compassionate leadership helps create a psychologically safe workplace where staff are more likely to listen and support each other, resulting in fewer errors, fewer staff injuries, less bullying of staff, reduced absenteeism and (in hospitals) reduced patient mortality.

An inclusive work team recognises, as Edmondson (1999) puts it, the deep human need to belong, and the anxiety anyone may feel when speaking up or sharing ideas in front of others for fear of saying something that may appear stupid or wrong.

Inclusion may be regarded as the extent to which staff believe they are a valued member of the work group, in which they receive fair and equitable treatment, and believe they are encouraged to contribute to the effectiveness of that group. Inclusive workplaces and teams value the difference and uniqueness that staff bring and seek to create a sense of belonging, with equitable access to resources, opportunities and outcomes for all, regardless of demographic differences.

As Shore (2018) put it, Inclusive organisations are more likely to be ‘psychologically safe’ workplaces where staff feel confident in expressing their true selves, raising concerns and admitting mistakes without fear of being unfairly judged.

Or as Professor Scott E Page describes in The Diversity Bonus: How Great Teams Pay Off In The Knowledge Economy (2017) – when more diverse representation is underpinned by inclusion, demographic diversity can improve team performance. The evidence for this is more nuanced than is sometimes presented, but is convincing nevertheless. An evidence base supports the proposition that effective leadership is diverse, inclusive and compassionate.

Psychological safety and inclusion impact positively on organisational effectiveness. When more diverse representation within teams and in leadership are underpinned by inclusion, it is likely that performance will improve, creativity and innovation will be greater, turnover will reduce and risks will be better highlighted.

One senior BME nurse put it to me, “I’ve spent my entire career walking on eggshells knowing that should I make a mistake or raise a concern I will be held to a higher standard than my White colleagues. I have more than once joined teams where I am not fully valued for the difference I bring or the insights I can share. Inevitably this affects patient care and safety”.


Tackling racism is first and foremost a moral issue but it is also a crucial part of improving the care and safety of patients and service users whatever their ethnicity.

Employers have a duty of care and a statutory duty to address many of the drivers of staff discrimination. On the resultant risks to staff health, for example, doing so requires that they not only address the risks to individuals but the root causes of those risks. It was remarkable during Covid 19 how employers disproportionately focused on individual health risk assessments rather than exercising their duties under the Management of Health and Safety at Work Regulations (1999 as amended) which require employers to ensure there is a work environment that is, as far as reasonably practicable, safe and without risks to health.

Covid 19 and Black Lives Matter have finally, I think, led to many NHS leaders (not all) asking HOW they can address this issue as a priority, not WHY. To do so we have to stop leaving it to those adversely affected by discrimination to be the ones challenging it. We have to recognise that while overt racism is not normalised in the NHS, the patterns of bias, stereotypes, assumptions and behaviours that characterise systemic racism are well embedded and that they significantly damage patient care as well as healthcare staff.

Roger Kline is Research Fellow at Middlesex University Business School. An earlier version of this blog formed a presentation to The Healthcare Improvement Studies Institute, University of Cambridge November 2021 conference

Editors Picks Social commentary

Working backwards with No. 10

Roger Kline is Research Fellow at Middlesex University Business School. In this blog he responds to the employment section of the controversial recent Commission on Race and Ethnic Disparities.

First, the pre-determined conclusion

The Government’s Commission on Race and Ethnic Disparities report is part of a political project mapped out some time ago.

In 2017, Munira Mirza, the (now) head of the No 10 Policy Unit, who commissioned the Sewell Commission) dismissed the concept of institutional racism claiming “a lot of people in politics thinks it’s a good idea to exaggerate the problem of racism”.

In 2019, Liz Truss, the Minister for Women and Equalities, said ”too much ground had been ceded to the Left on issues of identity […] We need to reassert the value of individual and character above the particular type of group you might happen to be a member of […] I think there’s been too much identity politics in Britain”.

Nine months ago, Kemi Badenoch, the Equalities Minister, having claimed (falsely as the subsequent leaks confirmed) that the Fenton Review on COVID-19 did not make recommendations, then “hit back at claims ‘systemic injustice’ is the reason ethnic minorities are more likely to die from coronavirus in England.”

Their collective views individualise the challenge to inequality, undermine collective challenge and institutional interventions. The idea of institutional discrimination is denied, whatever the data may show. There is an emphasis on individual effort rather than collective challenge, underpinned by the assertion (contrary to the evidence) that we live in a meritocracy where all may equally, irrespective of identity, rise to the top.

One crucial obstacle to this view of social policy is the MacPherson Report (1988) which analysed discriminatory practices within the Metropolitan Police in a manner applicable across all public services as:

The collective failure of an organisation to provide an appropriate and professional service to people because of their colour, culture or ethnic origin. It can be seen or detected in processes, attitudes and behaviour which amount to discrimination through unwitting prejudice, ignorance, thoughtlessness and racial stereotyping.

One purpose of the 2021 Commission on Race and Ethnic Disparities Report is to undermine that insight and instead counter pose individual effort to collective change.

In reaching its pre-determined conclusion it plays fast and loose with both data and research.

…Now, the evidence

Take the section on public sector (especially NHS) employment; there is no sense that the conclusions either flow from the assembled evidence or are a coherent whole.


Whilst the Commission attributes evidence of race discrimination to individual cases not to a pattern of structural discrimination, several of the Commission’s proposals (some of which are helpful) appear to acknowledge that there are indeed patterns of discrimination not just the individual instances the report argues are the norm.


The authors appear to have neither interrogated the very large NHS database on workforce and staff survey metrics, nor discussed their proposals with those leading the NHS work on workforce race equality including the Workforce Race Equality Standard.

The NHS database conclusively demonstrates that patterns of race discrimination do exist in NHS recruitment, promotion, development, discipline and bullying, and that they are so systematic and sustained that it is difficult not to conclude that Macpherson’s definition applies to the NHS.

Indeed the Commission itself appears to come close to accepting that institutional race discrimination as defined by MacPherson exists when it accepts that “Human beings tend to discriminate, even when unintended” (p.122) and that “it is possible to have racial disadvantage without racists”.


The authors suggests that the lived experience of racial bias is a matter of “perception”. The Occupational Preferences report (p.120) they commissioned found that respondents felt:

  • Being a manager is a risky choice
  • Feedback to become a manager is poor.

It is hard to know why this section is included at all. The sample is small (n=116), not representative (“an uneven distribution for gender, White and ethnic minority groups, and full and part-time employees”), and the conclusions are hardly new.

The refusal to accept that bias is a real and dynamic factor is repeated (p.123) where, discussing recruitment, the report states, “there is a perception that people at the top tend to have affinity bias, appointing people in their own image.”  

The Commission’s conclusion is that, “there are simple HR activities which can address these perceptions”. There is not even a hint in the report as to what the “simple HR activities” are that can address these “perceptions”.

That may be because these are not “perceptions” but are grounded in the widespread lived experience of BME managers across the NHS. In fact, the bias experienced is not ethereal but grounded in systematic discrimination at work.

There is a body of research showing how Black and Minority Ethnic (BME) managers are held to a higher standard and that feedback to BME staff (including appraisals) is systematically poor. Those systematic and sustained processes are what needs to change but “simple HR activities” that deny those processes exist won’t achieve that.


The report (p.121) unwisely launches an assault on the gold standard social audit research conducted in both the UK and the USA. Their results, replicated on several occasions by different researchers in different contexts, demonstrate that when identical job applications are submitted with one ‘English’ sounding name and one ‘foreign’ sounding name, this results in much greater likelihood of applicants being shortlisted if their name sounds ‘English’.

Such findings strongly suggest systematic racial bias, not the odd example of racism.


The report (p.125) states

“Most researchers remain sceptical about the impact of unconscious bias training, quotas and diversity specialists. Research by Kalev and Dobbin, published in the Harvard Business Review, found that mandatory diversity and inclusion measures have not always been successful.

Quotas have been slipped in to this sentence but it is not clear why, as they are not advocated by the NHS and are unlawful in the UK.

Targets are not unlawful, but are quite different. They are used across many aspects of employment (including by the UK Government) and there is a body of evidence demonstrating that whether they are called targets or goals, they can be effective, depending on how they are used.

The report is rightly sceptical of the impact of unconscious bias training (UBT) on decision making and it is true that too often employers have treated UBT as a silver bullet to tackle discrimination. However, as the report rightly accepts such training can play a role in improving the cognitive understanding of bias:

“[…] the Commission recognises the place of such practices (diversity and unconscious bias training) in the journey to promote diverse and inclusive work environments.”

The Commission rightly then states:

“[…] that diversity and eliminating disparities requires impactful organisational redesign and training that leads to truly inclusive environments.”

And on p.125:

“Organisations can be (re)designed to change behaviour, and therefore outcomes.”

It then muddies the argument by providing a rather random list of such measures which are of varying effectiveness and completely fails to include those measures that research highlights are essential such as debiasing processes and inserting effective accountability.

It states:

“This indicates ‘nudge’-style procedures (such as name-blind CVs, transparent performance metrics, family friendly policies, proactive mentoring and networking procedures) are more useful than methods that overtly discriminate against some groups, for example quotas.”

It raises again the straw argument of quotas. Its statement that, “research by Kalev and Dobbin, published in the Harvard Business Review, found that mandatory diversity and inclusion measures have not always been successful” is, of course, true. There is no magic wand.

However, Kalev and Dobbin are strongly in favour of accountability (both internally and externally) and provide evidence as to why, not just nudges. Indeed the Commission’s recommendation on the CQC role seems to suggest the Commission agrees.


The report notes (p.116) that ethnicity pay gaps are relatively small at NHS senior manager level and very between different BME groups and white staff and concludes:

“Such a picture is not consistent with a pattern one might expect of systemic discrimination, although undoubtedly, there will be cases of discrimination and bias in what is the largest employer in the country.”

This appears to be the only evidence in the entire report produced in support of the claim that there is no “systematic discrimination” in the NHS.

This conclusion ignores the rather obvious question about why the proportion of senior managers from BME backgrounds has been (and still is) so much lower than the proportion of senior managers from White backgrounds. It ignores the detailed data showing that currently across all grades it is 1.61 times more likely that White staff will be appointed once shortlisted compared to BME staff, and that there is a steep ethnicity gradient in which the proportion of BME staff declines as the grade gets higher.

For example, 27.5% of Band 5 Agenda for Change staff are from BME heritage but this drops at senior manager level to 10.5% (Band 8C) and 8.0% (Band 8D), something not mentioned in the report.


The Report counter-poses cognitive bias to demographic bias. It states:

“Greater emphasis should be placed on diversity of thought and perspective around a board table which is not associated with anyone’s race or ethnicity.”

This feels like a polite version of Dominic Cummings’ claim that people “talk a lot about ‘diversity’ but they rarely mean ‘true cognitive diversity.’ They are usually babbling about ‘gender identity diversity’ […] What [we need] is not more drivel about ‘identity’ and ‘diversity’ from Oxbridge humanities graduates but more genuine cognitive diversity”.

In fact we need both cognitive and demographic diversity since, as Scott Page (2017) and others demonstrate, they are not alternatives but very significantly overlap.


The employment section of the Commission report demonstrates the danger of reaching conclusions and then looking for evidence to support them.

It will not assist the work to reduce racism in public sector employment and risks doing the exact opposite unless rebuffed.

Health & wellbeing

A tale of two metrics

Roger Kline, Research Fellow at our Business School, discusses the two main findings from the 2020 NHS Workforce Race Equality Standard report.

The 2020 NHS Workforce Race Equality Standard (WRES) report is out.

There has been a sustained and significant closing of the gap between the treatment of Black and Minority Ethnic (BME) staff and White staff in disciplinary action. The progress on disciplinary treatment, however, is in sharp contrast with the standstill around recruitment and career progression.

Black nurse in green scrubs, face mask and blue gloves holding a clipboard of papers

What are the key findings?

Firstly, a growing number of Trusts have adopted a simple accountability nudge which aims to interrupt bias by requiring line managers to explain to a very senior manager, prior to any disciplinary investigation being started, why a formal disciplinary investigation is the only way of addressing an alleged concern.

Secondly, the parallel moves towards a just and learning culture (rather than blame) in a growing minority of Trusts (pioneered by Mersey Care) have led to a similar accountability nudge emphasising early informal intervention.  

It is a pity that neither of these interventions were prompted by any national initiative but in combination they seem to be working as research suggested, possibly compounded by some form of “Hawthorne” effect.

There may be some managerial attempts to do “workarounds” on the accountability nudge but there is no evidence this is on a large scale. These two approaches together save a large amount of management time, benefit wider culture change, and stop much unnecessary disciplinary action.

Comparing the numbers

In the last four years, the total number of NHS staff in England entering the disciplinary process has dropped from by 28.2% from 15,711, to 11,278 in 2020.

In the same period the relative likelihood of BME staff entering the disciplinary process has substantially closed from 1.56 to 1.16.

What explains this dramatic change when the other key WRES metric on recruitment actually got worse 2016-2020?

Table: Staff entering the disciplinary process 2020

Total White staffWhite staff entering the formal disciplinary processWhite staff likely entering the formal disciplinary processTotal BME staffBME staff entering the formal disciplinary processBME staff likely entering the formal disciplinary processRelatively likely BME staff compared to White staff

A comparison of how tackling these two metrics has been undertaken is telling. Whilst there has been some limited progress in the diversity of very senior posts, the standstill over the last two years amongst middle and lower grades reflects the failure to apply research evidence to the challenge.

By contrast, in 2016, I suggested that the NHS needed to change how we approach incidents that might normally lead to formal disciplinary investigations. The suggestions was to use the almost forgotten NHS Incident Decision Tree and combine the research evidence about the reasons for the disproportionate disciplining of BME staff in the NHS to create a new approach to “incidents”. The Incident Decision Tree was a simple but sophisticated means of asking four questions about an individual involved in a patient safety incident with a view to deciding if suspension was appropriate. 

This is not a new problem

Research commissioned in 2008 by NHS Employers highlighted the disproportionate disciplinary action against BME staff and subsequent evidence showed the discriminatory patterns of discipline involving midwives in London.

In 2017, the very significant variation between NHS Trusts as to the likelihood of White and BME staff being disciplined or suspended was noted and an accountability nudge was again advocated to interrupt bias and focus on learning not blame.

The NPSA Incident tree guidance argued:

“We know from research carried out in the NHS and in other industries that system failures are often the root cause of safety incidents. Despite this, where a serious patient safety incident occurs in the NHS, the most common response is to formally suspend the staff involved from duty and then deal with them according to disciplinary procedures. This route can be unfair to employees and divert managers from identifying contributory systems failures. Suspension of key employees can also diminish trusts‘ ability to provide high-quality patient care.”

I know of no evidence that greater levels of disciplinary investigation and action in healthcare lead to improved care. No one knows how much NHS time and energy is wasted on unnecessary disciplinary investigations, suspensions, hearings, and appeals, but it is a lot.

What’s the cost?

In 2018, Duncan Lewis and I estimated a typical bullying case cost employers around £40,000 (management time, sickness leave costs, cover, early retirement, replacement costs) excluding legal costs and the cost of professional regulator referrals and it is likely that is the figure for disciplinary cases is similar.

The biggest cost of all is the impact on patient care.

Unnecessary disciplinary investigations and hearings risk creating an environment where the response to a mistake or sub-standard behaviour is not “how do we prevent it happening again” but “who is to blame.”

The steep authority gradients in much of the NHS as a whole, and within individual occupations, exacerbate the problem. An environment of blame, allied to a steep authority gradient is toxic for patient care and safety.

None of this means that there will never be a need for NHS disciplinary investigations or indeed suspensions or sanctions. But in too many organisations moving to a formal investigation had become the default position without there being proper consideration as to whether that is necessary.

In researching the causes of disproportionate disciplinary action in the NHS against BME staff, Archibong and Darr (2010) found in their report NHS Employers that:

“….line managers found it difficult to deal with issues relating to disciplinaries and there were often inconsistencies in the application of disciplinary policies. It was acknowledged that the informal stage of the disciplinary process was critical in sorting out minor issues and that some managers were hindered in this process by a lack of confidence in applying informal strategies with BME staff. It was perceived that managers were more likely to discipline BME staff over insignificant matters and that disciplinary concerns involving staff from minority ethnic backgrounds were not always considered to have been dealt with fairly and equitably by human resources managers.”    

More recently we explored some of these issues again. Once a disciplinary investigation commences, it is very distressing for the member of staff concerned even if they are cleared of any allegation; it is very time-consuming for managers and HR; it can be demoralising for colleagues if they think the processes are unfair; and can run the risk of reinforcing blame, not a learning culture.  

Investigations can easily lead to “tunnel vision”, where the determination to find fault will inevitably eventually unearth some shortcoming, as it would with any member of staff. Bias is pervasive in workplace investigations, and this is especially true when the alleged “suspect” is of BME origin.

The data is good news for staff and patients

This different approach will not prevent the need, sometimes, for disciplinary investigations and sanctions. But the benefits are clear.

It is time to pay similar attention to identifying and implementing evidence based interventions to end race discrimination in NHS recruitment and career progression. That is surely the next big challenge for the NHS.

Less rhetoric, more practical action rooted in mitigating bias through accountability. That’s what research strongly suggests will work and it is good news that the revamped WRES team are focussed on that.

Health & wellbeing Social commentary

False harmony and the embedding of inequality

Roger Kline, Research Fellow in the Business School, discusses the impact and issues associated with identity and discrimination.

“My father values talents. He recognizes real knowledge and skill when he finds it. He is colorblind and gender neutral. He hires the best person for the job. Period.”  – Ivanka Trump

Liz Truss, the Minister for Women and Equalities, said too much ground had been ceded to the Left on issues of identity: “We need to reassert the value of individual and character above the particular type of group you might happen to be a member ofI think there’s been too much identity politics in Britain.

Big changes in social policy are often preceded by little noticed germination of ideas. Liz Truss has form with ideas that have traction. She is one of the authors of Britannia Unchained, an influential 2012 Conservative manifesto (other authors included Kwasi Kwarteng, Priti Patel and Dominic Raab) which called, amongst other things, for radically reducing regulation (including EU regulations the UK had helped draft).

It seems timely, therefore, to explore why Liz Truss’ approach to tackling discrimination and inequality, denying the importance of “identity” and treating discrimination as a matter of individual success (or failure), would embed inequality and discrimination and would help reverse the gains that have been made (albeit too slowly) in the last two decades.

Circle of blue cutout people with single orange cut out person on the outskirts

Data on “identity” is crucial in challenging discrimination

Firstly although some inequality and discrimination is overt and thus easier to challenge, often it’s more subtle. Working class children, for example, have a greater likelihood of ill health, shorter life expectancy, poorer exam results and jobs than children who go to public school. This is the result of multiple, systematic obstacles and a lack of opportunities, not evidence of lack of individual ambition or the result of a meritocracy.

Inequality and discrimination of all kinds is deeply embedded in our society and in institutions such as workplaces. A case by case challenge is largely reliant on individual anecdote and challenge, and is likely to fail. Robust evidence of patterns of inequality will help identify whether, how and where discrimination takes place.

Changing such patterns of discrimination is almost impossible unless we accept that people are treated differently (as a group) according to their characteristics (class, ethnicity, gender, disability) since those causing such inequality will either deny being discriminatory or not even realise they are discriminating (unconscious bias).

Data driven accountability is normal in most decision-making, not least since it is very unusual to find a “smoking gun” of admitted discriminatory bias. Without some means of categorising (and thus providing data on) the identities of those who may face unfair treatment, it’s impossible to understand either the scale of discrimination or its nature, or how to reduce it. Identity – and means of quantifying it – are crucial to evidence driven policy.

Our identity is a crucial part of who we are

Secondly, social class, gender, ethnicity, disability and other identities are a crucial part of who we are and what we bring to work and elsewhere. It’s important to all of us. It shapes our experience of the world. It gives us insight, and skills that others with different identities may not have. It directly affects our experience and opportunities throughout our lives including the connections and networks that will ease our path through life. So when interview panels look for recruits who will “fit in”, our identity directly affects whether we do.

Unless teams, employers and Governments acknowledge the “identity” of staff at work is a crucial part of who we are, they cannot develop strategies that enable us to draw on everyone’s potential, recognising that the different experiences that staff have are defined in crucial ways by their identities.

There is now overwhelming evidence that diverse teams where difference is recognised and welcomed (inclusion) are more likely to be effective, creative, innovative, productive and profitable than those which are not. Denying or ignoring those differences means we are unable to discuss or turn them into positives. If identity “disappears” what happens to inclusion and the benefits it can bring?

Who benefits (or not) from ignoring ”identity”?

Thirdly, those who “don’t notice” identity and suggest it is possible (or preferable) to ignore the differences that help make us what we are, whether well intentioned or not, can lead such managers, leaders and politicians to be unwilling or unable to acknowledge the systematic bias and discrimination that we know exists.

As Weingarton neatly puts itSocial psychologists have also noted that the myth of racial or gender blindness is one that is useful only to those in the dominant group. People who are marginalized or in lower-status groups don’t have the luxury of being blind to the identities of others; to be effective communicators at work, they need to understand the prevailing codes there, even if this awareness doesn’t always rise to the conscious level.”

White men in particular (I am one) have been the beneficiaries of centuries of well-honed positive action. A belief in meritocracy, or claiming to ignore identity, shows a lack of awareness of our own unconscious or automatic mental responses, and of the advantages that those proposing that we ignore identity enjoy. The individualistic focus of “merit” places responsibility for discriminatory employment outcomes on the shoulders of the unsuccessful, stigmatising them as incompetent or undeserving. It also ignores the possibility that “merit” is largely defined by those who have benefited from existing definitions.

The more people think they’re objective decision-makers, who take no note of identity and are unbiased, the more they may make biased choices. For groups such as scientists, lawyers, accountants and academics, for whom “objectivity” is regarded as a key part of their identity, admitting bias in attitudes or decision making may be particularly challenging.

Dovidio and colleagues (2016) reviewed some of the literature on the impact of colour blindness and identity and concluded that “seemingly well-intended policies and interventions to reduce intergroup bias by emphasizing colorblindness through overarching commonalities between groups may, either unintentionally or strategically, inhibit efforts to address group-based inequities.”

Their summary argues that members of advantaged groups, who wish to maintain the status quo, prefer to focus on shared identity to the exclusion of differences whereas disadvantaged groups seeking to alter the status quo show a greater desire to talk about differences between the groups albeit simultaneously being willing to discuss shared aspects of identity.

The personal impact of a denial of “identity”

Finally, colour blindness, gender neutrality and other denials of the importance of identity impacts personally on both advantaged and disadvantaged groups.

Holoien and colleagues (2011) found that “hearing colorblind messages predict negative outcomes among Whites, such as greater racial bias and negative affect; likewise colorblind messages cause stress in ethnic minorities, resulting in decreased cognitive performance”.

Dovidio (above) highlights research illustrating how the cognitive demands of suppressing the activation of difference can create communication problems such as hesitations and reduced responsiveness. If a White person espouses colour-blindness, they may be more interested in monitoring their own performance than learning about the needs and concerns of the Black and Minority Ethnic person they are with.

Other research suggests that when White people espouse a colorblind orientation they are less positive and supportive, avoiding topics that would bring to light meaningful differences than other White people who took a different approach that acknowledged differences between them and Black participants in the interaction.

In contrast, those with a multicultural perspective which appreciated both common connections and differences, were much more positive and likely to see the value of the distinctive potential contributions of members of different group, respect members of other groups and seek to promote diversity for common advantage.

Crucially, members of non-dominant groups whose identity is not recognised may allow their identity to become invisible, not only to others but for themselves. They may thus improve their own careers or life chances but this may be at the cost of the benefit of their “subgroup identity” and social support from other members of their subgroup.

The active masking of difference, “covering”, by members of non-dominant groups in an attempt to ‘fit-in’ and side-step “minority stressors” has significant costs since “when an individual’s behaviour or state of being is incongruent with their cultural values, the individual’s self-concept, self-worth, and well-being are negatively impacted.” 

Yoshino found that 32% employees who engage in “covering” reported it negatively impacted their sense of self that at an organisational level this “emotional dissonance” acts as a demotivating force that can negatively impact engagement. He found that employees who engage in “covering” strategies to fit into dominant organisational norms were 16% less committed to the organisation, 14% had a lower sense of belonging to the organisation, 15% were less likely to perceive having opportunities to advance, and 27% were more likely to have considered leaving the organisation in the past twelve months.


Any benefits from the apparent inter-group harmony gained by “colour-blindness” and other forms of denying the importance of identity are unlikely to lead to, and indeed can prevent, efforts to challenge the institutional and societal obstacles to equality, diversity and inclusion.

Liz Truss’ views individualise the challenge to inequality, undermining collective challenge and institutional interventions. This is even more important when the erosion of (already weak) employment rights is likely post Brexit. The emphasis on individual effort rather than collective challenge overlaps with the suggestion (contrary to the evidence) that we live in a meritocracy where all may equally, , irrespective of identity, rise to the top.

Social policy and employment decision making cannot be dependent on anecdotes or individual challenge. The Macpherson Report (1998) analysed discriminatory practices within the Metropolitan Police and described “the collective failure of an organisation to provide an appropriate and professional service to people because of their colour, culture, or ethnic origin.

“It can be seen or detected in processes, attitudes and behaviour which amount to discrimination through unwitting prejudice, ignorance, thoughtlessness and racist stereotyping which disadvantage minority ethnic people.”

Applied to all types of identify within employment, such “processes, attitudes and behaviour” become a means whereby employers systematically (often unintentionally) undermine the career opportunities and treatment at work of any disadvantaged groups of staff and potential staff, whilst simultaneously denying any effective redress. Such institutional discrimination may be driven not only by ethnicity, but by gender, disability, sexual orientation, class and so on.

Mitigating or removing those processes, attitudes and behaviours which produce biased outcomes in recruitment, development, investigations and treatment depends upon appreciating identity, collecting and analysing data based on identity, and holding leaders to account so they act to tackle patterns of inequality, not just individual episodes. Appreciating difference in identity is crucial to creating inclusion.

Liz Truss’s proposal ignores the systemic, societal and institutional obstacles to equality. Her vision embodies a false harmony, symbolised by “colour blindness”, “gender neutrality” or “not noticing people’s class”. It may seem superficially attractive but, far from reducing inequality and discrimination, it will embed it.

Law & politics Social commentary

Reparations for Slavery – A Contemporary Debate

Dr Angus Nurse, Associate Professor in Criminology and Sociology, examines the current debate over reparations for slavery in both the UK and US.

As election campaigns kick-off on both sides of the Atlantic, attitudes towards and the treatment of black citizens have become a topic of debate. Evidence on both sides of the pond consistently indicates that black citizens are disadvantaged in their treatment at the hands of the state and state agencies, particularly criminal justice ones.

In the US, the Black Lives Matter movement has shed light on the killing of unarmed black men and alleged disproportionate use of force by policing agencies against the black community.

In the UK, research continues to suggest disproportionate use of police stop and search powers against black and minority ethnic people. 

In both the US and UK, black people are disproportionately represented in  prison populations and evidence suggests they receive harsher prison sentences compared to their white counterparts.

Discrimination continues

Underlying these issues are social attitudes towards black people arguably situated in cultural perceptions of inferiority and of black communities as being predisposed towards crime. However social inequalities between black and white communities are visible in a range of areas including income disparity, access to professions and discrimination in the workplace and provision of services.

The racial disparity in US society is arguably more pronounced and visible to the extent that race based dialogue such as recent debates about whether calls to send elected (non-white) politicians ‘home’ is racist. However, the Windrush Scandal also draws into sharp focus the extent to which UK authorities have discriminated against black citizens and shown at best poor judgment in the creation of a hostile environment towards black people. At worst, Windrush gives the impression that racist attitudes towards black people permeate aspects of Government thinking and policy.

Against the backdrop of poor attitudes towards black people and concerns about differential treatment for black citizens and communities, a campaign for slavery reparations has been gathering momentum. At the heart of this campaign is a growing call for recognition of the impact of slavery on current communities. There are also calls for UK and US Governments to acknowledge a debt is owed to those who suffered and lost their lives as a result of slavery, while governments and other institutions benefited.

For those who believe that a long history of forced, unpaid labour, ownership and servitude and persistent social attitudes of black people as second class citizens has caused difficulties for current communities, reparations for the harm caused by slavery make sense. However, assigning responsibility at the level of the state and identifying who should make reparations and what form any reparations should take can be difficult.

The US movement

In the US, the slavery reparations movement is fairly advanced. In July 2019, Chuck Shumer leader of the Democrats in the US Senate backed a campaign for reparation. US Presidential hopeful Cory Booker and Congresswoman Sheila Jackson Lee have also called for a commission to study and develop reparation proposals for African-Americans

A range of court action has also taken place in the US in recent decades with the aim of having the courts rule that reparations should be paid and drawing some conclusions on who should pay them.  Legal cases have included action against major financial institutions that benefited from slavery as well as claims against the government itself.  So far, none of these cases has fully succeeded with the reasons for failure varying.

In rejecting these claims, reasons given by courts include arguments that present day institutions cannot be held responsible for the actions of their long-dead predecessors. It has also been argued that whether the state should compensate for something that was legal at the time is a political question rather than one that should be decided by the courts.

Claims have also been rejected because there is nobody alive today who has directly suffered from slavery and so in one sense there is no surviving victim who should be compensated. This argument distinguishes the ‘legacy’ of transatlantic slavery as an institution against black people who are still feeling its effects, from more recent harms like the persecution of the Jews in the Holocaust. Reparations have been paid for the Holocaust in part because not only is the Holocaust a more recent memory, but a number of its survivors and their children are still alive. As a result, there were living victims whose harm could be addressed when Holocaust reparations were initially agreed in the 1950s with later payments agreed decades later.

The same can not be said of the victims of black slavery which technically ended in 1865 in the US with the emancipation proclamation and 1834 in the UK following the passing of the Slavery Abolition Act 1833. That said, an argument can be made that reparations could be given for the descendants of slaves, many of whom continued to suffer the effects of slavery through segregation in the US until the civil rights reforms of the 1960s and 1970s.  US civil rights and Black Lives Matter activists might well argue that they are still suffering today.

The legacy of UK slavery

The legal arguments for reparations are complex and different arguments can potentially be made in the US and the UK and against private and public bodies or the Government. The US slave trade has arguably resulted in marginalised black and ethnic minority communities and poor treatment of black citizens when compared to their white counterparts.

The UK’s slave trade has resulted in Caribbean communities who may have achieved (legal) independence from the British colonial power but who are still slightly dominated by colonial influences, legal systems and British forms of governance. Caribbean communities still also suffer from general imbalance between the status and wealth of black and white communities. So a general argument can be made that slaves were denied the economic value of their labour (wages) and so at least some money is owed from those institutions that benefited from a free work force. 

Some universities and other institutions have admitted that they profited from slavery and so a simple form of reparation here might be to provide scholarships or other benefits that can be accessed by Afro-Caribbean or African-American students and other service users, as US Bank JP Morgan Chase and Company has already agreed to do.

Reparations should address not just the immediate harm caused to victims of an atrocity like slavery, but also its enduring legacy.  So while it is true that nobody currently alive directly suffered from slavery, giving this general type of reparation at least recognises that as a consequence of slavery, black people still experience difficulties in accessing some institutions that historically refused entry to these alleged second class citizens.

State reparations

Reparations by the state are a little more challenging but reflect the Government’s support for the institution of slavery and its impact on black communities.  Slavery existed partly because US and UK governments made money from the slave trade and the ‘free’ labour it provided and so allowed it to continue long after there were calls for it to end.

Caricom, the Caribbean Reparations Committee,  continues to call for slavery reparations to address the harm caused to Caribbean communities and the crimes against humanity endemic to the slave trade. However, on a visit to Jamaica in 2015, former Prime Minister David Cameron responded to calls from Jamaica’s Parliament for reparations by asking them to ‘move on’ and ‘continue to build for the future’. Yet inequality continues to be felt across the Caribbean and access to the wealth available to white Caribbeans as well as the luxury of the islands’ tourism industry and produce resources continue to be denied to large portions of the black and indigenous population who are arguably segregated from the benefits of island economies that have been made possible by slavery and the wealth made for Britain by its slave plantations.

The moral argument

Besides the legal arguments a moral argument for reparations also exists. Slavery represents a wrong inflicted on people due to a belief in their inferiority and a perception that they are fit only to exist within certain areas of society. Reparations provide a tangible means of acknowledging the wrong and harm of such thinking and clearly stating that it has no place in contemporary society.

While an apology for the harm caused by the slave trade is welcome, the gesture of reparations provides a means of giving something back to communities and nations who most felt its effects. With the rise of racist rhetoric in the US and of hate crimes in Brexit-fuelled Britain, concerns about racism are once again on the agenda. It’s time the reparations debate was as well.

Business & economics Social commentary

No quick fixes for fair recruitment

Joy Warmington is Chief Executive of BRAP and holds an honorary doctorate from Middlesex University. Roger Kline is research Fellow at Middlesex University Business School. Here they highlight some of the issues with recruitment processes that are preventing organisations from becoming more diverse.

With Ministers announcing targets for ensuring diversity amongst public sector leaderships, organisations are increasingly asking how can they diversify their workforce? A growing number of organisations are insisting on diverse panels as one means of doing so.

We know current recruitment practices repeatedly favour some groups of staff at every stage of recruitment, development and promotion leading to a loss of talent. We know that the evidence shows that diverse workforces and leaderships that are inclusive are likely to be more productive, creative, innovative and engaged. We now know that the reasons women, BME and disabled staff fail to get fair treatment in recruitment is because of multiple forms of bias that influence appointment panels to choose people who ‘fit in” or are “like us” so that too often individuals are hired because of who they are – rather than what they can do.

Understandably, the focus for helping change this lands on the recruitment process. How we shift this pattern depends on two simple things:

  • what we believe are the reasons behind un-diverse appointments?
  • what steps are we prepared to take to challenge the status quo?

The lack of diversity in appointment processes, has been, and often still is seen as the fault of the applicant. There are a range of measures employed to ‘fix’ this – including widening advertisement processes so that it is likely to attract more marginalised communities, using a range of innovative means (open days, tasters, shadowing opportunities) to help demystify roles and encourage applications, and getting further down-stream by reaching into schools to promote opportunities. This “deficit” model may be helpful but doesn’t tackle the core of the problem.

Unconscious bias in interviews

Interviewing has historically been seen as an essentially fair process, but research is beginning to recognise its inherent faults. In our attempt to address these faults, organisations have spent more time ‘tweaking’ the interview process than we have recognising that people work within a system that replicates unfairness, and that they too become part of this system.

Unconscious bias training is one step that organisations often take to address unfairness in recruitment processes. Fundamentally, it can be right to point out that all of us have biases, and that we actively replicate these in our lives – including as part of the recruitment process. This type of training is very varied – it ranges from the application of the implicit bias test (which analyses bias through an algorithm), power point workshops, through to more active training and development opportunities. As we have pointed out previously, and as the recent EHRC review shows, although some experiences are no doubt better than others, all come with the health warning that understanding our adverse biases doesn’t mean that we are capable or indeed willing to change them.

The ‘diverse’ panel

Another increasingly popular strategy is the inclusion of a ‘diverse’ individual as part of the interview process. This has become increasingly common yet the evidence base for it is pretty thin. The impact of ensuring selection panels include women, for example, is mixed. Some studies show that as the numbers of women on a panel increase, the more likely it is that women will be selected but other researchers have found the opposite. One study found that when a woman was the only female member of a high-prestige work group and was asked to vote on another candidate for the group, she is much more likely to choose a male candidate than a female one. In summary the evidence is mixed.

That does not mean diverse panels are a bad idea. Intuitively they can be a positive step, but its significance can easily be over-stated especially when done in isolation. We have unfortunately seen some organisations make this the cornerstone of their approach, yet it can easily risk becoming tokenism.

In one organisation BME staff were invited to be panel members but not be part of the shortlisting process.

In another organisation the main role for BME panel members was to ask “the equality question.”

In a third organisation, BME staff who were significantly more junior than panel members were invited to join panels, but without equal authority on the panel that would make up for their more junior status.

In a fourth organisation BME staff were mandated to join panels without more than token training and irrespective of whether they wanted to join the panel or felt able to contribute substantially.

All these approaches (and there are variants including one where the only panel members required to have unconscious bias training were the additional ones with protected characteristics) have at their core the idea that the responsibility for recruiting diversely is substantially remedied by the inclusion of someone who is diverse.

Interview processes are inherently flawed – even before you include someone in them who is more diverse. There is a tendency for those who interview not to have received any proper training on the specific ways in which bias creeps into the best-intentioned interview and their role on the panel is simply based on their position – rather than their skills in choosing good candidates. Furthermore there is no point in doing this training unless it is put into practice as part of the interview process. How many processes discuss and review biases and their decision making – and recognise this as part of the journey to a fairer decision?

This shortcoming is compounded by the seniority of the line manager who generally chairs and who can ‘trump’ other panel members. If the appointment is specialist in nature, then again, the final say on the appointment may well rest with the ‘specialist’.

There are all sorts of specific ways in which bias can be mitigated within the appointment process – from how the job is described, where it is advertised, what the “essential criteria” are, how shortlisting is done, how the core competencies and behaviours required are tested, and including the interview itself. Without serious attention to these, an additional “diverse” panel member will not make a serious difference.

Setting an expectation

At the heart of successfully building diversity into recruitment processes, including interviews, is accountability. When departments and professions are held to account over patterns of recruitment which show it is much more likely that men will be appointed, or white applicants will be appointed, or staff with disabilities rarely get appointed, then a “comply or explain” challenge – explain the data or change the outcomes, does work. That does not mean telling individual panels which individual to appoint. But it does mean setting an expectation – a performance indicator that says that irrespective of their backgrounds and characteristics, once shortlisted there should be no radical differences between the likelihood of different groups of staff being appointed. There is evidence that targets linked to accountability do work.

In an imperfect system run by imperfect people our willingness to recognise our “faults” can bring us closer to realising the opportunities that often lie right under our nose. Let’s think more critically about the whole process of recruitment rather than just trying to put in quick fixes that have limited fixing ability. And lastly, let’s be clear about the expectation – boards should be concerned about shoddy or unfair decision making – poor recruitment patterns are not ‘accidental’, they replicate the status quo.

Law & politics Social commentary

Burqa bans and gender (in) equality

Dr Erica HowardErica Howard is the author of a report for the European Commission on ‘Religious clothing and symbols in employment’ and a book on ‘Law and the wearing of religious symbols’ as well as a number of articles on this subject. Here, Erica shares her views on the recent banning of clothing which covers the face in public spaces by the Danish parliament.

Last week, the Danish parliament voted for a ban on covering the face in public. The ban will come into force on 1 August. Denmark follows France, Belgium, Austria and Bulgaria, which all have enacted legal bans on the wearing of face-covering clothing in public places (Religious clothing and symbols in employment). Such bans also exist at local level in some European States. Like in these other countries, the Danish ban is couched in neutral terms and prohibits the wearing of all clothing that covers the face in public spaces, but the bans are usually referred to colloquially as ‘burqa bans’, which indicates the real target of such bans: women who wear burqas – a long loose robe that covers the female from head to toe with the exception of the hands with gauze covering for the eyes – or niqabs – a veil that covers the head and face with the exception of the eyes. Although these bans are often referred to as ‘burqa bans’, very few women in Europe actually wear a burqa; the vast majority of women wearing face-covering veils in Europe wear the niqab or similar type veils.  The Independent reported on the Danish law with the headline: ‘Denmark becomes latest European country to ban burqas and niqabs’, again showing the real target of the ban.

So there are now 5 EU countries that ban face-covering clothing in all public places. This is so, despite the fact that the number of women in Europe who wear the niqab or burqa is very small. A  Danish research report from 2013, estimated that about 150 women in Denmark wore the niqab, half of which were ethnic Danish converts to Islam. This corresponds to about 0.1 or 0.2 percent of Muslim women in Denmark. These figures tally with current rough estimates of face veil wearing women in other European countries.

Image by Aslan Media (CC2.0)

Secular and democratic values

The reasons given for enacting the ban are the upholding of Danish secular and democratic values.  Supporters of the ban have also raised the issue that the veil is a form of female oppression as will be clear from the Independent and other press reports (see e.g. here and here) on the Danish ban. This is the argument I discuss in this blog post. The argument is based on the assertion that women wear burqas and niqabs because they are made to do so by men, be it spouses, family or religious leaders. These veils are thus seen as going against a woman’s fundamental rights and freedoms. The same argument has been put forward for bans on Muslim headscarves.

However, this is based on a very stereotypical view of Muslim women who are seen as the victim of a gender oppressive religion, who need to be rescued from this oppression and who need to be emancipated. Research in five European countries – Belgium, Denmark, France, the Netherlands, and the UK – showed that many of the face veil wearing women interviewed in the research emphasized that they wore the face veil of their own autonomous personal choice, often in spite of disapproval of parents or other close relatives (E. Brems (ed.) The Experience of Face Veil Wearers in Europe and the Law, Cambridge University Press, 2014).

There are many reasons why women wear face veils and the research did not deny that some women are indeed pressured to do so. But, would the fact that some women are under pressure, even if it is a small number, be a sufficient reason for a ban? I would argue that, whatever the number that is under pressure, it is not sufficient to justify a ban. Bans are not only unnecessary, but they are also counterproductive in achieving emancipation for women who are under pressure to wear the face-covering veil. Bans could very well lead to these women not being allowed to go out of the house at all and thus not being permitted to go to school, university or work. Rather than hindering their emancipation, allowing this group of women to wear face veils would promote their emancipation because it might well be the only way they can go outside the home to study and work. Banning the wearing of face veils in public places would also lead to the exclusion of these women from society and would thus punish the victims. Allowing face veils would thus give this group of women a chance to gain equality through work and education.

Paternalism or free choice?

There are two more problems with using gender equality as a reason for banning face veils. First of all, this is based on the view that Islam is a paternalistic religion where men determine what women should wear. But the accusation of paternalism can just as well be levelled at the people using the gender equality argument to support bans and at the state for enacting such bans: banning women from wearing face veils is just as paternalistic because it is another form of prescribing what women should or should not wear. Both sides here ignore a woman’s fundamental human right to autonomy and free choice.

The second problem with using the gender equality argument to support bans on face-covering clothing in public spaces is that the European Court of Human Rights has rejected this argument in a case challenging the face-covering clothing ban in France. In S.A.S. v France, the Court held that a state cannot invoke this argument in order to ban a practice that is defended by women such as the applicant in this case (paragraph 119).

Despite this rejection, the gender equality argument for enacting bans keeps cropping up in debates in many European countries about whether such bans are necessary, as it did in the Danish debates, and the stereotype of the Muslim woman as oppressed persists.