Introduction
Acute shortage of nurses over the last decade has characterized the National Health Services (NHS). The main cause of this shortage is the fact that there was an under investment in the nursing education during the 80s. It has therefore become essential for The British government to recruit nurses from Africa, Asia and the Caribbean in order to substitute the already ageing population of indigenous nurses.
However despite the fact that Britain needs these nurses, measures to protect foreign nurses and other practitioners is still a far cry. (Lorraine, 2005) Though there is very little research of African’s nurses in the UK, it is known that ethnic minority nurses suffer discrimination but their precarious situations force them to endure discrimination among many other negative experiences that they undergo. Right from recruitment, training, orientation to employment and subsequent remuneration, ethnic minority nurses have experienced one or two forms of discrimination while working in the UK.
Statement of the Problem
A study carried out in Southern England showed that discrimination and denial of equal opportunities were the main problems experienced by the ethnic minority. An interview involving nurses showed that both white nurses and patients are cruel to the black nurses. It emerged that the white nurses and patients were not having trust in the services offered by the blacks even when their services were just the same.
The British government has for the last five years been involved in recruiting trained nurses from former British colonies. (Lorraine, 2005) However the British government has not taken the necessary step to ensure that when the nurses come have a good working environment. There have been cases of white nurses being abusive to the blacks and the Asians. The victims however said that they had to endure undergoing such negative experiences since they feared being deported to their countries. However it also emerged that the foreign nurses were also benefiting from the professional experience they were getting.
Given the prevailing situation that Britain is experiencing acute shortage of labour, there is need then to ensure that hired nurses from outside the country are treated with dignity they deserve because both the Britons and the nurses need each other. It is important to note here that nurses from different countries and continent have different forms of training and work experiences and so therefore there is need for consideration of orientation of the new nurses instead of them being looked down as non-performers. It is the National Health Services responsibility to make ensure that there are no any forms of discrimination and denial of equal opportunity taking place in Britain. (Kemshall, 2002)
Aims
The aim of study is to critically evaluate the issues of recruitment and selection within the NHS and to analyze the effectiveness of equal opportunity policy in UK organizations in solving discrimination problems to promote equality.
Objectives
The overall objective of this research work is to carryout the Analysis of diversity issues in the health labour market. The other objective is to critically review equal opportunity legalities of the United Kingdom. To carryout an analysis of employees’ views relating to discrimination in the health sector and lastly to evaluate the equal opportunity best practices in UK health organizations
Research Questions
Based on the objectives of this study research questions will include the following:
- Does equality play a key function in attaining organizations goals or objectives?
- What are the different ways of ensuring equality in health labour market in UK?
- How can the NHS management link equal opportunities to performance in its effort of trying to achieve stated objectives in the health labour market?
- What are the appropriate remedies for recruiting of the health industry staff based on the equal opportunities existing?
Benefits of Conducting the Research
This research will not only benefit the health organizations in the UK but it will be applicable to all those health organizations who wish to attract and retain a motivated workforce that can accomplish stated objectives efficiently. It will provide focus and insight to the management of NHS as well as portraying to the management the importance of equally satisfied workforce in any health organization.
Limitations of the Study
Because this is an exploratory study it will mean that more time will be required to carry out the research in order to find the relevant information that will reflect the issue of equality as a key force to achieving results in any health organization. Also another limitation is that of availability of funds because the study will require the researcher to reach to a wider population through interviewing many respondents.
Literature Review
Discrimination can take place in many forms including race, age, marital status, disability, gender, status, ethnic background, domestic belief, etc NHS has the responsibility to be proactive in ensuring that discrimination is eradicated if not minimal and has a duty to ensure that equity is practiced among people groups. It has to ensure that nobody seeking employment or seeking or medical services feels that the he is of lower class whatsoever.
The Importance of Equal Opportunities
Equal opportunities are fundamental to the delivery of necessary medical services to the sick. It is out of this realization that NHS fights for equal opportunities for its clients. A non discriminated member of staff is naturally expected to provide services out of his good heart and therefore eliminating discrimination promotes good will of the service provider subsequently improving on the quality of services provided. However is important to note that there it is one thing to come up with policies and another to ensure that it has been effectively implemented. NHS goes ahead to supervise and ensure that there are administrators who will be responsible for implementation.
For equal opportunity to arise in a working environment there should be administrators who are responsible of educating the workers of their duties and responsibility. An organization is expected to organize for meetings, educational seminars etc for the purpose of ensuring that everybody is aware of both his responsibilities and rights. Mostly this falls under the Human resource department. The HR officer ensures that all the policies are adhered to the latter and that in case of any breach of policies necessary action is taken in order to protect the victim and punish the offender accordingly. (Lorraine, 2005)
Many employees of NHS are recruited from foreign land and especially developing world. The member of staff will not therefore be expected to be up to speed during his first day of days at work. it is expected therefore that before delegation of duties, there will be an orientation program that will ensure that all the foreign members of staff are familiar with advanced machinery of this new country that they are working for. It is also expected that they will be treated without prejudice, with respect, no harassment or down grading. The new employees should be given enough time not only to come up to speed with the new working environment and race but also with other social amenities.
For example the new employee should be given ample time to become familiar with the geography of both his working and living environment. This will help him relax and learn fast as opposed to when he is being pressured for results and efficiency even before they can learn their physical surrounding. It is also important that the policies are presented to them in their first languages to avoid any ambiguity or misunderstanding.
A cultural background of the indigenous people will also be required in order to familiarize the new worker of the kind of people he is working for and with. As a result of the research conducted for the ethnic minorities working for NHS it emerged that there are patients and local nurses who are abusive to the foreign workers. It also emerged that the local nurses made the patients believe only the whites can offer qualified services and that the foreign nurses were less qualified. As a result, many patients have very little trust for the foreign nurses and inhibit the quality of services that they would otherwise receive if they had been made to believe that these nurses are as trained. (Kemshall, 2002)
It is ironical that during recruitment in their respective countries only the best nurses are given the opportunity to go abroad to work but when the same qualified nurses get to the other side they become the least. There are often breaches of contracts where nurses have been promised an attractive package of remuneration and allowances only to get to the other side and find different arrangements. This becomes very difficult for them to live with since they can not go back to their country and the living standards in the new country are not accommodative.
Governments should therefore come out straight with their foreign policy in order to avoid such misrepresentation of their working policies right at the recruitment stages so that the nurses already know what to expect. There are even times when qualified doctors and nurses are taken in as just social health workers. This is another breach of contract that has been reported to take place. When this occurs the victims of such acts are demoralized and frustrated since they were used to a particular status quo in their country only to find different treatment on this other side.
Types of Discrimination Practiced During Recruitment
Racial discrimination
Apart from downgrading of the nurses, most of them are discriminated against just because of their colour. Different geographical setting and continent have people of different colours. There unfortunately has always been discrimination against people just because they have a different colour. Blacks and Asians are always considered inferior to the white on the basis of the colour of their skin.
It becomes ironical then that the same inferior colour has the most needed services. Take for example Britain, since the 80s, there has been under production of qualified nurses for different reason including under investment in such an important sector of a country, to an extent of recruiting from outside not only the country but the continent. Isn’t then ironical to imagine that the same source of the necessary nursing services is inferior to its own that does not even produce enough for their services? It is evident that the so considered inferior countries have great manpower and ought to be respected as opposed to be discriminated just because of the colour.
Gender discrimination
Gender has always been another base of discrimination. It is ironical that women are also seen as inferior to men especially black women are seen to be like a double disaster, yet they are the majority. If they are inferior in any way then their numbers would not be speaking too loud to their discriminators. They do well in school, contribute to the economy yet they are denied the status quo they deserve in any given community.
In her book Young Female and Black, Heidi Safia has tried to show clearly that women may have different functions from me but they are not less gifted or performers. In many African and Asian communities, women were seen as inferior to their men on the basis of provision. However Heidi was able to prove that to be false when she found out that West Indian women contributed significantly to their homes and were in fact the major bread winners in their communities. It is therefore wrong to judge women as inferior. It makes it worse to judge them as inferior just because they are blacks.
From her book, Heidi establishes a sad truth that though the West Indian women were put in the same class as their white men counterparts, the women were not considered worthy of the same pay as their male counterparts. The scale of pay was so different and this adversely affected the choice of career of many black women since they could not see hope in the future. The NHS is therefore expected to provide a different environment in order to attract the most needed workmanship. It is of no benefit to have Acts like Sex Discrimination Act and Race Relations Act that clearly stipulates how women and different race members should be treated in books yet nothing is happening on the ground.
Ideological statements should not be made in speeches and documented just for the sake of it because at the end of it all is what that is happening on the ground that really matters. Though there is scanty information about the well being from African and Colored nurses working in Britain, there has been complains from the black women nurses that little is implemented on the ground despite legal frame works being put in place. What really matters should be the treatment these foreigners on the ground and not what is documented or stipulated in many legislation. (Coral and Peter, 1989)
Disability
Apart from the issue of gender, and race discrimination, there is also another aspect of disability. It is obviously rare for any government to recruit a disabled person. However understandable this may be due to the much requirement these persons might need, this must also be viewed a serious form of discrimination that must be dealt with. Policies must be put in place to ensure that even during recruitment be it local or foreign persons with disability are considered just as normal persons. Once this has been taken care of and the person with disability has been taken in as a member of staff, follow up measures must be taken to ensure that just like his counterparts he experiences a better working conditions. (Armstrong and Carlopio, 2005)
He must for example be provided with suitable mode of transport, a comfortable home, and especially in the working place there must be special amenities for the disabled. It should be put into consideration that disabled people may not be able to work with the same machinery that the other normal people use. Therefore there should be not only machinery but also separate working station for the disabled as need may arise. When it comes to orientation or training programmes, the disabled should not be ignored since they also need to be appraised on what is happening. Due to their special needs, their remuneration should also be considered according to their specialty. Also, the disabled persons should not be subjected to stigmatization based on their areas of disablement. As such, the disable will feel as part of the community and as a result the community will benefit from their services. (Gray, 2003)
Negative effects of Discrimination on an Individual Worker
Research indicates that when decisions in an organization are made basing on the issues of inequality and biasness it leads ultimately to some negative effects i.e. on both the workers and to the organization itself. Such workers effects include the following;
- Decreased job satisfaction; if workers are mistreated then they will not be motivated to work thus leads to low productivity in the workplace. For instance, if workers are exempted from decision making based on their race they will become demoralized to undertake their responsibilities.
- Poor career development; this is another effect on the health workers; lack of promotion for the discriminated people in the organization will greatly affect the workers development. Such policies like promotion being based on certain colour or gender instead of academic qualification will greatly hamper the development of the workers and they may opt to shift to other organization that provide opportunities for career development thus affecting the organizational negatively because of labour turnover. (Gray, 2003)
- Loss of job; this may also be witnessed particularly when a worker will feel oppressed and may opt to contradict his/her bosses who advocates for such vices like sexual harassment. Since the bosses would not like to be viewed by their juniors as being on the wrong they may opt to sack such workers who refuse to adhere to their rules.
- Stress and anxiety; is also another effect that may be caused by biasness in an organization i.e. both gender and colour biasness. For instance; workers may get stressed because of the way they are treated by their managers thus reducing their output level which will affect the organization’s operations and overall productivity.
- Poor Productivity Levels; The most obvious effect that workers will exhibit is that of poor productivity levels. If workers are mistreated by the managers then they will reluctantly accept to work for the sake of their salaries and wages only but not putting the objectives of the organization to be their priority since they will not be motivated to work. Another effect is that of isolation and discrimination of workers either by the management or co-workers. If decisions for instance are made depending on gender or even colour barriers then it will imply that those who are not involved will feel discriminated and thus isolate themselves from those being involved in the decision process. Women also for instance abused in the workplace for instance sexually harassed by their bosses in the organization may opt to isolate themselves since they may have feelings that other workers within the organization are aware of what is going on. (Lorraine, 2005)
- Personal insecurity; the gender isolation is believed to have made more women to be at a risk from violence in the health organizations where this segregation is regularly practiced such as workplace violence where physical disfigurement remains to be a serious threat to women in the country since many women are regarded as burdens rather than assets. However, it should be noted that not only women are subjected to personal insecurity but also men too are reported to at risk.
Methodology
Research Design
This study necessitated the researcher to identify the main causes and the methods of discrimination of workers in the health sector in Britain. The researcher mainly concentrated on the issue concerning the equality opportunities and how best it can be applied by health organizations in there attempt to boost there profitability levels. Given that this study was an exploratory research it was based on; desired activities and time-based plans, research questions, selection of sources and types of information required, outline of procedures for every research activity that was to be carried out and also it was based on the framework that specified the relationships among the samples identified for this research purpose.
Sampling Procedure
Before adopting the suitable sampling technique several factors for example; cost of conducting the research, time constraint, accuracy of sources to be utilized, availability of population respondents, physical impossibilities of acquiring all the necessary items in the target population and the destructive nature of certain tests was considered in detail in order to avoid minor mistakes in the course of conducting the research.
Probabilistic type of sampling technique was chosen since the sample identified gave each and every respondent a known likelihood of being included in the sample selected. For that reason, the research was conducted using simple random method of collecting data because it was difficult to reach all the participants in the population. Under this technique, the selected sample gave the person identified the opportunity to have an equal chance of being incorporated in the research work.
Target population
The target sample was mainly those workers who are involved in day to day operations in the health sector in the UK. However, some middle level and top managers were considered and given an opportunity too to air their views on the equal opportunity factor. A total of twenty respondents in UK were identified and questionnaires administered to them. However, the administering of questionnaires as a tool of measurement was based on the willingness of the respondents to adhere to the instructions thus in the process answer the questions in their best knowledge.
Techniques for Data Collection
Since a sample of the population was identified the researcher utilized both open and closed questionnaires to collect the required information from the respondents that were selected from the sample identified. This method was considered and found to be effective and efficient to the researcher since he was required to only drop the questionnaires to the respondents and collect them at a later date. The reason for choosing both open and closed questionnaires to be administered is that it gave the respondents an opportunity to answer freely to the set of questionnaires that were administered to them during the study.
Findings
Equal opportunity policies
There are many policies including recruitment procedures that stipulate that no job applicant should receive less treatment and consideration to from the other yet this is not what happens on the ground. White men are always given the first priority followed by their white women then colored and black nurses following in that order. It is not a wonder that even most managers in hospitals are white men as compared to their otherwise evenly qualified black women. Despite there being documented procedures of equipment, there are always exceptions to the rule within the rules that provide for unjustified recruitment. (Pyett, 2002)
Terms like classified position and ring fenced position are often used to justify recruitment of the most “favourable” persons. We find that it is true that advertisements are disseminated with the right format, i.e. no colour, age or gender discrimination so that no one feels discriminated against yet without saying the most favourable person to qualify for the job will definitely be the one that the system will feel comfortable with despite many non-favourable applicants having the same qualifications.
This is exhibited clearly when one looks as to who does what in a given hospital. It is no wonder to find that white male are the majority in the higher ranking of an organization and black female are the majority in the lowest rank of the hospital. Though it is normally stipulated very well on the recruitment forms that no one should be judged besides his capacity to do the job, more often than not additional advantages are normally considered for the “right persons”. It could be considered probably that a white nurse may well be suited to serve a white patient. Though this is not in books it is likely to happen leaving out another person just because of their difference in colour.
During training and development, every new employee normally undergoes through an induction program what is ignored that the foreign nurse might need more time since this is not his homeland. So in actual facts if the local nurse is to be given the same time of induction as the foreigner, the local is obviously advantaged since he is familiar with the machinery and the surrounding.
For example right now is winter in American and Europe while it is sunny in Africa, there will be obviously a great challenge for an African going to work in Britain as compared to a Briton. Such consideration must therefore be put in place to at least try and mend the gap though realistically is not completely possible but more effort should be put to ensure that at least foreign nurses are given a chance to prove themselves worthy of their calling and duties as life savers. (Armstrong and Carlopio, 2005)
Performance plays a key role in every aspect of working life and especially the health sector. It is therefore important that every member of staff have a plan that is tailored to specifically meet their professional and social need. This is significant because it is obvious that what is necessary for the local nurse may not crucial for the foreigner and therefore provision for both their needs must be customized to effectively serve them. When it comes to working environment for example, managers should ensure that members of staff are working within the environment that they feel free from any form of discrimination or harassment.
Since it would take time to change the mentality of the patient towards the non local nurses, it would be considerate for example to let an arrogant and abusive patient to be treated by a nurse of his origin in order to protect the non-local nurse who might end up being abused and hurt as opposed to her services being well received. Caution should however be taken to use this as an excuse for sidelining non-local nurses from performing their duties where could have otherwise have done so without trouble. On the other hand, offenders should not be easily let go and let behave the way they want, but rather dealt with according to the harassment policy. This way, cases of abuse will reduce and as a result, foreign nurses will not only feel protected but respected and will be able to offer their services better. (Brewster, 1995)
As mentioned earlier in this paper, terms and conditions of employment which basically includes basic salaries, benefits and grading etc should be taken to consideration based only on the qualification of a persons and not on their gender, race and physical fitness. It is important to also keep on reviewing these to enable workers to cope with the ever rising inflation of the world’s economy. This will be possible if there will be a monitoring and review systems in place which will help accurately judge the performance of a staff. From the monitoring system, it will be possible to see where additional benefits are deserved and this should be rendered without delay or favouritism.
It is important to note here that despite there being rules and regulations, there must be cases of offenders and these should not be taken lightly. All staff should be aware that any form of discrimination, abuse, victimization will be dealt with according to Trust’s Disciplinary and harassment policy without favouritism. Managers should ensure that every employee is aware of the principal terms and consequences of failing to adhere to them in order to ensure that there are no excuses on the breach of the same. In recognition to the fact that discrimination may not be easily eliminated, affirmative action may be required to protect victims. (Lewis and Giullari, 2005)
Despite there being many loopholes in many policies that have been put in place there are hospitals that have however gone the step ahead in ensuring that discrimination is minimal. One such hospital is Queen Elizabeth Hospital NHS which is committed to equal opportunities for all. The hospital has recognized inequalities that people may endure and takes action to reduce them. The hospital is committed to ensure that it looks into the provision of each member of staff according to their own specific needs thereby promoting equality in the work place. (Kay, 2005)
Every one can work in Queen Elizabeth hospital provide they have the minimum qualification since interviews are conducted in a manner that gives the interviewee a chance to present themselves the best way possible without fear of any discrimination. In Queen Elizabeth hospital anybody can apply for a job despite their sexual orientation, religion, race, cultural background, marital status, responsibility for dependants, national origin, age, political and trade union affiliations etc.
In addition to the above, the hospital are committed to career develop people with disabilities in fact they have been awarded Two Ticks disability symbol by he Employment Service as appreciation for their consideration to the disabled. Some of the benefits that people with disability get from Queen Elizabeth hospital are adapted keyboard for written tests, a facilitator during the interview, wheelchair access, and special car parking places, sign language interpreter and accessible toilet facilities.
Recommendations for Best Practices in Recruitment and Selection
Wrong recruiting of people can be a very expensive affair for both the employer and employee. The employer has to consider employing people who are going to be beneficial to the company both for turnover and for the common good of everyone. This is an important consideration because there are employees who are qualified but are not in relationships and this can cause adverse effects on the other workers. Since this employee’s efforts can be sufficient for the company, the company will thus have lost as opposed to gaining. Again, the employer might need to consider his employee’s needs since lack of such might cost the employer a lot of worthy employees. For example an employer might choose to consider employees’ needs for instance career development, and family needs in order to accommodate otherwise helpful employees.
Employers need to have flexible requirements and be ready to adjust their requirements especially in a job market that is experiencing a shortage of skilled persons. (Pyett, 2002)
An employer is expected to forecast future demands in order to accommodate the ever increasing span of labourers. Depending on the kind of employee’s availability and demand, the employer should consider accommodating people who are likely to be discriminated against for his gain. For example in our situation where there is a shortage of nurses, an employer might choose to adjust working hours, accommodate more disabled people, favour a certain gender according to their availability, offer part time facility etc. such measures might help an employer to win favour from employees who would not have considered him a potential employer. (Alcock, 2003)
Again it is advisable to consider the kind of community an organization seeking employees is. If for example a company is in a region where family values are highly valued, an employer might need to consider more family favourable related work policy whereby he will accommodate especially mothers who have to stay home with their children. The employer should consider offering jobs that can be done at home e.g. home/teleworking.
Another example would be if the company is situated near a university, the employer would consider offering training programs that are necessary for his kind of work and also adjust work timings so that his potential employees who are likely to be university students be attracted by his invitation since they are assured of time for their course work. For nursing students an employer might consider that offering attachment to the students. That way the company will attract more skills for the company and secure job applicants in the future who by the way the same company will have trained. (Armstrong and Carlopio, 2005)
An organization can also make use of old workers by recalling them back to work. these workers can either be retrained but since that would not be worthwhile for a long time, they could be used to substitute the others i.e. work according to their abilities while at the same time training the younger ones from the source of their past expertise and experience. Again age limit can be reconsidered in order to lengthen the working period of the old workers NHS would consider this as an option to cover for the shortage of nursing in Britain. However to avoid this kind of scenario, continuous investment on nursing and really any kind of training should not be ignored. Instead there should encouragement for students to study the especially not very popular science subjects. This could be done by subsidizing fees for such courses further so that a great number parents and guardians can be encouraged to pay for their children. (Alcock, 2003)
Conclusion
Labour market is increasingly changing and there needs to be serious consideration when formulating working policies. Issues of ethics during recruitment of staff should be highly considered. There also should be fair foreign policy so as to ensure that first in case particular country needs manpower from another country both countries will benefit. Issues of discrimination and victimization should be taken into serious consideration. The colour of anybody’s skin, sex, national origin, religion, cultural background, physical and mental ability, sexual orientation which includes lesbians and gay, etc should not be used against any employee.
Every employee has right to political thought, freedom of speech and religion, freedom from discrimination and harassment, right to full participation despite age, colour and gender, right to equal social amenities whether normal person or disabled, right of choice of residence, whether white or black, right to political choice either democracy or republican despite him being either a foreigner or a local. It is important to remember that sometimes, human beings are like computer garbage in garbage out so in order to get anything good from employees, and they also must be treated fairly from early stage of recruitment, all through the whole process of working and eventually retirement.
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