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Exposed: a documentary illuminating the shameful racism in the NHS

On the NHS's 74th anniversary, Rizwana Lala looks at Exposed, a documentary about racism in the vast organisation. 

Exposed, a poignant documentary, narrates the incredible stories of Black, brown and migrant nurses and midwives’ experiences of work in the NHS during the pandemic. The film was fittingly screened in Sheffield on Windrush Day; two weeks after the Empire Windrush anchored at Tilbury Docks, the NHS was formed. And so Windrush and Commonwealth nurses and midwives were recruited to build the foundations of Britain’s most beloved institution.

The NHS continues to survive on the labour of Black and brown working-class women.

Overall, ethnic minority workers make up one in five workers in the NHS. But 41% of nurses, who are predominantly women, identify as Black and Minority Ethnic. Despite this, racism and racial inequalities are a known and well-evidenced reality of the NHS. After years and even decades of NHS service, ethnic minority and migrant nurses find themselves stuck on lower pay grades that apply to newly qualified staff. This injustice is reflected in the average hourly pay of ethnic minority nurses being a staggering 28.7% lower than their white colleagues.

In 2020, as the pandemic unfolded, Black and brown faces of health professionals dying in service on the NHS frontline were splashed across media outlets. Images that prompted academics at Sheffield Hallam University to undertake research titled Nursing Narratives – Racism and the Pandemic to understand if racism in the NHS played a role in the disproportionate deaths of Black and brown health professionals. Exposed is produced from this research, which powerfully and shamefully illustrates how working-class Black and brown women are institutionally harmed and humiliated.

Stories of nurses and midwives evoke horrific images that should be consigned to history books. Roseline, as an agency nurse, noticed patterns in multiple hospitals. She describes how Black nurses were allocated in the red zones with Covid patients whilst white nurses worked in green zones, a testimony that conjures up disgusting images of segregation in NHS hospitals.

Unequal work distribution is rife; with Black and brown women given more patients and riskier Covid-related tasks. When Gemma challenged this, she was told, “it beats being a slave”.

A Black woman wearing scrubs has a sign that says "BoJo show us you care about the NHS... we cared for you"
Ehimetalor Akhere Unuabona

Over and over again women described the hospital as a ‘battlezone’, but they were not given the much-needed armour. Black and brown nurses were less likely to receive Personal Protective Equipment (PPE). When it was available, the PPE was less likely to fit; it just isn’t designed for ethnic minority facial features, Black hair or even hijabs.

As one nurse said “we were chosen to be exposed [to the virus]".

Featured is the cross-cutting ignorance of racism and the needs of ethnic minority health professionals. When a student nurse excitedly Googled her first placement at a community hospital, the search engine returned the area as one of the most racist in Britain. But university education is unsatisfactorily silent. It does not prepare students to deal with racism because this ordinary everyday experience of Black and brown people is imagined as exceptional. White health professionals are not trained to recognise racism and thus fail to support colleagues. It’s lucidly put by one nurse in the film “I want my colleagues to know, racism is not on the TV – it’s real, it’s next to them”.

The care, courage and dignity of nurses despite the institutional hurt and humiliation is especially poignant and beautiful. Nurses talk of trying to be ‘everything’ for patients dying alone in the pandemic. They became their family, read the Quran and the Bible. They applied make-up and brushed patients’ hair so that they could feel human.

Exposed illustrates what the title suggests. It exposes the role of power in maintaining the colonial legacies of racist inequalities. The well-documented overrepresentation of privileged white men in positions of power across institutions such as the NHS and universities leaves an unacceptable lack of awareness of the needs and experiences of working-class ethnic minority women. These systemic failures and inequalities only deepened with the decade-long austerity measures that drained NHS, public health and community services. Not only did this leave us wholly unprepared for the pandemic, it has created toxic systems where exploitation of vulnerable workers is the norm. Deep cuts and inequalities allow racism to flourish in all areas of civic society.

Nurses in the film testify how the murder of George Floyd gave them the courage to speak up. Nurses and midwives compiled 'A Manifesto for Change', which calls upon NHS Trusts, organisations and trade unions to sign up to an anti-racist health service. The racism in the NHS and wider civic society may not fire bullets but it does kill. Despite multiple Freedom of Information requests, the government has not disclosed how many Black and brown staff died in the NHS during the pandemic.

On the 74th anniversary of the NHS, tackling racism is not only essential to build a fairer NHS, it chimes with its founding principles — universal access to healthcare is grounded on the premise that all humans are equal.

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