In the wake of the death of George Floyd and Black Lives Matter protests, the anti-racism movement has prompted people around the world to examine the inequalities that exist in the sectors they work in. In community pharmacy, the first step is recognising that, for some individuals, racism exists as a daily reality. The next is taking action to combat it.

There are vastly different opinions between pharmacy professionals on which method would be the most useful in stopping racism in the sector and which concerns are the most urgent. Views on these issues tend to see significant variations depending on individuals’ ethnicity, according to a survey of 886 respondents by C+D that ran between June 18 and July 27.

Black, Asian and minority ethnic (BAME) individuals experience racism differently depending on which community they are part of, yet often they are bundled together under the same broad acronym. The term 'BAME' has been criticised by some, as it risks diluting and confusing the voices of different ethnic minorities. For example, an Indian pharmacy professional will not receive identical racist treatment to that of a Pakistani member of staff, and therefore these individuals may have different ideas about the best way of tackling racism.

Of the ethnic groups surveyed, there were the highest number of responses (276) from white individuals, followed by people from Indian (210), African (135) and Pakistani (105) backgrounds. There were not enough responses from other ethnic groups to produce reliable data, but their comments are included in this article where relevant.

The survey asked respondents to indicate which methods of tackling racism in pharmacy they were in favour of, including: antiracism training; more conversations about race; more people calling out racism when it happens; hiring more people of different ethnicities; promoting an environment where employees feel like they can talk to managers if they have issues; and bringing in an effective complaints procedure with disciplinary action against racist colleagues.

There was broad support for all six of these categories across Indian, African and Pakistani respondents. However, fewer than half of white respondents backed anti-racism training (40%), more conversations about race (45%) or hiring more people from different ethnicities (28%).

White respondents showed less support for every category than Indian, African and Pakistani respondents except for promoting a safer environment for employees to talk to managers if they have issues – where they had the strongest reaction, with 68% in favour.

The category with the biggest difference in opinion was hiring more people of different ethnicities – 28% of white respondents selected this option, compared with 62% of Pakistani, 52% of Indian and 72% of African individuals. The category with the second greatest disparity in support was introducing anti-racism training – 71% of Pakistani pharmacy professionals said this needed to happen, compared with 60% of Indian respondents, 66% of African respondent and 40% of white respondents.

A key influencer on individuals’ opinion on handling racism will be their experience of personal discrimination. African respondents reported the highest level of racism from pharmacy colleagues, with 78% reporting at least one racist incident over the previous six months. The figure for Pakistani respondents was 61%, and it went down to 49% for those identifying as Indian. This compared to 31% for white respondents.

Recruitment diversity

Employing individuals of different ethnicities must happen at all levels within the workforce, several African respondents stressed. There must be “fair career promotion at senior levels”, one said. “Hire more BAME people in higher positions,” suggested another.

A third said: “Sadly, if everyone at the top looks the same, they definitely fail to understand the problem of racism. They might try to empathise but unless you have been through it yourself it's likely to be downplayed. Companies should make recruiting process more transparent.”

Several respondents said a report of racism must trigger clear repercussions, such as publishing reports of racist incidents internally and externally. “A complaints form should be made available for temporary staff and locum workers,” one respondent said.

“Where a colleague is found guilty [of racism] they should be disciplined or dismissed depending on the nature of the offence,” said another. “It should also be made possible for racist patients to be reprimanded.”

Independent equality body?

Elsy Gomez Campos, president of the UK Black Pharmacists Association, suggested in a C+D blog earlier this month that pharmacy needs an independent body to monitor and report on workforce racial equality standards.

Some Pakistani respondents endorsed the idea of an organisation in charge of racial equality in pharmacy. The sector should have “an external body” to protect the jobs of those who report racism, they said. A Pakistani locum said that after filing a report on a racist patient, the business they were working at made no attempt to prevent another incident. The company “sees us as disposables who are not actual members of staff”, they said.

Some respondents went as far as to suggest how an antiracism body could work in practice. The organisation could have a hotline for pharmacy professionals to report racism, two Indian respondents suggested.

Anti-racism training

Indian respondents also stressed the importance of cultural education. One respondent said there needed to be “education on systemic racism and different religions so people can understand what is not OK to comment on and may be offensive”. Another said overcoming racism “will take generations of education – people are too scared to call it out as you need proof to be believed”. There has to be better “understanding of culture difference”, said a third person.

Encouraging anti-racism training was popular among Indian, Pakistani and African respondents with 60%, 71% and 66% of votes respectively.

The most-popular method for managing racism across all ethnicities was getting more people to call it out when it happens.

Many white respondents (61%) agreed that pharmacy professionals need to call out racism when they see it. In turn, companies must stand up for their employees in the face of racist patients, some suggested. “Everyone needs to point out when a comment or action is racist to help others see it,” one respondent said.

Another said: “While I, as a white woman, have not been exposed to racism, I have certainly intervened and banned customers where they have behaved in a racist manner to any of my team as we do not tolerate such behaviours.”

Although there are disagreements on the ways of combatting racism in pharmacy, C+D's survey results show that individuals across all ethnicities have a wish to act. All are united, for example, behind the need to call out racism when it occurs. The differences reveal how popular a proposition might be in the workforce of pharmacies, depending on the ethnic mix of a team.

By acknowledging the variations in the way individuals experience of racism, and the impact these have on the desire for change, we can work towards a more equal future.  

Listen to C+D’s podcast on overcoming racial bias