A message from Dame Clare Marx – New targets to tackle inequality and discrimination

So much has changed for the better in the 43 years since I qualified as a doctor. The workforce is more diverse, there's growing recognition of the importance of compassionate leadership and affirmative culture, and a sense of teams endeavouring to be more transparent and inclusive. Yet when it comes to true equality, some areas remain difficult to change.

Looking back, I remember instances where a colleague's ethnic background, or the country in which they qualified, resulted in a failure for them to progress for reasons which were difficult to explain other than on the grounds of conscious or unconscious discrimination.

The pace of improvement in measurable parameters has not matched the urgency of the challenge.

An attitude of passive acceptance, and a misplaced idea of inevitability, have resulted in a tendency for these issues to lie either in the "too difficult" or "not our problem" basket. Well it is our problem. It's all of our problem. A culture that walks past inequality and discrimination creates a pervasive erosion of confidence in the whole service. It disincentivises a large and valued section of the workforce. And it impacts negatively on patient experience and safety.

We all deserve the same opportunities, the same timely honest feedback, the same encouragement or constructive critique. But the GMC's data clearly shows disproportionate fitness to practise referrals of ethnic minority doctors from employers and unequal outcomes in education and training.

This is not simply chance alone. It is time for concerted focus and collaborative action to level the playing field.

That's why we're setting out our ambitions and qualifying them with clear, stretching targets. Focusing on two persistent areas of disproportionality, our goals are:

  • To eliminate disproportionate fitness to practise referrals from employers, in relation to ethnicity and primary medical qualifications, by 2026.
  • To eliminate discrimination, disadvantage and unfairness in undergraduate and postgraduate medical education and training by 2031.

"An attitude of passive acceptance, and a misplaced idea of inevitability, have resulted in a tendency for these issues to lie either in the "too difficult" or "not our problem" basket. Well it is our problem. It's all of our problem. "

Dame Clare Marx

Chair of the General Medical Council

As the doctors' regulator, it's only right that we practise what we preach. That's why we're also setting targets for the GMC itself, including increasing progression and representation of ethnic minority colleagues at all levels and improving the gender and ethnicity pay gap.

There is a moral imperative driving this work – it is simply the right thing to do – but there is a practical one too.

Doctors who work in supportive, inclusive environments, underpinned by strong teamwork and open communication, deliver better care. So it's in all our interests to make this the lived reality for all doctors.

We all have a part to play in ridding healthcare of discrimination and inequality. The outstanding response of the service to the pandemic is proof of how much can be achieved when we pull in the same direction.

As we look towards a post-pandemic recovery, let's work together again, so every doctor can perform at their best and deliver the best possible care.


Dame Clare Marx, Chair of the General Medical Council