Discrimination in the discretionary points award scheme: comparison of white with non-white consultants and men with women

Methods and results

We used data for 2000–1 from the Advisory Committee on Distinction Awards for England and Wales and the Scottish Advisory Committee on Distinction Awards. These disaggregated data included date of birth, sex, ethnic origin, specialty, level of award or number of discretionary points held, and the year the awards or points were granted.

We categorised the ethnic groups Bangladeshi, black African, black other, Chinese, Indian, and Pakistani as non-white and compared these groups with consultants who described themselves as white. Consultants classified as from any other ethnic group and those who did not give their ethnic origin were excluded. We divided the number of consultants with discretionary points by the total number of consultants who did not receive distinction awards, as consultants without awards are eligible for discretionary points. We compared the proportion of consultants with discretionary points between white and non-white consultants and between men and women (table).

In England and Wales, white consultants had 1.37 (95% confidence interval 1.31 to 1.44) times as many awards as non-white consultants, and men had 1.25 (1.21 to 1.30) times as many as women; in Scotland the ratios were 1.34 (1.08 to 1.66) and 1.36 (1.23 to 1.51). The ratios increased with increasing level of award (table).

Comment

Non-white and female consultants may be disadvantaged under the discretionary point award scheme. The non-response rate of 16% (3597/22389) in England and Wales may have affected the results. To negate the differences, all the consultants who did not give their ethnic group and received awards would, however, have to be non-white. Non-white consultants are older when appointed, and, therefore, their period of eligibility for discretionary awards is less than for white consultants. Non-white consultants may also be concentrated in specialties which are less likely to receive awards. 2 3 The reason for differences in the number of points awarded to men and women is unclear, but differences could be due to discrimination.4

Points are awarded by local decision making groups which usually consist of three non-eligible consultants and three managers. The deliberations of these groups are not usually open to scrutiny. The lack of published data on the scheme locally and nationally is a continued source of concern. Employment tribunals have already found in favour of consultants who have alleged racial discrimination.5 Without effective monitoring, it is impossible to judge whether the scheme is operated fairly and without discrimination.