Y Pwyllgor Cydraddoldeb a Chyfiawnder Cymdeithasol

Equality and Social Justice Committee

20/11/2023

Aelodau'r Pwyllgor a oedd yn bresennol

Committee Members in Attendance

Altaf Hussain
Jane Dodds
Jenny Rathbone Cadeirydd y Pwyllgor
Committee Chair
Ken Skates
Sarah Murphy
Sioned Williams

Y rhai eraill a oedd yn bresennol

Others in Attendance

Debbie Eyitayo Bwrdd Iechyd Prifysgol Bae Abertawe
Swansea Bay University Health Board
Dr Robert Jones Prifysgol Caerdydd
Cardiff University
Dr Shanti Karupiah Coleg Brenhinol yr Ymarferwyr Cyffredinol
Royal College of General Practitioners
Farzana Mohammed Muslim Doctors Cymru
Muslim Doctors Cymru
Professor Uzo Iwobi Cyngor Hil Cymru
Race Council Cymru

Swyddogion y Senedd a oedd yn bresennol

Senedd Officials in Attendance

Angharad Roche Dirprwy Glerc
Deputy Clerk
Claire Thomas Ymchwilydd
Researcher
Gareth David Thomas Ymchwilydd
Researcher
Rhys Morgan Clerc
Clerk
Sam Mason Cynghorydd Cyfreithiol
Legal Adviser

Cofnodir y trafodion yn yr iaith y llefarwyd hwy ynddi yn y pwyllgor. Yn ogystal, cynhwysir trawsgrifiad o’r cyfieithu ar y pryd. Lle mae cyfranwyr wedi darparu cywiriadau i’w tystiolaeth, nodir y rheini yn y trawsgrifiad.

The proceedings are reported in the language in which they were spoken in the committee. In addition, a transcription of the simultaneous interpretation is included. Where contributors have supplied corrections to their evidence, these are noted in the transcript.

Cyfarfu’r pwyllgor yn y Senedd a thrwy gynhadledd fideo.

Dechreuodd y cyfarfod am 11:30.

The committee met in the Senedd and by video-conference.

The meeting began at 11:30.

1. Cyflwyniad, ymddiheuriadau, dirprwyon a datgan buddiannau
1. Introductions, apologies, substitutions and declarations of interest

Prynhawn da. Welcome to the Equality and Social Justice Committee. The main items on the agenda today are around our 'Anti-racist Wales Action Plan'. I've had no apologies for this meeting as all Members are present. Are there any Members who have a declaration of interest that's relevant to the agenda today? No. I see none. This is a bilingual meeting, so there is translation from Welsh to English available. Shanti, you wanted to raise your hand.

Yes. I just wanted to declare that I am one of the members of the workforce race equality standard steering group.

Great. That's lovely. I think the declarations of interest are mainly aimed at the Members, but thank you, anyway, for giving us that important piece of information.

2. Ymchwiliad i weithrediad 'Cynllun Gweithredu Cymru Wrth-hiliol': sesiwn dystiolaeth 3
2. Inquiry into the implementation of the 'Anti-racist Wales Action Plan': evidence session 3

So, just to introduce you all, we've got Farzana Mohammed, Muslim Doctors Cymru, who is present in the committee room; Debbie Eyitayo from Swansea Bay University Health Board; and Dr Shanti Karupiah from the Royal College of General Practitioners. So, thank you, all of you, for helping us understand the extent to which the NHS is tackling anti-racism.

In our previous sessions a couple of weeks ago, we heard mainly from educators plus Show Racism the Red Card, who obviously do a lot of work in schools. And we're aware that there are three racist incidents in education reported every day. Clearly, that's hugely undermining for educators and for encouraging more ethnic minority people to become teachers or teaching assistants. So, I wondered if you could tell us, in your view, what priority actions the Welsh Government should be taking to achieve an anti-racist Wales and step up the pace of change, particularly in relation to the health service. So, I don't know which one of you would like to start. If you could raise your hand if you're not in the room. Okay, nobody wants to start—. Right, okay, Shanti, please go ahead.

Firstly, thank you for this opportunity. I'm glad that we're having this important discussion. It's really important to discuss so that we know which phase we're at in tackling this important issue that's affecting many black and ethnic minority members in Wales. 

Just to start off, I think it's important to learn, to understand, to embrace and to accept that all of us have distinct and unique cultural beliefs, cultural identities and languages. It's also important that we continue to listen and initiate measures to tackle the issues that are being brought forward and have solutions or responses in place. Because most of the time, when we hear about any complaints, I think, for the person who is bringing forward this complaint, to ensure that they are listened to and that what they are mentioning is taken on board and that there is a response or a solution in place is really crucial for this action plan. Thank you.

Debbie, did you want to follow up, or are you happy with what Shanti has said?

Yes, I am happy with what Shanti said, but, just to add, in terms of a workforce perspective, it's really great that Welsh Government are working on the anti-racist Wales equality standards, because, in actual fact, that is a tool that will enable us to measure the experiences of ethnic minorities in the workplace and help us to put in place actions to address those. So, that's really important.

I suppose another thing, speaking from an NHS employer perspective, as an employing organisation, it's also really important that we have a multisector approach to it. In your example, Chairman, you mentioned schools. Many of our ethnic minority employees have children in those schools, and we have an approach whereby we're bringing quite a huge number, particularly of nurses, into Wales from ethnic minority backgrounds, and those people come with their families. So, it's really important for us, as a system, to work collectively to address this shared knowledge, and, in terms of Swansea Bay, we actually go into schools just to promote NHS careers, but also to show that we are diverse in our workforce as well, and to give those children examples of what a diverse workforce looks like.

11:35

What I would add from a workforce perspective is that the race equality standards are really important, and there is work being done in Wales for Welsh WRES on the back of work already being done in England. I would say that, because this work has been done elsewhere, it shouldn't take us long to repeat here, so we should be able to run with what works and reach up to where England is faster. Our demographics are different, our challenges are different, but we need the baseline data to begin where we're going to take action. So, that is one point that's really important.

The other thing, in terms of raising those concerns—. So, again, going back to the workplace, a piece of work was done with Diverse Cymru in terms of getting information around the lived experience of staff and also identifying policies and procedures that are in place within organisations within Wales. It would be interesting to see the outcome of that piece of work and what came from it. The one thing I would say from that is I did a similar piece of work as a clinical fellow in England, looking at the experiences of black and ethnic minority trainees, and one learning that I took away from my fellowship project was that I focused solely on the black and ethnic minority population, and I excluded the white British population from my survey. What I inadvertently realised later was that there is a viewpoint that they can share, which is most likely going to be the person witnessing something happening, and it was clearly evident from my results that I had excluded that from my survey, and, therefore, I was missing information. When I looked at the make-up of the focus groups for that piece of work, it was again targeting black and ethnic minority groups, so just to let you know we don't want to create gaps when we are collecting data as well.

We certainly haven't got time to be reinventing the wheel. If things are working well elsewhere, we should adopt them. How do you think the Welsh Government is ensuring that organisations like yourselves, who have responsibility for ensuring that anti-racist Wales actions are actually being implemented and having an impact—do you feel that all the organisations involved in the NHS are clear about what they need to do, have the resources to carry it out and are held accountable for delivering on those actions? Who'd like to go first? Debbie.

There was a lot in that question, Chairman.

Just thinking about how we've approached it in Swansea Bay, the action plan is very, very robust, and I think it's a really great action plan. It's clear in terms of what it's trying to achieve and we're given quite a good timeline to achieve it. It's a vision for Wales for anti-racism by 2030. So, in terms of that timeline, it's excellent. We were told in the action plan that we will be measured by it as health boards through our JET meetings, our joint executive team meetings, which they are beginning to do more robustly as well. For us, in terms of our approach locally, we started from our board. So, we developed our action plan, we consulted with our staff, and we provided board training. It does cost money, and that might be a bit more of an issue, given the current climate. But our boardwere trained in February 2023, and that training was undertaken by Race Council Cymru, as well as Heather Payne from Welsh Government, so it was about a cascade approach from the top down, but also involving our staff in terms of developing the action plan and moving forward.

And I think what we can do is do the things that we can do within the resources we've got, but it's also important that we measure the impact, particularly as we are becoming—as I said before, our workforce recruitment plan is to recruit from abroad, so it's even more important than ever. I think there's more work we can be doing, and, again, we're thinking about this locally with the local population, the public, because, from what we are seeing, all of a sudden, they are seeing more ethnic minority nurses. I think they're more used to doctors, but, seeing ethnic minority nurses, that's been a bit of a challenge that we've had to work through in terms of educating the public that they are competent, credible nurses who can provide great support and care for them, and that's what we're continuing to work with.

11:40

Okay, before I bring in other witnesses, I wondered if Jane Dodds can ask her question.

Diolch yn fawr iawn, Cadeirydd. Roeddwn i jest eisiau cadarnhau efo Debbie: roeddech chi'n defnyddio 'JET meetings'. Allech chi jest ddweud mwy am hynny, os gwelwch yn dda? Pwy sy'n cael eu cynnwys yn y JET meetings? Ydy'r Llywodraeth yn rhan o rheini, ac yn y blaen, os gwelwch yn dda? Diolch yn fawr iawn.

Thank you very much, Chair. I just wanted to confirm with Debbie: you used 'JET meetings'. Just tell us a bit more that that, please? Who is included in these JET meetings? Is the Government a part of them et cetera, please? Thank you very much.

So, Debbie, who's included in these executive meetings?

All the executives from Welsh Government as well as NHS Wales, Welsh Government, as well as our own executive team. So, all our board executive members are involved in that when we have quarterly meetings, whereby we're managed on our performance, and a part of that is how we're delivering the 'Anti-racist Wales Action Plan' in terms of our service provision as well as employment.

Thank you for that clarification. Shanti, did you want to follow up?

Thank you. I think I just want to say things—. From the start, actually, what's happening on the front line—. Honestly, I know we have this action plan, and it's brilliant, because I had a sight of it and we are going in the right direction, but it's not filtering down to the front-line team. Most of this information that we are working on, the front-line team are not aware, and we are facing regular discrimination, regular bullying and harassment, from just not within the organisation, but also members of the public, and we also need to ensure that this anti-racism action ethos filters through to the public, just like Debbie says. Because we are very much patient-facing, and it's important that we capture the experience of the staff who are facing this, because that is important, to use that as the way to move the plan forward. Because, at the end of the day, we want to eliminate the negative experience that the workforce is facing so that we can provide better care for the public.

While we're tackling workforce, I think we need to have a wider look at how we can also assist the public. Education is important—it's where are we going to capture and educate—and start from the early years onwards: what is it that makes us unique? What is it that makes us different? And all of us have different accents, and accent is not a measure of intelligence. That is crucial, because people come with a variety of skills and experiences, but, sometimes, it's this unconsciousness that's going on, that people see the person in front of them based on their colour or the way they speak or how they put language forward. All this matters when we're looking into leadership and recruitment, and also making sure that we're also looking into health and well-being. Health and well-being is very much being impacted because of this negative experience that the staff are facing. One of the things very recently that happened is COVID-19. We had information coming through, somewhere, in the pandemic that the black and ethnic minority workforce were at risk and that a large number of them were falling ill. I did the project in Wales, the all-Wales primary care occupational health and safety survey, and it captured that 65 per cent of the primary care workforce had fallen ill with COVID-19, and 41 per cent and rising are struggling with mental well-being. Mental well-being does not choose the race that you're from or the language that you speak; it can affect everybody, irrespective of what profession you are in. So, it's really important that we capture the essence of what the difficulties are, what we are facing, so that we can put appropriate measures in place so that staff are willing to stay.

There's a report from the General Medical Council that states that over 35 per cent of doctors in Wales are international medical graduates, and 28 per cent are international medical graduates who, after completing their GP training in Wales, leave for another UK country because of the experience that they are facing. It is really important that we capture this, and I'm glad that we have this work happening, although I wish that it was moving at a faster pace. But I appreciate that, for all of this, we need to gather data so that it's informed appropriately and we see what other measures need to be in place. Thank you. 

11:45

You raise some really important issues about how we engage the public in respecting all the people who are working so hard in the NHS, to support them. Clearly there's work going on in schools; what work is going on in primary care? Because that's where 90 per cent of people are using the health service. They're not going to hospital at all, from one month to the next. So, how are the leaders of primary care, i.e. the general practitioners, ensuring that their staff are protected from the public behaving in a racist manner?

It is not robust, I must say, and the data that's being captured by the workforce race equality standard does not include primary care, the survey that's being put out at the moment. I think they mentioned that, in this first round, they're going to capture what's happening in secondary care. And I was really pushing hard for primary care to be included, because at the end of the day, primary care is part of the NHS. The NHS is our biggest employer, and we're contracted by the NHS, and it's important that we include every person's experience, not just one. Including everybody is just being inclusive, not being exclusive just for one set of members of the workforce. So, that's really important.

As I mentioned, if you even just Google the data on social media now, there are so many issues, current issues being faced by the primary care workforce, not just GPs, because now primary care is not just GPs alone, we've got a wider team, a multidisciplinary team. We've even got social care. I think we really need to encapsulate everybody, because from the start, if we start with everybody included, I think we'll have a better picture than just doing part by part. This is my thought process. And a lot needs to be done. To answer your question, 'Is there much being done?' Not much. People are still struggling. 

Thank you for that honesty. Altaf Hussain wants to come in at this point. 

Thank you, Chair. My area of questioning is access to healthcare. What, if any, impact has the 'Anti-racist Wales Action Plan' had on the way black, Asian and minority ethnic people access our healthcare, and what action can be taken to make a real or tangible difference in providing it?

I'm here today to represent Muslim Doctors Cymru. We're a not-for-profit organisation, predominantly comprising healthcare professionals. We actually joined together in the pandemic because we felt, with the data that was coming out, the ethnic minority communities out in the public were missing out on the information that was vital that they needed in the pandemic, which then moved on to the resistance to taking up the vaccine and everything that was offered—for example, the PANORAMIC trial, to ensure that we could get diversity in trials. So, we got involved in the pandemic, and actually our role has continued beyond that.

What we've done is we've made a name for ourselves within the communities that we live in. Our unique selling point is a very simple one: we are the doctors—. I'm a pharmacist by background. So, we are the doctors and pharmacists who you see when you are unwell, and, actually, when you are well enough, we then give you advice as to how to stay well. Being that trusted face and a face that they can relate to that represents them—and representation is key to this—means that we can reach individuals. The other way of reaching individuals is to go where they are; rather than having an intervention and waiting for them to come to you, you actually have to find out where they go.

I can give you an example of a collaborative piece with the Welsh Government. It's done every year. Race Equality First hold a minority ethnic fair at Cardiff City Hall. We've attended that two years running. We go as volunteers. We have a group of doctors, pharmacists, medical students, and we go and we do population screening. We screen for atrial fibrillation, we screen for blood pressure, body mass index, and then we provide that advice to them. If that's in a language that they understand and we have the capability, we can do that as well. We've had some really interesting results and some really positive feedback. Even if one person off the back of a screening has to go into hospital and then have an angiogram done, for example, and then an intervention, that wouldn't have happened until maybe that person had a heart attack, for example; that has happened.

Then, we did a similar event in Newport. A gentleman came back, he's in his seventies or eighties, and he said, 'I never go to the doctors, never go to the GP, even when I'm unwell', and he said, 'I came to you for screening'. And he goes, 'On the back of your screening, you told me there was something not right with my ECG and that prompted me to go back to the GP'. He had a fast heart rate and he was on medication. And he came back the following year to do the screening again and share his story and that he wouldn't have gone. And he said, 'I just don't like to go to the doctor and I didn't know that I needed to go'. So, I just wanted to share that.

But what we are doing—and I would like to stress this—is a lot of our clinicians are NHS doctors and pharmacists, and we are working full-time. We are doing this in the evenings, on our weekends, and there doesn't seem to be anything, whether it be funding or whether it be support or working with other groups who are tasked to do this, for example—. We have the knowledge and the expertise that we can bring to the table, we do have links with the Welsh Government, Public Health Wales, within general practice, pharmacy, primary care, but the work that we are doing is off our own bat, and that will then lead to burn-out for the clinicians that are working with us.

11:50

Dr Shanti or Debbie, do you want to come in on this point?

Yes. May I step in—unless Debbie wants to go ahead first?

As a GP working at the front line, the issue that I'm seeing in areas where there is a high number of black and ethnic minority patient groups is language. I think it's really important that we make time to have LanguageLine. Communication is important, language is important. If you don't speak the language clearly, it's hard enough to express what's going on with your physical health, let alone your mental health. The practice that we have is that, when the patient tries to access us and then requests LanguageLine, we try to allocate sufficient time so that we can get enough information from the patient. It's important we use LanguageLine and encourage them to communicate. Because sometimes patients come in with family members; I really feel that's not safe. And it's not just primary care, it happens in secondary care. Because I can tell you about many cases where misdiagnoses or near-misdiagnoses happened because of poor communication. So, improving the communication line is really important.

The other thing is that there was a meeting recently on social prescribing, and I mentioned about language, and they said, 'Oh, yes, it's bilingual'. I said, 'No. Right now, Wales is very much multicultural; it has to be multilingual'. So, this is something that we really need to look into. Encourage language, encourage learning of language, to appreciate a different person's accent. Because sometimes, accent in a different community or different background can come across loud, if you like, or may come across as maybe they're trying to be angry, but not really. It's important we take time to understand a little bit about the background and the culture they're coming from so that we can better communicate and get the information that we want so we can provide the best care for them. Thank you.

Thank you very much. Farzana, you just pointed out about your project on awareness of vaccines. Can you tell us briefly about your project? I think you have projects where the aim is increasing the awareness of vaccines amongst the Muslim population.

11:55

It was wider than the Muslim population, but that's where it started from, because at the beginning of the pandemic what was happening was there was a lot of misinformation. The other thing that we need to talk about is language, absolutely. That then links on to health literacy—the understanding of the individuals about their own health. And then thirdly digital literacy as well.

What we found in the pandemic, the reason that we came together, was the misinformation that was happening on social media. All the information was going out on Facebook, on Twitter, on Instagram, but our older generation don't utilise social media—they're not posting anything—but what they are doing is they are phoning home, and to phone home they use WhatsApp calls, which are free over Wi-Fi. Whilst they have those channels open, what was happening was they were getting messages back from whatever groups they were on, and most likely YouTube videos. It was that misinformation from videos, because they can watch, listen, interpret, and then take away more from a two-minute video clip than they can from a poster on social media or someone telling them something. That is why we came together.

We did a lot of myth-busting videos regarding COVID, which then moved on to further myth-busting videos regarding the vaccine, and then trying to get our communities to take up the vaccine. We did webinars, to answers questions that they may have as to why they were hesitant to take that up. We gave them accurate, up-to-date information on statistics, and were there to answer their questions. Then, finally, we went and we set up the first vaccination hub, which was in the Newport mosque, and we did that back in February, literally as the vaccination programme started. We had a huge response, and moved to Cardiff and just widened that. We formulated a blueprint that works, which is have your intervention, take the key people with you, and then go to where that population is, because if you can't reach them any other way, they are somewhere, and they're never hard to reach if you have the means and capacity to go and make that intervention. And utilising the mosques, we were able to capitalise on the congregation. And actually, during lockdown, we also managed to reach the local rough-sleeper population, which was very close to the mosque in Newport.

So, we went with the intention to vaccinate the local Muslim community, but we quickly realised that with lockdown they were praying at home, so we didn't think that bit through, and we then used that opportunity to look wider as to who else can we reach. Two doors down from the mosque was the food hub where they were getting the food and lunch, and there was no problem at all in going into a mosque as a non-Muslim. No-one at any point had any qualms about that. They just couldn't reach the place of vaccination centres, because you need transport. You need money to catch a bus. All of these factors are the factors that stop somebody from getting it, and then there's also the level of understanding—'Do I want that intervention?'—as well. So, it was multifaceted, but we learnt a lot from that experience.

So, there were a lot of good lessons that you learnt. And now, with regard to religious identity, including how it intersects with other identities, it has the potential to impact on the quality of healthcare and health outcomes, because of perceived negative stereotypes. To what extent does the 'Anti-racist Wales Action Plan' reflect these concerns? Do you think it's all in that?

I think it covers it from an intersectionality point of view. It really depends on the interventions that you target. There are some areas of intersectionality that we try to cover where there are taboos. So, we do a lot of myth-busting around taboos. If there is anything that impacts from a faith perspective, then it links to ethnicity, because faith varies within south-Asian communities, and then you start to dig deeper and no two people are the same. Areas that we have done work in include mental health specifically, because there are a lot of taboos around medication, there are a lot of taboos about acknowledging that you may have mental health problems or even understanding what they may well be, and then there's a religious connotation, especially when you go to conditions such as schizophrenia, depression and actually how it's perceived within the communities as well. So, we do a lot around education, and we've actually been approached by third sector groups like the Bangladeshi women's society. We've done two sessions with them. They've found it really helpful to have clinicians from the backgrounds of the individuals, answering the questions in their language, and it was a women-only space as well—sometimes that is really important. And we find that accommodating to the best of our ability means that we're getting better outcomes.

12:00

Thank you. I want to bring in Sarah Murphy at this point, as she wants to pursue some of these issues.

Good afternoon. Thank you, all, for being here today. I'm going to pick up a little bit more on what you've already touched on, which is the language barriers and the access to interpretation, specifically. So, it'd be good for us to know why you think that people face language barriers when trying to access health. What are the main factors that contribute to this? Is it policy or processes, is it funding or the behaviour and knowledge of the workforce, or do you think it's a combination of all of those factors?

I think the combination of all of the factors—it's multifactorial. And, on top of that, we have a huge shortage of workforce in primary care, including secondary care. So, when people are overstretched and exhausted, they're really trying to find that strength to pull out, just to spend the extra time, but that's not coming forward at the moment. The struggle is real, because the workforce are struggling with exhaustion and fatigue, like Farzana said, and there's also decision fatigue because you don't have time, because you're trying to see many people in a very short period of time. We want to make sure that we are actually thinking about differential diagnosis. So, language is crucial. It's hard enough, with people who speak English and Welsh, to try to put forward what is going on with their physical health and mental health; imagine how hard it is if they can't speak the language. So, they resort to second-hand information or social media information, and it's really hard. And, on top of that, we also have this gender bias as well—a difference of how a man would approach their health and how a woman would, and how men and women from different ethnic backgrounds approach this. There are lots of taboos, like Farzana said, and there are a lot of cultural beliefs. It is really important that we learn about the different cultures and the belief system, and use this in a non-judgmental way to provide the service that our population really needs. By looking after the workforce, we're actually looking after our population, and this is my thought process. Thank you.

Thank you. Can I just ask a follow-up question as well, for anyone else wants who to come in? I've heard cases as well where, sometimes, patients' children are brought in to interpret for their family members, which is very concerning, because, as you touched on, all of you today, with the kind of information that's being discussed and the questions that have to be asked, it's not always appropriate—well, it's never really appropriate—for that to be the case. I've seen this happen. I know that, in primary care, I think, this is more common, and I was just wondering as well, just to build upon what we were talking about and what you said about what factors contribute to this, if you're aware of this happening as well, and if you think that that's contributing to children being used as interpreters as well.

Absolutely, without a shadow of doubt. I see this often, because sometimes the patient says, 'Oh, I came last time. They didn't have LanguageLine, so I brought my son with me'. Even harder. And there are cases where the son says one thing, because mum is so embarrassed to say the things that she wants to say, and he interprets, as best he can, and then there's a missed opportunity, near misses and misdiagnosis. I mentioned this case in the last Senedd meeting as well: I saw a late 50-year-old woman coming in with recurrent issues with urinary tract infections, and I happened to be locuming in that practice. She came in with her son, and then the son looked frustrated. I can see multiple contact with the surgery, and she was even admitted to one of the A&Es in London for similar problems, treated for UTI. So, when she came, I said, 'I'll use the LanguageLine'. Her son said, 'No, no, no, I can speak the language fine'. You know, you're so proud that he can speak the language—and I don't want to take away that from them—I asked the patient, 'Is it okay?'. Mum said, 'Okay', even though I'm not happy at all, and I said, 'Okay, let's do it part way—let's start off and then we start off with the LanguageLine, if needed', because I wanted to compromise and I didn't want to put them off. They were agreeable. Then I realised that what the mum is saying—I don't speak the language; even though we are Asians, I don't speak the language. I told the patient, 'Is it okay if I take you behind a curtain and we'll do some perineal examination?', and she said, 'Okay', because I suspected something else. When I did the examination, it turned out she had cervical cancer, and when I referred her as a USC—urgent suspected cancer—it came back at stage 4. And this is something that, if we had used LanguageLine appropriately, from the start, there's a possibility we would've picked this up earlier. Because of the communication issue, this was missed.

12:05

Thank you for sharing that example. That's really powerful. 

Just very quickly, can I ask Debbie whether you would normally have the appropriate language interpreter booked when there's a planned secondary care consultation going on? 

I don't think it's across the board, I would say. There are some times when we just don't have it in place when we should. It is really challenging, I think. And I think the other thing in terms of the access, which I just wanted to add, is that there is something around us building trust with our ethnic minority population because, in actual fact, sometimes they just don't trust us and that's why they bring the family member to be by their side and interpret for them. We've worked in Swansea quite closely with the Ukrainian refugees and we've had some examples of that, working with them in terms of the mental health and psychological support for them. In actual fact, we were quite fortunate; we had a psychologist who was from Ukraine and had actually worked across the border in Romania. So, he was able to come back with some experience of that and support people to come out of their shell, and actually ask for help as well. 

As Shanti was saying, sometimes we need to think about the cultural aspects of people, because some people are quite proud. They don't want to be in these situations sometimes, or in those positions. So, it is about us, as healthcare professionals, building that trust with the community groups and breaking down those barriers. So, this gentleman who went in to work with the Ukrainian refugees was able to help them and intervene in terms of mental health support. But, also, people came with children. So,actually, at one point, he went into schools to go and help educate the teachers around supporting these children. So, it is very multifactorial, as Shanti was saying. It's not easy and, even if we did have LanguageLine, that's not the total solution.

Thank you very much. That was just going to be my question, really: what further action would you like to see, because the action plan does very little to address the language barrier issues in healthcare? Would you like to see a specific part of the plan that addresses this?

Can I take that one, only because there's work happening in this area? So, as I mentioned, I'm a pharmacist by background, and primary care includes general practice but also includes community pharmacy. One of the fellows working with me did a fellowship project looking at the access to interpreting services within community pharmacy. It was a big project done in England. That has subsequently gone to the General Pharmaceutical Council, who did a round-table about a month ago and then came back out to pharmacists to get their opinions on this topic, and the report is due out. They are looking at solutions for community pharmacy so we can work more professionally and learn from each other, and take some of those actions forward. That was just to make you aware of that.   

That's excellent. It's good to hear the stuff that is happening, and also examples of good practice as well as the examples where things have gone very, very wrong. So, thank you, all, very much, and thank you, Chair. 

Fe wnaeth Debbie sôn yn gynharach am bwysigrwydd y grŵp anghydraddoldebau iechyd y gwasanaeth iechyd, ac felly hoffwn i ofyn cwestiwn cyffredinol. Rŷm ni wedi trafod rhai o'r enghreifftiau penodol o'r anghydraddoldebau hynny a'u heffaith nhw, ond, o ran y grŵp a gwaith y grŵp, ydych chi'n gallu rhoi unrhyw enghreifftiau o ba gynnydd sydd wedi cael ei wneud i nodi'r rhwystrau o ran mynd i'r afael â'r anghydraddoldebau yma, a sut gellid mynd i'r afael â'r rhain? Sut gall y grŵp fynd i'r afael â'r rhain yn effeithiol? 

Debbie mentioned earlier the importance of the health inequalities NHS group, and therefore I'd like to ask a general question. We've discussed some of the specific examples in terms of those inequalities and their impact, but, in terms of the group and the group's work, can you provide us with any examples of what progress has been made in identifying the barriers to tackling health inequalities, and how these can be addressed? How can the group address these effectively? 

That's for me. So, the group I'm involved with and I'm aware of is the workforce race equality standards group, and that's the group I also sit on from an NHS organisation's perspective. That group has really picked up the work from England, and we're learning from the mistakes that were made in England, actually, to build on something that would be helpful for Wales. So, at the moment it is really around the data capturing stage, understanding what we've got and how we can utilise that to measure impact. So, it's really in its infancy at the moment.

Locally, within the organisation, we have a strategic equalities group, and, again, that has only just started on the back of the 'Anti-racist Wales Action Plan'. So, I would say a lot of this work is still in its infancy, so it's really difficult at this point to measure impact. The good thing is that it's on the agenda and we are focusing on it, and I think that is helping us to get somewhere. From my local perspective, about 15 per cent of our nurse workforce are from ethnic minority backgrounds. We’ve got 29 per cent of doctors from ethnic minority backgrounds. So, it’s a huge focus for us locally as a health board. We work with agencies to bring nurses from overseas into Wales, and it’s their first time outside of their home country, most of the time. Therefore, for us, it is about us integrating our nurses—because predominantly they’re nurses—into Wales. So, it’s not only into the workforce, but also into Wales itself, understanding the culture, helping them to have access to schools, bank accounts, all those sorts of things. So, that’s the type of work we’re doing. Again, like I said, it’s not something we’ve been doing on a long-term basis, so it’s difficult to measure impact at this stage. 

12:10

Diolch. Allaf i jest ddilyn lan o ran cleifion, wedyn? Fe wnaethoch chi sôn am ddata, ac rydyn ni wedi cael tystiolaeth yn dangos i ni fod cofnodi ethnigrwydd cleifion yn amrwyio'n eang iawn o le i le, a hefyd o ran y mathau o driniaeth maen nhw'n cael. Sut gallem ni fynd i'r afael â hynny? Pam ŷch chi'n meddwl bod hynny yn digwydd?

Thank you. Could I just follow up in terms of patients, then? You mentioned data, and we've had evidence showing us that the reporting of ethnicity of patients varies significantly from place to place, and also in terms of the type of treatment they receive. How can we address that? Why do you think that happens?

I don't think I'd be the best person to answer that question. I don't know, but I can find out.

I think data capturing is really important. We need to make sure that we have audits in place. I did reach out at a number of clinics who are working in the maternity unit to find out about the awareness of our maternity and neonatal safeguarding programme that was launched last year. What I found out was very interesting. The doctor groups were not aware, and only a few nursing staff were aware that it is happening, and they have seconded a number of staff from different health boards to do this project. So, awareness is of paramount importance when you do this kind of project and framework and planning. It's important that everybody is aware, everybody is on the same start-off platform, has understanding and has an idea what's going on, so they can contribute to this project. It has to be everybody involved equally—a collaborative project. Otherwise, we won't be able to move. 

Again, to answer the question you asked, data capturing is really important, which has been not very robust to start off with. If we don't capture the experience of patients and of our workforce, and analyse it appropriately so that we can actually respond appropriately, we are not moving anywhere—we are still where we started. So, I think data is really important. We need to make sure we have something in place to capture this so we can analyse it appropriately and we can respond to it with an independent panel. That's crucial.

We also have something called— just to add—a 'speak up' framework that was launched in September this year. It's really, really crucial that we have an independent panel and that they're reporting. We also need a monitoring system to capture racism complaints and all that. We need to have all the systems in place so we can capture, analyse and respond to eliminate and resolve the issue.

From my perspective, workforce inequalities and patient experience inequalities are linked. If your workforce are having a particularly bad experience, the care they provide is demonstrated to be worse for patients. And it's the mechanism to collect that stuff—so, patients surveys—and they will then turn around and say, 'We had a very poor experience'. If that happens to ethnic minority communities—and they don't access our services that often—and they have a poor service, they are even less likely to go back in future. So, that's the first point.

The second point is that when you look at maternity statistics, for example, we all know the statistics: black women are four times or five times more likely to have an adverse event going to the hospital and having a baby. And we know the data. Now, in pockets of places in England, people are moving to interventions. Rather than having equal interventions, they're actually having targeted interventions, where they are actually having interventions with black women only. So, I went and listened to someone's presentation. It was really interesting because somebody else said, 'What about Asian women? And what about— ?', and they said, 'No, we want to make a difference and we want to change the experience of black women, so we're doing this project'. And whether it was coffee mornings or whether it was helping them with the babies post delivery, whatever it was, they did quite a few interventions and it was specifically targeted at black women. Everyone else was not allowed. And they made huge improvements. So, that was really eye-opening. So, if you know where you want to target, go for that, that population.

And there's a lot of research and information out there. England has the NHS Race and Health Observatory and they are doing lots of targeted interventions, lots of research, good-quality commissioning of universities to do pieces of work for them. That is open to all and can be utilised. And they then delve deeper within the ethnicities and target groups that they know fare worse because of the colour of their skin. So, we may well need something like that to help you push your 'Anti-racist Wales Action Plan' along as well. So, there are quite a few areas there.

In terms of the population itself, there are quite a few things. For me, I'm a pharmacist, and I know there's a lot of work in health inequalities, and community pharmacy will come to its fore, I would say, in the next four to five years. And one example from community pharmacy—. The thing that the pandemic showed was that they were opened up and when patients couldn't go anywhere else, and it was a frightening time, they could walk into a pharmacy. But we are having closures of pharmacies now as well and it's more likely that if a pharmacy closes, it will close in a deprived area.

But prior to that the statistics were showing that 80 per cent more pharmacies are in deprived areas; they're providing more services. And if we're addressing health inequalities then it's access, and these under-served communities that are finding it difficult to pay to reach a hospital or catch a bus, they can walk in. They're within 10 to 15 minutes to a pharmacy somewhere, and so they can walk in. They don't need an appointment. They might be asked to come back if it's busy at that point. There is no booking system and that then helps with any digital exclusion. And there has been more money ring-fenced with Welsh Government, and I know with the chief pharmaceutical officer's team and Community Pharmacy Wales. That is one way forward, and I think we will see huge benefits, especially with pharmacists becoming independent prescribers as well.

So, there is a lot happening on the horizon. We may not see it right now. But when your pieces come into place by 2030, there will be a lot more in place by then, and to answer a lot of those questions.

12:15

I'm not sure. 

No. Okay.

Diolch. Un cwestiwn olaf, felly. Rŷn ni wedi sôn yn benodol fanna am un maes penodol sef edrych ar famolaeth a gofal newyddenedigol. Rŷn ni wedi cyffwrdd â hwn yn gynharach hefyd sef cymorth iechyd meddwl, ac rŷn ni'n gwybod bod pobl ddu, Asiaidd ac ethnig leiafrifol yn llai tebygol o gyrchu cymorth iechyd meddwl yn y sector gofal sylfaenol drwy feddyg teulu, ac felly, wrth gwrs, yn fwy tebygol o wynebu argyfwng yn y pen draw. Felly, pa gamau gallwn ni eu cymryd i fynd i'r afael â'r mater hwn yn benodol?

Thank you. One final question, then. We've spoken specifically there about one specific area, looking at maternity and neonatal care. We've touched on this earlier as well, namely mental health support, and we know that black, Asian and minority ethnic people are less likely to access mental health support in primary care through a GP, and therefore, of course, are more likely to end up in crisis, ultimately. So, what steps can we take to address this issue, specifically?

Can I just say?

Yes, I think, again, like we've spoken about a communication barrier, I think communication is really important. For this particular group of patients, there is taboo around that, just to talk about it, to acknowledge themselves that there's an issue. They worry that they'll be judged and they worry that they cannot communicate what they're feeling. There are a lot of things going on here. I think it's important that we have a proper workplan for this specific area. I know that there's a lot of work going on in terms of mental health and well-being per se, but again, as Farzana said about a targeted approach, this should be an area that we need to target and put measures in place so that we can capture it better.

I see a lot of patients—. In fact, depending on where I'm working, more than one third of my patient list is people struggling with mental health and with their well-being generally. And I hardly see people from different race backgrounds, black or ethnic minorities—it's very rare. And that, again, rings an alarm, because I do hear, outside of the workplace, that people are struggling, but it is, again, a cultural belief that they want to keep everything within the family. It's something that I think we need to encourage people to talk about, to make sure that it's normal to talk about and it's okay. And this is something that I'm seeing a lot amongst younger patients as well. We're seeing lots of children and young adults coming to the door, and the pandemic also has had a lot to say for this issue.

12:20

Yes, and the thing that I'd echo is that there's a lack of culturally appropriate well-being services, and that is a big issue as well. And that came out of—. From a professional perspective in my fellowship project, I subsequently joined the professional support and well-being service in NHS England, so I work with doctors who are in training, and then, if they need support, they can access this service. Health Education and Improvement Wales have a similar service for their doctors. It's not just these communities, it's also the black and ethnic minority workforce we have as well, and what they say when I talk to them is that, just when they know that they're going to speak to somebody, first and foremost, when my name comes up, they go, 'It's just a relief'. They see the name and they think, 'I can relate to that person'. So, I've had that comment.

The second comment I've had is, if they didn't clock the name and the screen comes on—it's on Teams—and they see me and they straight away, visually, have a sigh of relief, 'I think I can relate to this person'. That's without even having a conversation. So, representation matters. It matters all the way through, whichever service you're accessing, because you want to feel comfortable accessing a service and get the best out of it. So, that is something that we haven't got right yet, and when we bring these topics out more and they are being tackled, I think you will have that representation.

And the final thing is third sector charities, et cetera, as they play a huge part in this. So, professionally, there are a lot of charities supporting the professions and also I think out there, like I mentioned the Bangladeshi women's group, there are a couple in Cardiff, and Time to Change. So, there are a lot of these other groups, please don't forget them, because without them, we wouldn't be able to cope with the requests and the volume that we have.

Very good. Jane Dodds, would you like to come in here?

Thank you. I just wondered if I could just follow up on that, if that's okay. I'm just interested in this issue around mental health and diversity. I think it's right that black women are far more likely to be detained under the Mental Health Act 1983 than any other cohort of the population, and black people are something like 11 times more likely, once again, to be detained under the Mental Health Act. I just wondered if you had any good practice that you could cite. We heard a little bit there—thank you—around engaging with Bangladeshi women. But what are the barriers to the good practice that would avoid that significant disproportionate representation of people in terms of either sectioning, as we call it—Mental Health Act detentions—or even earlier in the process? Just really quickly, what's the good practice and what are the barriers to actually enshrining that good practice in our services in Wales? I don't know who'd like to go first. Who would like to leap in on that?

I can, if no-one else wants to. I will direct you back to the NHS Race and Health Observatory, who have specifically looked at this question, and it may not have been black women, but definitely the black ethnicity group and the fact that there's more chance of them going to prison, being triaged and then it's been realised that they should have gone to hospital, and then getting somebody out.

I also work in NHS 111 in Wales, and we do get calls when someone is admitted, from a medication perspective generally, to get that verified so they can carry on treatment. But it is widely known that if it was somebody who was white British ethnicity in the same circumstances, they probably would go to hospital, but somebody from a black ethnicity would probably go to the police station and from there go to the hospital. So, again, there have to be some factors, whether it is bias, discrimination or racism, which is why we're here today, that fits to that. The research has been done by the NHS Race and Health Observatory, which you will find interesting and will answer your question.

12:25

Thank you. I'm sure we'll look that up. It's still concerning, and I'm sure we can find that report, but I wonder if it's that training or awareness raising, funding for that across the services that may respond to people who have mental health issues. But I'm happy to take that forward.

So, I just have a very brief question for you all, really, and that's around the system and the processes to address complaints of racism or discrimination within our health services. I wonder if I could ask you, in turn, do you feel that they're good enough, and if they're not, what we can do to improve them. I don't know who would like to go first. Debbie, maybe you, from the perspective of Swansea. Thank you. Diolch yn fawr iawn.

Thank you. So, we have the violence and aggression policy, and that really was developed to cover issues of misconduct in general in terms of violence and aggression. But I think what we have realised, and this has been brought about by some of the incidences we've had to manage in terms of patient aggression, is that it needs to be amended, and we are in the process of doing it. It's an all-Wales document, really. It needs to be amended to incorporate racism and that sort of action, because I think that document predates the action plan, so it really doesn't address those kinds of misconduct appropriately, and what we do in terms of when there is aggression from patients. So, that's in terms of the patient-staff aspect. What we are also doing locally is developing an unreasonable behaviour guidance. Again, that is to support everyone involved to be able to address these issues.

What we have seen is that when, for example, there's been racial abuse against a member of staff, those around are frozen into inactivity. So, it's really supporting them to think about what they can do, the bystanders, and how they can support these individuals. Also, of the patients, we have other patients who witness it who think, 'This is shocking. I find this very distressing'. Because it's all very new, we're trying to put something together to address that, thinking about, actually, if there's even really bad behaviour from the patient, how we give a warning, and then actually decide, 'Well, we're not going to offer any more treatment for the protection of our staff'.

The other thing that we have done is we're working with the community safety police in south Wales, so that, again, this is multidisciplinary and a multisystem approach to this. They want to engage with us around hate crime, and also, basically, provide a presence in the hospitals that would be of benefit to staff and patients around this matter. So, again, it is work that is ongoing, but it's really, really important. I think, because we've seen similar incidents happening in schools, transport and other areas, it would be really great if we could all get together and just have a system solution to this. Thank you.

12:30

May I just step in and just mention about the workforce issues, the negative organisational culture that we're facing at the moment? Yes, I'm here representing RCGP Wales; I'm also a member of Morgannwg local medical committee, and I hear a lot of issues from doctors and staff coming through the door. We provide pastoral support. We try to bring forward these complaints as much as we could, reach out to the British Medical Association and so forth, but what I hear all the time is: there is no independent complaints capturing system in place when it comes to racism; there is no independent analysis or independent panel to look into it. It's difficult; when you are complaining about somebody in your own organisation, people feel very uncomfortable. They will just try to tolerate as much as they can, but it's not good; when you internalise, you're going to not only get physical symptoms but mental symptoms as well, and it's not a very nice situation to be in. And what, when somebody complains, they are looking for is a solution to the problem—not just listening, they want a solution to the problem they are facing. So, it's really important to have an independent panel of people looking into this, because I can say from experience, talking to various members, they will not complain if they have to go back to the same organisation, talking to their line manager about the problem they are facing. It's really hard.

Thank you.

Diolch yn fawr iawn, Cadeirydd. Yn ôl i chi.

Thank you very much, Chair. Back to you.

Back to you, Chair, because I think—[Inaudible.]—time limit.

Okay, thank you very much. I think, Ken Skates, you wanted to follow up on these very issues.

Yes, thank you. Just any more observations, really, that you might have on anti-racism education and training within the workplace. What more could be done in terms of accessing, ensuring that there's access to training, and are there any further steps that you think should be taken to address bullying and racism in the workplace, such as red card systems, any other ideas that you might have?

Yes, I'll start. Yes, I think there is significantly a lot more we can do around the education and training, and I have a slight fear, because of the financial position, that that might not be a priority. Like I said earlier on, we have supported the development of our board. We've incorporated now equality and anti-racism objectives in our senior leadership's objectives, but there is more to be done around filtering that down. We do have mandatory training for equality, diversity and inclusion, but I think there is more to be done with the workplace around managing, for example, a multicultural workforce, and what you need to do to support that, how you can identify talent.

So, I think, like I think I said earlier, for us, as employers, it's our responsibility to ensure that we can develop what we can with what we've got, within the resources we've got, but, hopefully, it'll not fall off the radar, and it will not be considered as less important.

Again, I think—. I'm glad you pointed out the yellow, red—amber, red— card system, again, I think that's really important, but it would be unfair to do so if we haven't worked within our population group to really get them to understand that Wales is a multicultural population and the workforce is multicultural, and to instil confidence that you're still going to get high-class healthcare, even probably excellent healthcare, with the people who are taking care of you.

So, again, I think that's not down to one employer. And again, as a NHS system and with support from Welsh Government, that's something that we should do in terms of reaching out to our population, and really supporting that. And it's not going to be a quick fix; England have been like this for years and they're still not there, let alone us in Wales, where we're just building up this workforce.

12:35

Okay. Fine. Just a couple of things from me. I just want to go back to what Farzana was saying near the beginning of this session, which is around the fact that you're a voluntary organisation and you don't feel there's anybody else really doing the sort of outreach work that you've been doing, initially provoked by the COVID pandemic. So, where are Public Health Wales, then, because this is the sort of preventative and early intervention work that I would expect them to be doing? Do you not collaborate with them at all?

We collaborate with them, and some of the data that we have is from them. I'm probably not the best person to answer your question because, obviously, I have 10 other members with me, but they have numerous meetings with Public Health Wales, and then we work collaboratively with them. So, for the current events that we're doing, they are there with us, but they will be coming in their work hours with their work uniforms on if it's a weekday, whereas we would be taking annual leave from our day job, which doesn't match this, to come and help and support them to do the clinical aspect of it. 

Okay. Thank you. I've got one other question for Debbie, which is: what happens in the emergency department, when you get somebody coming in who doesn't speak very much English or Welsh? Clearly, it's an emergency; do the emergency staff have, if you like, priority access to a language—? Because clearly we need to know if somebody has swallowed something that's going to kill them or whatever it might be. How does it work in Swansea Bay?

Again, I might not be the best person to give concrete details, but I know that in the emergency we would try to get hold of LanguageLine but also ask whether there are multilingual or bilingual staff, if it's an urgent situation, as well as family members who are there. That's what we tend to do. 

Okay. All right. Are there any other Members who—? Altaf, you wanted to.

Yes. Some participants in the COVID-19 inquiry have questioned the role structural racism played in the higher death toll among the BAME community. Do you believe that the 'Anti-racist Wales Action Plan' will help address structural racism in healthcare?

You kept this question until last? [Laughter.] I believe so, and one of the reasons why I believe so is that there is more knowledge about it. So, as we talk more, the key is—. Education is one aspect of it, and that's to educate from the top at board level and have key performance indicators that drop down and actually are checked in on. We probably need champions for your plan within health boards, and that should feed back into the board to say what they're doing and into those key performance indicators. We have to start in schools and training programmes.

In terms of pharmacy, all of the foundation training is done through Health Education and Improvement Wales. I do the pharmacy training on micro-aggressions, and what I've learned is that, as our youngsters are coming into the workplace for the first time and they haven't actually gone in yet, they don't necessarily know. So, they might have experienced some things within the school setting, but, when you go into the workplace setting, it is totally different, because you're working, you could be full-time, you could be studying, and there are immense pressures.

And then, likewise, when I talk to the doctors who have been in training for a lot longer—and I've done these sessions with educators—the doctors are telling me that the sessions are fantastic for the person who is experiencing this, but you have to train the educators. And I was vehemently told, 'You've got the wrong people in the room', when I did this. And I said, 'I am doing this with educators, but I'm not mixing the two of you together, because I do feel that would make the conversation difficult. So, I will take your concerns back.' And I had a really enlightening conversation with the educators, who said, 'You're in a catch-22, because you know about this, you are educating and signing off portfolios, and then something may happen and then you, yourself, feel, "Have I done something wrong?"' There is a lot more education out there, that is the key.

We need safe spaces. It needs to become normal to talk about anti-racism. If you want to be an anti-racist Wales, we need to talk about the steps to get there and that, actually, it's normal. It can be uncomfortable to use the word 'racism' because of the connotations of what it actually means, so we have to become more comfortable in the language that we use and what is okay, and not feel like you're going to get targeted for that. And then, if we create safe spaces—and I guess that should be organisational—we can do it within professions and staff networks, and then I think that will lead back out onto the population and the impact that it will have there. But it will take small steps and everyone working together to do that.

In terms of the structure, there are some things that may not change at all, but, if we change what we can, I think, slowly but surely, we'll chip away at it.

12:40

Very good. I can't see any other Members who wish to ask a question. Oh, sorry, Sioned.

Ie, jest yn gyflym iawn. Rŷn ni wedi trafod eithaf lot ynglŷn â'r gwaith sydd wedi bod yn digwydd yn Lloegr, a cymryd hynny i ystyriaeth wrth inni ddatblygu cynlluniau fan hyn, ond fe soniodd Debbie, dwi'n meddwl, ynglŷn â rhai o’r camgymeriadau—dŷn ni ddim eisiau ailadrodd rhai o'r camgymeriadau. Oes unrhyw enghreifftiau cyflym gyda chi o'r fath o beth roeddech chi'n ei olygu wrth y ffordd maen nhw wedi gwneud rhywbeth yn anghywir yn y ffordd maen nhw'n taclo hyn yn Lloegr?

Yes, just very quickly. We've discussed quite a lot the work that's been happening in England, and taking that into consideration as we develop plan here, but Debbie, I think, mentioned some of the mistakes that we don't want to repeat—that we don't want to repeat some of those mistakes. Are there any quick examples that you have of what you meant in terms of what they've approached wrongly in the way they tackle this in England?

Yes, well, a prime example is actually the workforce race equality standards, which have been going on for many, many years in England, and, in actual fact, we are here in Wales in a really good place to learn from the mistakes that have been made, and that's the approach that we have been taking with that, implementing that. For example, in England, it just became a data collection exercise, which was extremely onerous, but then, in terms of the results and impacts, you just never got it, because you were consumed with collecting data. And also it was used almost like a stick, as opposed to a carrot, in terms of supporting improvements. Again, we don't want to be in that place in Wales. I think we need to see it as a really positive tool that will enable us to collectively develop and produce change in our workforce in the way that we treat ethnic minority people—service users as well as our staff.

Thank you very much. And on that very positive note, I want to thank you all for the excellence of your contributions. We've had a really, really interesting session, where we have captured an awful lot of information. We could have gone on for three days, but we haven't got three days. So, I want to thank you very much indeed. You will be sent a transcript of what you have said, and obviously you need to correct it if we've misheard you, but also, if there's anything in particular you want to add as supplementary evidence—if you have the time; I appreciate you're all extremely busy—then we're very open to that. So, thank you very much indeed.

Members, we'll now take a break until—. I wondered if we can resume for our final session for today on the 'Anti-racist Wales Action Plan' at 15:30—I beg your pardon, 13:30. So, for the members of the public who are interested in this subject, please do rejoin us at 13:30, and I wonder if Members can just come back a little bit earlier than that so we can start on time.

Gohiriwyd y cyfarfod rhwng 12:44 a 13:32.

The meeting adjourned between 12:44 and 13:32.

13:30
3. Ymchwiliad i weithrediad 'Cynllun Gweithredu Cymru Wrth-hiliol': sesiwn dystiolaeth 4
3. Inquiry into the implementation of the 'Anti-racist Wales Action Plan': evidence session 4

Welcome back to the Equality and Social Justice Committee meeting this afternoon. We are now going to have our fourth session on the 'Anti-racist Wales Action Plan'. I'm very pleased to welcome Professor Uzo Iwobi from Race Council Cymru, who is joining us online, and Dr Robert Jones from Cardiff University, who is with us in the Senedd.

Dr Jones, I just wanted to ask you, picking up from your paper—. The Ministry of Justice paper, 'Ethnicity and the Criminal Justice System, 2020', and the Lammy review both identify that minority ethnic groups are over-represented in the criminal justice system, but then you're able to tell us that Home Office data shows there's a disproportionate use of stop-and-search on black and minority ethnic groups in Wales. So, we have some data that tells us what's happening in Wales as opposed to just putting together England and Wales. How come the Home Office is so much better at doing this than the Ministry of Justice?

So, the Home Office data was gathered through freedom of information per 1,000 people. But one of the things I would say about the Home Office, which is where that point does stand, that it might be a bit better, is that, of course, a lot of the data is done on a police force level, which, therefore, makes aggregating it to the Wales level a lot easier. The Ministry of Justice is far more territorially and almost geographically illiterate in terms of how it maps the system. So, it's got this bizarre thing about regions, firstly, which is actually quite good for Wales, because Wales is, some would say, obviously, not a region, but it's a region of that structure, but then it will also break it down into other smaller regions within the region. So, the Home Office data, just by virtue of the fact that it's broken down by force level area, is better to understand the Welsh picture than the MoJ's.

Okay. So, what action do you think is needed to deliver a much less racist criminal justice system in the light of your research?

Well, that's a huge question. I mean, I think we're talking about systemic change across the board. I don't think that's the first time that's ever been said. I think, here in Wales, though, as to the answer to that question, we cannot get at that question within the nature of the current dispensation. I mean, if we're talking about this strategy that you're scrutinising, the anti-racist strategy, that's a matter for the Welsh Government, and, of course, the Welsh Government do not control all of the necessary levers in order to achieve that. I think one of the things that's important to raise, and Richard Wyn Jones and I did this in our book, is that the fundamental principle of the jagged edge is that Wales is unique. It's an anomalous system, because it has a legislature and an executive but doesn't have the justice function—the only common-law country in the world to have that anomaly. But even if you did, and so if you get into a territory that does have the alignment between those three things, the answer to the question that you asked me is still incredibly difficult. It's still a huge task to tackle the systemic racism throughout the criminal justice system, because, of course, of its relationship with poverty, education, health, housing, and how deeply embedded it is in society. But if it's incredibly difficult where you have that alignment, it's nigh on impossible for a government in the position of the Welsh Government, where you don't have that justice function, to actually do that in Wales. So, without being too despondent about that, I think it's just about facing the limitations and the frustrations within the current system. So, difficult where you have alignment; almost impossible for the Welsh Government to do that within the current dispensation.

13:35

It makes it difficult for us to set achievable targets for the Welsh Government, because we don't know what the baseline is. Nevertheless, there are people in England who are also just as concerned as everybody else in this room is to ensure that we have an anti-racist society. It doesn't mean we can't make any progress, but it does mean it's difficult to target exactly what the Welsh Government's contribution to this is.

Yes, I agree. How we define progress, I think, is also quite an important point. Are we talking about less racist, less disproportionality, which of course is some progress, but we still have disproportionality and we still have evidence of racial discrimination? I think the question of how we define progress is heavily subjective and I think needs to be part of that discussion. That said, I think that there are still clearly things that we can do in Wales to understand the picture. I think, before we even begin to think about tackling the problem, our understanding of the problem has still got some way to go. The data that we managed to pull together for this—. One, it takes an inordinate amount of effort, but secondly, even when those data are available, what we do with them and how we understand them and what we make of that, we're still miles behind. Indeed, look at the evidence that's been submitted to the inquiry. Look at academic research and academic evidence. I couldn't see anywhere the academic evidence submitted on the crime and justice area of the plan. There are six universities in Wales—seven actually—that have criminology departments: Wrexham, Bangor, Aber, Swansea, the University of South Wales, Cardiff, and, I think, Cardiff Met as well. How we actually pluck that evidence out to understand that picture, that would be progress, I think, working towards what the nature of disproportionality actually is in Wales.

Thank you for that. I'll just call in Jane Dodds, who is going to pursue this further.

Thank you very much. Diolch yn fawr iawn, Cadeirydd. I really wanted just to hone in on the disproportionate number of black people who are in our prison system. We know it's around 28 per cent across England and Wales, and yet they represent around 18 per cent of the population. We've had decades of training, awareness raising, and we're still in this place. In fact, this year, we saw statistics around the number of black and minority ethnic young people on remand going up by 18 per cent. What needs to happen? What radical solution can we be taking here in Wales in order to try and address this? I don't know who'd like to start. Perhaps, Professor Iwobi, would you like to go first and give us your views? Diolch yn fawr iawn. I think you're muted.

Thank you very much, Jane. I have to say that the work that Race Council Cymru has been doing for a number of years relates to even taking some of our diversity training and anti-racism inclusion work into the prisons, such as Parc prison, such as Swansea prison. We have done practical engagement initiatives in these prisons. I think, for us, the concern is a whole review of individuals who are involved in the criminal justice system, from magistrates to judges to the Crown Prosecution Service to people who provide services to black people. Significant disparities have been noted by black men who have been through this criminal justice system, and the feeling is that it is institutionally racist—it is clearly institutionally racist—and biased against black men in particular and black people generally.

I listened to a presentation by a young man called Jacob Henry, and he's a black Nigerian—half Nigerian—and was involved particularly in the criminal justice system as a very young person who came from a lot of abuse in his own personal background. He then arranged with two white people, white men, to go and fight and beat up the people who'd been calling him 'black monkey' and all sorts of negative names, and when they were arrested, according to his testimony, the two white people who had knives were sent home and told to go home; he was arrested and taken and placed in police custody overnight whilst he was interviewed. Only him went to jail. And yes, he was involved in this particular incident, supported by two other people who felt quite angry about the racism he experienced, and he spent a significant number of years in jail. He gave a witness statement, at the leadership summit of the 'Anti-racist Wales Action Plan', about how, in prison, he saw so many young black people, like him, who could've been handled differently as young people whose homes were dysfunctional, and how he could've been handled differently, and definitely how the white counterparts were treated much more favourably than he was.

So, there has to be a real review and an overhaul of the attitudes. I mean, the values of people who sit in judgment need to be reviewed. They have a criminal justice race action plan. How anti-racist is that? Who's actually delivering on the plan? What are their own attitudes and behaviours? Have they undertaken significant anti-racism training right across the criminal justice system? How do we begin to give and sit in judgment when our own values and belief systems are racist? There will always be that racist outcome. Thank you.

13:40

Diolch yn fawr iawn. Can I ask Dr Jones just to give us a general overview of his thoughts around why we are still here decades later? Thank you.

Yes, sure. Firstly I agree with everything that Professor Iwobi has just said, so I second that. I think, on the question of prisons, of course, the people who run the prisons will say, 'We get sent the population and, therefore, what then happens in prison is essentially out of our hands', although there is still an awful lot to do in terms of the training and things that we've talked about.

So, we're looking at front end, and I think then we can maybe look at some initiatives that perhaps have taken place elsewhere. One of them might be in relation to sentencing. So, we know that there are clear disparities when it comes to sentencing, and I guess I would just point the committee towards some of the things that have been introduced in Canada to try and, in mitigation, understand how racial discrimination has led to that individual ending up in court or, indeed, in relation to the crime, how it has somehow underpinned or contributed to the life circumstances of that individual and therefore that they're in court and being sentenced for that crime.

There are other things that I think are raised in the Lammy report around pleas and the legal profession. So, the trust of the legal profession that we see amongst minority communities—so, things like less likely to take a guilty plea because there's a lack of trust and faith in the profession—so, what can be done there to try and overcome those barriers in terms of a lack of faith and lack of trust? And we can even go on a more granular level. There's a paper recently been published about the sentencing disparities, particularly in relation to drug offences. So, even on particular offence levels, that might be a recommendation. Substance misuse is a devolved matter, so maybe there's the hook in, in terms of dealing with this, in terms of the jagged edges between what's reserved and what's devolved. Maybe the fact that we're talking about substance misuse, a devolved area, maybe that is something that can be used as a way, as I say, to hook into what the Welsh Government can actively be doing in this space, given that drug offences have been a very clear area highlighted in research. And I can send that paper on, if that's helpful, afterwards.

13:45

Thank you. I wonder if I could just pick up something with you, please, Dr Jones, because you said in your written evidence that the Welsh Government cannot really deliver change in this area without the support of its partners from the criminal justice board. So, can you just say a little bit more about that, please? What evidence is there and what change does there need to be in order to make sure that we do deliver real change in the criminal justice system?

Yes, of course. The dominant levers for the criminal justice system are reserved to the UK level. They are those partners that I refer to. So, without the criminal justice system, sadly, you can't achieve this. And, of course, the elephant in the room is the criminal law. A lot of this is we talk about it in being institutionalised in agencies, and, of course, we very often focus on the system where there's discretion—so, where individuals have discretion, that is where we look at bias, that is where we look at where these inequalities emerge—but the law—. A lot of this is rooted in the law, and the Police, Crime, Sentencing and Courts Act 2022 would be a very, very clear example. The law of joint enterprise would be a very, very clear example. So, while the Welsh Government and the Senedd cannot do anything about those areas, I think it's very important to hold the Welsh Government to account, but also very important to recognise that caveat that I alluded to in my evidence. I think I made the same point in relation to the work on women as well.

Thank you very much, Chair. Diolch yn fawr iawn. 

Good afternoon. Thank you both for being here this afternoon. I'm going to ask some more questions now about hate crime, which is very prevalent in the news at the moment. I'll come to you first, Professor Iwobi, because in Race Council Cymru's written evidence, it says that the data suggests that there's been a fall in overall recorded hate crime where race was the motivating factor in Wales, although it is a very small drop. So, I was wondering if you could just talk us through why you think that was and also, I suppose, to open it up to both of you, to make the point that maybe where racism was a motivating factor it has dropped, but where religion is the motivating factor, that continues to increase. If you could give us your perspective, really, on why you think that is happening. 

Diolch yn fawr. I think, first and foremost, the rates of reporting through established channels like the police and Victim Support Cymru have dropped, but the contacts with charities such as ours have significantly increased. For example, in one week, we had 15 phone calls from schools across Wales narrating different incidences of racism involving children as young as three, which is horrific. We've had all sorts of individuals telling us that they don't have confidence in the criminal justice system, in the police. They don't think the police will do anything. And they have reported in the past, and nothing has changed. 

We have worked quite concertedly with Victim Support Cymru to provide direct support to individuals. I think that post the introduction of the 'Anti-racist Wales Action Plan', the work of the Welsh Government and a variety of organisations and grass-roots bodies involved in deploying and implementing this action plan has really gathered a lot of support and enabled people to feel better able to talk to black-led or ethnic minority-led organisations about their problems. So, we then encourage them to report, but the take-up is very limited.

In fact, I remember two incidents—one was a vicious attack on a 14-year-old boy outside his school, where two white children of the same age grabbed him by the hair, knocked him down and punched him severely. For about 15 minutes he was being beaten up. And the parents contacted us and didn't want anything to do with the police, which was very concerning for us, because that is definitely a hate crime. We feel that there has to be more understanding of the impact that the lack of trust, and the lack of ability to feel confident that the police will do something about it, is having on reporting figures.

I think also many people are beginning to feel like this is everyday racism. This happens to us time and time and time again. How many times are you going to continue to raise the alarm about what is happening? At the same time, part of our work is to continue to highlight the availability of the police service to take information. I think something that would help is really for the police to begin to publish statistics and information on how many reports they receive, and what has happened as a result of the reports, to ethnic minority community forums where the information can be cascaded to raise awareness of action being taken. I think that's part of what I want to add at this time. Thank you.

13:50

Thank you very much. And to come to you, Dr Jones, you mentioned earlier on about the data, and it is very difficult to find, and then it's very difficult sometimes to disaggregate for Wales, and even further down into particular Welsh communities. So, we've heard a number of times in this inquiry that we need better data, but I was also wondering if you'd had a look at the data that's been collected for recording hate crime about race and about religion, and what you think is happening there. Because the increase is quite stark, especially against Muslims and Jewish people. 

Yes, I think the simple answer is 'no'. In terms of my submission, I didn't look at that particular area. I have done in the past. I think post Brexit there was an uptick, wasn't there, at that time? And I think I looked at the data then, at that particular moment. But what I would say around religion, and religious identity, is that I've also got those—. It's an interesting question, because I've been gathering the data on religion since 2018, but it's never really included in the fact files. We've just tried to—. We could be there for years and it would still not be complete. But when I have looked at it and analysed it, again there's clear evidence there of disproportionality. So, I think again, as part of the committee's inquiry, I can perhaps send that through, and that would be the first time I think it has ever really seen the light of day. So, that might help, but it's obviously at the back end; it's not in relation to crime and victimisation.

Absolutely. Thank you very much. Then, to ask you both about what Welsh Government is doing, because most of the actions to tackle hate crime in the 'Anti-racist Wales Action Plan' do sit with Welsh Government. So, what do you think they are doing to lead, and do you think the cohesion team and how it's working is effective, and what more could they be doing?

Thank you. If I may just contribute that there's been a significant increase in antisemitic attacks and verbal attacks and assaults on Jews and Muslims because of what is going on in Israel and Palestine at this time. We've been touching base with the leaders of the Jewish communities who are part of the race council's wider network and the Muslim Council of Wales, who've been reporting increasing concerns about the lives of Muslims.

If you look at the submission that we sent through, the number of Muslims in prisons has more than doubled over the past 18 years, making up to 17 per cent of the prison population, and also black people, significantly. Islamophobia is generally reported as on the rise and specific hate targeting Muslims continues to be on the rise, especially women who are wearing hijabs. Three reports we had last week were: one woman who was egged as they walked with a hijab through the streets of Cardiff, and another person who had liquid thrown at them—it turned out to be water—and told to go back home. And, unfortunately, the statements about those who wear the full burqa are reported to be using very defamatory language.

The leaders of the Jewish community reported to Race Council Cymru that Wales, sadly, is almost not a safe place anymore for you to be Jewish, and the fear factor about their own personal safety and all sorts of abuse that is sent in their direction. We're very concerned about this and I know that, having spoken to our Minister, the reinforcement of the Welsh Government has been to visit all the Muslims, the imams, as many as possible, and to engage and touch base with the Jewish community leaders. I think the tension is real and global events will always affect us here in Wales, and the need to recognise that it is only by communities coming together to provide support, to say 'no' to racist hate crime, and by deploying the full impact of the 'Anti-racist Wales Action Plan', that we can begin to support our colleagues.

Sadly, with the protests on the way it's resulted in more targeting against others who are not protesting and it's a very, very frightening experience to be out there involved in community work at this time. We were actually advised to cancel one of the black history events in parts of Llanelli because of the negative reception of asylum seekers there and the worry by ethnic minority people about how people would be impacted if they attended the event. So, we had to suspend black history celebrations in Llanelli this year.

It is just such a worry and I believe that the work that the Minister for Social Justice and her team are doing is really important. They've been doing some round-robin regional updates and sharing tips and supporting strategies to help people feel safe, and identifying elements of the 'Anti-racist Wales Action Plan' that could really help local authorities to ensure that their local communities are safe and have a space to raise their concerns. Thank you.

13:55

Thank you so much, Professor. That's incredibly helpful and powerful, I think, for all of us to hear today. Dr Jones, I'm just going to come to you with my last question, then. Just to ask you, really, what you're seeing. Do you think that the Hate hurts Wales programme and the hate crime perpetrators direct work and all the initiatives, really, that the Welsh Government is overseeing, do you think they are having an effect, from what you see, and do you think there's more that can be done?

Yes, I don't think I can speak directly to the work on hate crime because I've not been across that, so it would be inappropriate for me to do so. But I think more generally in relation to this chapter of the strategy and the plan, I think that there's a huge amount of work going on within Welsh Government. And I think that this is something that Members and officials in the Senedd know only too well, that there are issues around capacity. There are huge issues around capacity and how far they can spread across what is ultimately a reserved matter in relation to criminal justice. And I think there's a huge amount going on in relation to officials and we know that there’s been a shift now in terms of rather than just making the case for devolution, but actually preparing for devolution.

I think that there's still a way to go with regards to data. I mean, this is something your committee will hear about, I imagine, across all of the areas, including those that fall within devolved competence, but those outside as well. If we were having this conversation in 2018, we would have been talking about data as well, and obviously even further back than that.

I think there's more to be done, from my own perspective in academia, to support research. I've alluded to it already that if you look through the evidence submissions to this inquiry and indeed the inquiry on women, despite the number of academic institutions we have in Wales that all do research around criminal justice or law, there are very, very few submissions. Whether that's an issue around Senedd outreach and engagement or whether it's actually an issue for those academic institutions to become more attuned to that, I think the Welsh Government can maybe bring those things together. So, I think better support for research can help to generate data, but also analysis. For example, you ask me a question and my hands are immediately in the air saying, 'It would be wrong of me to try and do it'. Even if the Ministry of Justice and the Home Office said, 'There you go, there's your data', you still need someone to analyse it. We still need people to make sense of it. So, I think the data is one thing. You then need capacity to analyse, to make sense, to write submissions, so I think that anything that the Welsh Government can do to improve the levels of research and engagement would help as well.

14:00

Thank you very much. That's very helpful. Thank you, Chair.

Before we move on, I just wanted to pick up on something that Professor Iwobi said at the beginning of this discussion with Sarah Murphy. You said that you'd been contacted by 15 different organisations in a week, including concerns involving children as young as three years old. That's not my experience of three-year-olds. They tend to be both colour-blind and blind to all manner of intersectionalities. I wondered why schools were not able to cope with that sort of incident properly within the school environment.

In one of the schools, which was located in the Valleys, the teacher who called us said that they had had three separate incidents in the same school where unconnected children made statements relating to the adults in their lives or what they had said. In fact, one of the complaints stated that they should go home and be with their own people. Now, that's not a four-year-old or three-year-old kind of statement. We said to the teacher that racism is learnt behaviour and children are influenced by the adults around them: 'Don't play with somebody who is black', 'Don't play with somebody who is Asian', and words to that effect. So, the teacher actually called for support and training on how they tackle it. In the classroom, it was addressed, and they were told it was absolutely not acceptable, but also we were able to talk to them about the need to educate the parents and to inform the parents of their duties to uphold the Equality Act 2010, and the need to ensure that their children were not going to be permitted to make racist comments and put other people's learning experience in jeopardy. Because what then resulted was that one of the little girls refused to come to school, because she had been told she should live on a tree, because her family looked like monkeys, or words to that effect. A race hate crime lead really supported the school and we delivered some very focused anti-racism training, but levelled at the children.

It's similar to what happened in another school, which was a secondary school in Gorseinon. We went along to the school and held an assembly, and addressed some of the kind of language and behaviours, making sure that they understood it was totally unacceptable to treat people differently. I think that's the beauty of the fact that the Welsh Government has now embedded the teaching of black history in the Curriculum and Assessment (Wales) Act 2021, because now every child will hear of the contributions of black people: the inventions, like the stethoscope, which was invented by a black man; the lifts, the elevators, positive contributions; the traffic-light system—all these things that many children don't know. When they hear that, it begins to challenge some of the narratives that they hear from home and from social media.

14:05

Thank you for that. That's really useful. Sioned Williams. 

Diolch, Cadeirydd. Dwi eisiau sôn tipyn bach am groestoriadedd. Oes yna unrhyw fylchau penodol yn y 'Cynllun Gweithredu Cymru Wrth-hiliol', a'r cynllun gweithredu gwrth-hiliaeth ar gyfer y system cyfiawnder troseddol, o ran cefnogi anghenion gwahanol grwpiau, er enghraifft menywod o leiafrifoedd ethnig, plant, pobl hŷn, Sipsiwn, Roma a Theithwyr, ffoaduriaid, pobl anabl, ac yn y blaen? A byddwn i'n hoffi gofyn, o ran y pwynt yna am ymchwil prifysgolion, a fyddai'n ddefnyddiol, os oes yna fylchau, i Lywodraeth Cymru, er enghraifft, gomisiynu ymchwil a dadansoddiad o'r data sydd ar gael i ni o ran cefnogi'r grwpiau yma.

Thank you, Chair. I wanted to discuss intersectionality. Are there any specific gaps in the 'Anti-racist Wales Action Plan', and the anti-racism action plan for the criminal justice system, in terms of addressing the different needs of different groups, for example women from ethnic minorities, children, older people, Gypsies, Roma and Travellers, refugees, disabled people, et cetera? I'd also like to ask, in terms of that point about the research within universities, whether it would be useful, if there are gaps, for the Welsh Government, for example, to commission research and an analysis of the data that's available to us in terms of supporting these specific groups. 

Shall I go first? Diolch. On the first question in terms of intersectionality, absolutely, I think there are huge issues around that and the need to think about that. In terms of whether there are gaps, I'm struggling to now cast my mind over the chapter and think about what those gaps are. But one of the things that struck me as you were talking, and then you said it, was about—. If you look at the data I present to you, we separate white, black, Asian, mixed. Within the white category, it's not homogenous. So, what we often do is we compare the white rate with the black rate, or the Asian rate, and we look at the white rate and say, 'Well, that's the majority of people in Wales', but, of course, hidden within that are lots of different diverse communities. And if you could break that level down for that, I think there's all kinds of different things to learn and problems to get at. 

I think one of the issues around where we're at with the debate is that it's very basic. In 10 years' time, academics, I hope, will come back and look at the reports we produced and say, 'Yes, they were good, but they were a bit basic, weren't they?' And I suspect I'll be ridiculed and thrown out of various conference halls for being responsible. And I hope they do, because it means we've made progress. They'll look at it and say, 'Okay, great, you showed the higher imprisonment rate, but you didn't explain why'. So, I think, as we move forward, we need to start with these top-line statistics, and then build our analysis. The problem that I as an individual face, which I think then ties into your second question, is that if you're the only person doing it, by the time you've got this one we published last week done—. I feel like a six-month break as it is. By the time that comes round, I've got to go again. And if it's only you, all you can ever really do is, in a sense, just try to, once again, heave it on the table and say, 'It would be great if you looked at it and took it seriously this time'. We're never really going deeper; it's breadth, not depth.

I think one of the things that this issue demands is the depth. We've established now, even on the Welsh-only level, that this problem exists. I don't think anybody could refute that. Those statistics are irrefutable. The evidence that Professor Iwobi has given is irrefutable. What we now need to do is get into the minutiae of the depth and the intersectionality. To do that—to come to the second point—you need support and you need research, and there is currently no research institute that receives funding for criminal justice research. So, if we're to make sense of how—. Even forget the devolution of justice powers to Wales. If you were to think about how the justice system currently intersects with housing, last week's report showed that rough-sleepers have trebled. If it's about substance misuse, if it's about mental health, if it's about equality, if it's about language, there are so many areas that are already under the auspices of the Welsh Government and the Senedd that merit serious investment and research in Wales. We haven't got a chance of getting that depth if we don't have that research. We're only really going to, every single year, at a push—. Richard Wyn Jones often says, 'If Rob takes a holiday, it doesn't get done'. I don't take a holiday—so, there's the answer. Maybe that's what you want to do. If you see me go near Booking.com, you intervene. But we need the depth, and, in order to do that, you need serious investment in research. On the point I made to you earlier about there being very little research submitted to you from universities, maybe that picture looks different once you actually do that. So, sorry there's not much more on the first question, but I think the relationship—

Fe glywon ni yn y sesiwn gyntaf ynglŷn ag ymchwil oedd wedi cael ei wneud gan aelod o Muslim Doctors Cymru, ac roedd hi'n sôn am race observatory sydd i gael yn Lloegr. Ydych chi'n gyfarwydd â hynny o gwbl a'u hymchwil nhw?

We heard in the first session about research that had been undertaken by a member of Muslim Doctors Cymru, and she mentioned a race observatory in England. Are you aware of that at all, and their research? 

14:10

I'm not aware of that specific initiative, but the concept of an observatory is something that we at the Wales Governance Centre have worked on and are working on at the moment for a Welsh criminal justice observatory—something that would do what we've been able to show before, but with a lot more capacity. Again, this is even without justice powers being transferred. If justice powers are transferred, then all of these issues that I at the moment say are matters for the UK Government are here. Just to give you an insight, if you take the Howard League for Penal Reform and the Prison Reform Trust, who have submitted evidence to this committee before in separate inquiries, their job is to think about crime and justice, of course, and those powers are in Whitehall. They don't have a Wales branch. Of course they don't—they've got capacity issues, and all of the real powers and all of the real goings on in the justice system are in London. They do a hell of a good job in actually trying to reflect the Welsh context, but it's a huge struggle. So, even beyond research, civil society organisations struggle. So, I think that something like an observatory that can gather data, but can do that analysis, can disseminate research, whether it's submission to committees or whether it's publishing reports like last week, is absolutely key at this stage. Without it, we will just continue to heave on one report a year, just saying the same things that we've said year on year, without ever really getting into why, or, crucially, to come back to your first question, can we ever get over these problems. 

Diolch yn fawr. Athro Iwobi, oes gyda chi rywbeth i'w ychwanegu at hynny?

Thank you very much. Professor Iwobi, would you have anything to add to that?

Thank you very much. Strangely, from the ethnic minority perspective, when we gathered all 58 members to write the 'Anti-racist Wales Action Plan' alongside civil servants, our concern was that we had too many research papers that are doing nothing. We were calling for enough research already; let's do something to make life better for black, Asian and minority ethnic people whose lives were absolutely blighted every single day. For them, they felt we have enough research to begin to do something. Disaggregation of the data is not the urgent concern. They're looking at the children going to school and coming back with bruises and broken faces, attacked and verbally assaulted, psychological trauma, mental health issues on the rise for young people who go to school to get an education and they come back racially targeted. So, I will agree that there is a lot of value in having relevant data that is analysed and can be used, but, at the moment, for ethnic groups who are on the front of these racist incidents, that is not their primary concern.

Diolch. Alla i ofyn cwestiwn penodol ynglŷn â phrofiadau menywod yn y system cyfiawnder troseddol? Yn ystod ein hymchwiliad ni mi wnaeth y Gweinidog Cyfiawnder Cymdeithasol gyfeirio at ymchwil oedd yn cael ei chynnal i ddeall yr heriau sy'n wynebu troseddwyr benywaidd o leiafrifoedd ethnig yn well. Mae’r cynllun gweithredu yn dweud y bydd adroddiad ar gael ym mis Mawrth 2023. Felly, beth yw’r cynnydd sydd wedi cael ei wneud, ydych chi’n gwybod, o ran y gwaith yma’n benodol?

Thank you. Can I ask a specific question to do with the experience of women in the criminal justice system? During our inquiry, the Minister for Social Justice referred to research that was being carried out to better understand the challenges facing ethnic minority female offenders. The action plan states that a report will be available in March 2023. So, what progress has been made with regard to this work specifically?

I'm not aware of what work has gone on. That's not because I don't think it's happening, I've just not heard anything. 

Dych chi ddim wedi clywed. Athro Iwobi, ŷch chi wedi clywed am unrhyw gynnydd o ran edrych ar fenywod o leiafrifoedd ethnig o fewn y system cyfiawnder troseddol?

You haven't heard about that. Professor Iwobi, have you heard about any progress in terms of looking at women from ethnic minority communities within the criminal justice system?

We have the external accountability forum, which holds different committees. So, the health sector of that external accountability forum would be able to update. But, generally, I'm aware that interim reports are produced around all the themes and areas of the action plan. I don't sit on the health expert accountability forum, sorry.

Ocê. Diolch yn fawr. Dŷn ni wedi cyffwrdd tipyn bach ar droseddau casineb. Jest o ran ystyried lle mae casineb croestoriadol yn digwydd, a'r gefnogaeth benodol sydd angen wedyn yn yr achosion hyn, ydych chi'n gweld tystiolaeth bod hynny yn digwydd?

Okay. Thank you very much. We've touched a bit on hate crime. Just in terms of the consideration of where intersectional hate is happening, and the support that is therefore needed in this instance, have you seen evidence that this is happening?

14:15

I think hate crime is probably beyond what I've done.

Dim problem. Yr Athro Iwobi.

No problem. Professor Iwobi.

Well, I do see that there's a concerted effort, especially amongst community members, to recgonise that they're experiencing race hate crime. There's been a lot of training delivered across communities to help people identify. Again, it comes back to the issue of the exhaustion, honestly, amongst people like me, that nothing gets done to people. Often, the hate crime reported is only witnessed by the individual, the victim, who has been subjected to it. So, where there is very little evidence, it's just like one of the incidents affecting a very senior consultant who was racially abused by his patient in a one-to-one office, and he reported this to the race council, as well as to Welsh Government. The challenge was that you were just there with that person in that room; there is no recording of what was said to you. How can you actually prove it? So, it's really tough to be able to—unless there are witnesses, so unless someone else is prepared to step up and say what they've heard, you are struggling to prove what you have experienced and what you've lived through.

I know that there's a cyclical review with the criminal justice element of the external accountability group on the numbers and the reporting of race hate crime. Also, I think the race disparity unit, which is set up by the Welsh Government, is looking at some of the statistics that are coming out now involving black, Asian and minority ethnic people, Gypsy, Roma and Travellers, asylum seekers and all that, and what progress is actually being made. They're looking at, 'How do we understand what the major gaps are in examining what happens with the data and how it can be collected, and what we do with it at analysis?'

Can I just make just a very quick point, actually? It just came to me there. When we talk about this and when we teach this area, this topic, we often talk about how minority communities are over-policed and also under-policed, and I think that's quite a nice framework to think about this, that you've got over-policing in relation to arrest and stop and search and then when they have experiences themselves that need to be taken seriously, they're under-policed. So, it's a real double whammy. So, when you get into the crux of the problem—what is the problem—you've got both of those things: there's over-policing in some areas, and then you've got under-policing in others, and that, of course, absolutely shatters any confidence in the system. Sorry—I just thought I'd add that in when you were talking about it.

Ie. A diffyg llais, er enghraifft, pobl anabl, yn croestori wedyn gyda diffyg llais pobl o leiafrif ethnig, yntefe?

Yes. And the lack of a voice, for example, for disabled people, that they don't have a voice, and there's that intersectionality then for minority ethnic people also. 

Yes. Absolutely. 

Thank you very much, Chair. My question, really, is monitoring and measuring progress. The 'Anti-racist Wales Action Plan' stated that by June 2023 it will have in place an agreed monitoring system to capture key data to enable a more robust, consistent approach to collecting and reporting. What progress has been made by the race disparity evidence unit, the Welsh Government and criminal justice partners to achieve this?

So, I've not had much engagement with the race disparity unit, so as of where we are now, November 2023, I don't know. I've had some engagement with them at the start. It's my understanding that things aren't yet public. I think the question about data, I mean, my goodness, if you Ctrl+F in the transcript of this, and all of your other meetings, data is going to appear quite a lot. The House of Commons Welsh Affairs Committee are currently doing an inquiry into prisons in Wales, and the data question is going to be big there. In terms of monitoring, the data stuff at the moment is probably caught in the crossfire of the debate on justice devolution, so I wouldn't be surprised if there are some delays on some of these data being made available. But as to what the mechanics of what the race disparity unit are doing and the success they've had so far, I'm really not privy to that information.

14:20

Sure, thank you. We have met a number of times with the Welsh Government leaders of the race disparity unit, and they have presented a series of focus areas. I think, at the moment, their aim is to improve the availability and quality, and looking at the granularity and accessibility of evidence of individuals from black, Asian and minority ethnic backgrounds across the protected characteristics areas, to look at what kind of quality of data can we begin to produce and expect. Because of the problem my colleague mentioned earlier, the disparity is more visible when you're able to break down the type of ethnic individual that you're talking about: is it mixed-heritage people, is it black people, is it Asian people, is it black international people, is it black Welsh-born people? So, all those data, the research that is currently carried out on descriptions of characteristics, are not as well broken down as they could potentially be, for us to see a Welsh picture.

So, they're talking about publishing an analysis of all the statistics, through looking at things like the social care statistics by ethnicity, looking at identifying gaps in evidence in relation to domains, including the criminal justice data collected and reported on ethnicity. They're looking at leadership and organisational culture change, which will then equip decision makers across Wales to work for better outcomes for our diverse ethnic communities. I think the lack of evidence on equality particularly relating to Wales—which is what the Welsh Government is really working on now—is affecting our ability to progress individual, drilled-down work, because the sample sizes are not really large enough to provide estimates for some of our communities. But I think these are some of what they know, and my understanding is that they are continuing to address those, and they're going to be publishing some information, hopefully very soon.

Thanks, prof. And what further actions are needed to improve the confidence of ethnic minority people to share data? Probably, prof, you could address it.

Sure. I sit on the NSDAC, which is the National Statistician's Inclusive Data Advisory Committee group, set up in London, and I highlighted the concerns about the lack of trust of our communities about what people are doing with their data, the lack of appropriate breakdown in data sets. So, for example, you can be white and Welsh but you can't be black and Welsh, so people who object to being listed as British when they are born here and they're Welsh people—black Welsh people, like my daughter—many of them would feel that nothing on the current census form describes their ethnicity or their nationality or their sense of identity. So, we've highlighted that to the UK Government, through this NSDA committee, chaired by—oh goodness, I can't remember the name of Dame somebody, who's chairing it in the Home Office, and they have commissioned a review on what the new forms could look like, and taking into account that you have to provide appropriate questions for people to tick the boxes that relate to them. But if it's not there, and you can only be white and Welsh and no other ethnic groups could be identifiably Welsh, that is a problem in itself. So, that work has just progressed. And in the last meeting we had, in London, they were identifying how they need to review the concerns that we have raised in this regard.

14:25

Thanks, Chair. Can we just talk about funding a little bit more, if that's okay? Obviously, we're facing really pressing times with regard to public finance, and we have heard during the course of this inquiry that there's a lack of resources, and that's having an impact on organisations and their ability to deliver necessary changes. Do you share these concerns, and how much of an emphasis would you place on funding as a barrier to improving the situation?

I think it might be best for Professor Iwobi to take that one.

Yes. That is a huge one, Ken, to be honest. Black, Asian and minority ethnic community groups, who are the front-facing and the recipients of a lot of the concerns raised by the communities around race issues, are not core funded. Race Council Cymru is not core funded—we're only project funded, and we do a lot of the work around anti-racism in a voluntary capacity. So, I think, with the work that is ongoing around appropriate resources, in some of the areas, yes, you could see the deployment of funds. In education, you have the diversity and anti-Racist professional learning system, but that's only addressing early learning. Within the social justice work, the absolute request by ethnic communities is that these external accountability forums are funded, to be able to keep the pressure on the Welsh Government to give an account. So, those are critical. And the establishment of the race disparity unit, and subsequently, appropriately staffing the unit that deliver on this work, that oversee the implementation of the action plan—those have been supported.

But I have to say that the UK Government needs to deploy further funding to Welsh Government to distribute in this sphere. If it's going to be successful, it needs to really be able to core fund black-led organisations, Asian-led organisations, that are on the ground, doing the grass-roots work. And there is no core funding, so for many groups, they would struggle to survive. And that means that the whole of the delivery of the plan will rest on Government bodies and local authorities who are currently funded. Grass-roots charities, who actually do a tonne of the work on the ground with grass-roots ethnic groups—I don't know any that are core funded, apart from one or two.

Do you think that there is sufficient resource as a whole? When you take all of the project funding together, is there enough resource, which, okay, might be channeled in a different way, but nonetheless there is pretty significant resource being utilised at the moment? Is there enough money at the moment, as a whole? And, secondly, is there any resource that is not actually producing results? Could money be diverted from certain projects, or from any other area of activity?

I think, if you attended our Wales race forum, you would see just how diligent and how hard-working grass-roots charities are. Many are frustrated because of a lack of core funding. I do think that the Welsh Government itself can only distribute what funding it has, and if there is insufficient funding allocated to this particular area, the well-being and the ability of this plan to be effective will be seriously impaired, and that would be such a shame, because the plan was written jointly, the first collaborative document of its kind across the whole of the western world, I have to say, and I'm not exaggerating. We had 58 ethnic groups and civil servants working together to co-produce this document. There was a lot of hope, a lot of energy and a lot of ideas that were brought together in the writing of the plan, and all really dependent on the resources that were available to be deployed. From what I can see, I would say that the Minister for Social Justice has really done the best work that she can to ensure that the core staff are in place to be able to support, but if there's no funding available for the charities and the organisations, non-governmental bodies that are delivering on the ground for ethnic minority groups, how can this be sustained?

So, I think it's a challenge for UK Government in terms of their value of equality, inclusion and anti-racism work, because you can see a total difference between the approaches in the UK and the approaches in Wales. Wales is directly demanding an anti-racist nation by 2030, and that is not the same. So, I guess the deployment of funds to the Welsh Government may not quite reflect the programme of government, which I think is so sad for us, because if all the groups, all the organisations and charities around the Wales Race Forum could be funded, imagine how much more work we could be able to support in this sphere.

I also think that it is worth reviewing how much of anti-racism work funding is given to local authorities. I think if you go directly and fund grass-roots organisations that are actually working to support people who are victims of racism, I think that might be a better use of funding in this sphere.

14:30

And I guess that's the question that I was getting at. A lot of funding goes in different ways, doesn't it, and you've identified local authorities. Has there been any kind of audit, if you like, of how much the total sum is that is invested in anti-racist action across Wales, or is that something that is going to be really difficult to calculate and quantify?

I think because the plan is still so new—. There was some research undertaken by Professor Emmanuel Ogbonna who co-chaired the group with the Permanent Secretary, and he stated that he believes that the plan is so young and early in its implementation that it would take time. It's still at the early phases here in Wales. It will take years to evaluate the success and also what has actually worked in terms of deployment of grants. But he talks about the work to make Wales anti-racist being significant, and some of the—. The anti-racist Wales initiative has laid a foundation to societal changes that are likely to be quite profound, but cannot be achieved unless appropriate resources are placed around it.

I would definitely say it's wonderful to see the work that the culture, heritage and sport department are doing alongside the social justice work, which is where they've deployed funding to deliver training and mentoring, led by people with lived experiences of racism right across the whole of the performance industry—music, the creative arts industry. So, that is really powerful. That's never happened before, where chief executives and directors of theatres are having to meet people with lived experiences of racism to explore how inclusive their programming is. That's really groundbreaking; it's very new. And the work that the Minister for Social Justice's team are doing on highlighting and raising awareness on a regional and very grass-roots basis is really also powerful. I hope that those can be continued.

Thank you. Just one final question. You may not have the answer to it, but I was just wondering, are those third sector organisations that operate in this sphere getting their fair share of grants and funds from UK institutions and from bodies such as the lottery? Or is there a disproportionate sum of money being targeted at other parts of the UK, where racism is a major problem?

14:35

Well, if you asked a number of charities that work in this sector, they would say they're not getting as much as they could. Unfortunately, the grass-roots charities who are actually doing a tonne of work—. This is something that we shared with Comic Relief, when we ran their distribution of funds during the COVID pandemic here in Wales: we advised them that the ones who are actually doing the work are very grass-roots led and not really good at writing funding bids. So, to be able to target resources where they are needed, and to the people who are walking those streets and addressing those social issues that are affecting society today, you need to adopt a new and a fresh approach, and you need to go where they are and support them with what you need to be put together. They would say, 'We’re not getting half as much from the UK as we possibly could'. 

Thank you. I just want to pick up on something that we've mentioned in passing, but we haven't properly explored, and that's around the Gypsy, Roma and Traveller community. You, Professor Iwobi, mentioned that you tend to be project funded rather than core funded. So, has any of the work that Race Council Cymru has done focused on the needs of the Gypsy, Roma and Traveller community?

Right. In the recent past, one of our trustees was Isaac Blake, who is the chief executive of the Romani Cultural and Arts Company. He's finished his term on our board, and he has highlighted a number of times how much the Gypsy and Roma communities were not supported. I know that the Welsh Government supports the work of Travelling Ahead, which looks at Roma and Gypsy provision, but he has highlighted the need to do more to support and fund the Romani arts company, which is the charity he leads, because he gets slightly more support from the UK Government for Gypsy, Roma matters.

So, it's interesting, the dynamic that a lot of their work is moving out of Wales, and he's wanting more reflection and support for his charity. But I do think that the work that the Welsh Government is doing in supporting Travelling Ahead, to look at the broader Gypsy, Roma and Traveller community’s needs, will need to be highlighted, definitely. They are part of the Wales Race Forum, but I don’t think there’s any community organisation around that table that would say, ‘We have everything we need’. We’re all desperately in need of funding, or desperately in need of core funding, so that we don’t have to keep worrying about stuff.

Okay. I just want us to move beyond funding for a moment, because clearly the outcomes for this particular community are the worst as far as education is concerned, and in many respects in terms of housing as well. I don't even know what the outcomes are health wise, because I'm not sure if anybody's actually done any research on that. So, is this part of Race Council Cymru's work, to look at that specific community within this whole subject of race equality? Because numerically they're small, and therefore are in danger of being lost.

That's true. We haven't done specific research on Gypsy, Roma, Travellers to date, but in terms of the research we did with Professor Heaven Crawley on everyday racism, we consulted and engaged with Gypsy, Roma, Travellers. There's a significant amount of research that has been undertaken by Isaac Blake and the Romani arts company, which is published on his website, which gives a little bit of an insight into the disparities and health, in which he refers to the mental health and well-being of their community. He generally believes that it is important that they are empowered to do research on their own lives and Race Council Cymru agrees with that, that black people, Asian people and Gypsy, Roma, Travellers should be empowered to deliver work and research in their own affairs, in addition to working with other organisations.

14:40

Okay. So, taking it back to funding. We know that the funding that the Welsh Government has allocated for improving the quality and the number of Traveller sites, which is there waiting for local authorities to bid for, year after year is never taken up. So, is this something that Race Council Cymru might look at because this is about the amount of priority given to this issue by local authorities across the board?

I definitely think that Race Council Cymru adheres to the principle of, 'Don't do anything for us without us'. We would want to invite a conversation around the table with senior members of the Roma, Gypsy, Traveller community to have that conversation and explore how they can approach Welsh Government to explore whether they can fund them directly. Because they have these organisations that are set up, but because of a lack of funding they are not able to do as much in all the 22 local authorities as they possibly could.

So, we are definitely open and willing to have a platform where people can converse because we cover all areas, all peoples irrespective of their skin colour or their ethnicity. We're here as an open anti-racist body and we would be willing to do that. But, again, I have to remind you that we are not funded at all, so everything we do is in a voluntary capacity, which is—. You can only do so much as a volunteer.

Okay. All right. Thank you very much. Is there anything further that you wanted to say?

No, just on that. His Majesty's Inspectorate of Prisons, I think they did a thematic review, or certainly a review in 2010 on the experiences of Gypsy, Traveller, Roma communities. So, that might be just worth looking at in terms of experiences of the justice system, from memory.

Very good. Well, thank you both very much for your evidence. You’ll be sent a transcript of what you've said, and please do correct it if we've captured the information wrongly. And meanwhile, thank you very much for your time this afternoon and I hope you have a good rest of the day.

Diolch. Thank you. 

Thank you very much. 

4. Papurau i'w nodi
4. Papers to note

Right, so, there are three papers to note. Are Members content to note these papers? 

5. Cynnig o dan Reol Sefydlog 17.42(vi) i wahardd y cyhoedd o weddill y cyfarfod
5. Motion under Standing Order 17.42(vi) to exclude the public from the remainder of the meeting

Cynnig:

bod y pwyllgor yn penderfynu gwahardd y cyhoedd o weddill y cyfarfod yn unol â Rheol Sefydlog 17.42(vi).

Motion:

that the committee resolves to exclude the public from the remainder of the meeting in accordance with Standing Order 17.42(vi).

Cynigiwyd y cynnig.

Motion moved.

Therefore, under Standing Order 17.42, can I ask Members if you are happy to exclude the public for the remainder of today's meeting? I see no discord on that, so I will now go private. 

Derbyniwyd y cynnig.

Daeth rhan gyhoeddus y cyfarfod i ben am 14:43.

Motion agreed.

The public part of the meeting ended at 14:43.