Lala R, Baker S R, Muirhead V E. A Critical Analysis of Underrepresentation of Racialised Minorities in the UK Dental Workforce. Community Dent Health 2020; DOI: 10.1922/CDH_IADRLala08.

Inequalities are concealed by institutional processes.

The term BAME (Black and Minority Ethnic) places people of non-white origin into one homogenous category. This stereotyping may be seen as an exercise in power by institutions to minoritise certain groups. These are not, however, limited to racial minorities and other groups may include those of gender, class, sexuality and religion amongst others. The intersectionality of these groups creates complicated inequalities which lead to disempowerment. Institutional power is exercised through what does, and what does not, appear on the agenda.

Using the metaphor of a 'dental workforce pipeline', the authors examine the success or otherwise of racialised minorities to pass through the three stages of entry to dental school, graduation and career progression. In 2018/19, compared to overall UK university intake, racialised minorities were better represented in medicine and dentistry admissions but Black and Chinese students were underrepresented. On graduation, the General Dental Council (GDC) register shows that 29% of the workforce comprises racialised minorities, compared to 14% of the national population. Black registrants are underrepresented. The broadly based 'BAME' category also conceals differentials in those of Asian origin, where Bangladeshi's are underrepresented as compared to those of Indian or Pakistani origin. The intersection of race and class may be at play in this complex picture.

Using specialist lists and achieving consultant status as career development markers, the data show that Black dentists were just as likely as white to be registered as specialists with the GDC, but Asians were least likely. White people were more likely to be consultants than all other racialised minorities. Similarly, most clinical academics are white, as are 100% of UK dental deans.

The authors argue that the blockage of Black people to dental school entry and the underrepresentation of all racialised minorities at senior levels are a consequence of the misuse of power. Firstly, by choosing to use the broad 'BAME' category to demonstrate racial diversity, institutions conceal inequality. Secondly, institutions set their own processes. Data show that white applicants are more likely to be shortlisted for jobs and less likely to be subject to disciplinary processes. Thirdly, institutions have the power to set their agenda and while gender equality has received high priority, progress on racial and the other minority groups has been minimal, revealing institutional non-decisions to prioritise these groups.

The authors conclude with suggestions on how to address the issues raised.