Saturday 23 July 2022

With Pride, July 2019


Something New Every Year


(July 2019)

The other Saturday, I did something I’d never done before. At my age, it isn’t often I get to do something as new as this, but the other Saturday I marched in the London Pride March openly as a nurse.

I’ve marched in the Pride March many times before, with friends, with LGBT organisations, but never before openly as a nurse. This year, a group of staff in my Trust’s LGBT Network organised to take part in the London Pride March and we had the blessing of our Trust.

On Pride Saturday, all of us in bright yellow tee-shirts (with our Trust’s name and logo emblazoned across them) and all wearing our security bracelets, we took our place in the march. We were LGBT staff and our straight allies gathered around our placard that announced who we were, Whittington Health Staff Inclusion Network.

Marching in Pride openly as NHS staff was one thing, but the reaction we received from the crowds along the route was amazing. People smiled and waved at us, they clapped and cheered us, people were so happy to see us. All we were doing was marching.

The NHS is still not an inclusion or safe place for many LGBT patients. A recent Stonewall report found one in four LGBT people have witnessed homophobia from NHS staff and one in seven of them have avoided treatment because of fear of discrimination from NHS staff (1). Yet how much has the NHS done to reverse this situation? Very little. This isn’t the first report by Stonewall, there have been many over the years, all reading the same, and yet the NHS does so little to change this.

In the four years between 2014 and 2018, LGBT hate crime rose by 144% (2) and yet the NHS is still not a safe place for LGBT patients.

What my colleagues and I did at Pride was not a great step forward and for most of us did not require a large amount of effort, yet the reaction of the crowd was almost breath-taking. Those people cheered us on because they were happy and grateful for us being there, and our presence told them that our Trust was working towards providing care in a safe place.

Taking part in London Pride fired all of us up, our WhatsApp group has gone crazy, and we are already making plans for next year’s Pride and getting off the ground an LGBT Staff Network. We need to work hard at making our Trust an inclusive organisation, a safe place for all, but we are starting.

We talk a lot about person-centred care but are we just paying lip service to it when so many LGBT people do not feel able to be open with us about themselves for fear of discrimination?

Every long journey starts with a single step, but who would have thought that step would be marching at Pride? So why aren’t more NHS Trusts taking part in the different Pride celebrations around the country? Our presence would say so much to the LGBT people there.


(This was originally published as a comment piece in Nursing Standard magazine)

Drew Payne


Find out more about this short blog series here

Wednesday 20 July 2022

With Pride, January 2017

And Some Things Change and Some Things Remain the Same

(January 2017)

I started to come out when I was nineteen, more than thirty years ago, and nearly overnight I lost almost all of my friends; I was ostracised just for being gay. It was a shocking experience that has left a lasting impact on me.

Today, I am married to my husband Martin and work as a community nurse in North London. Everyone at work knows my husband and no one has a problem with him, I have almost forgotten the last time I experienced homophobia at work, it was so long ago.

So much has changed since I was a teenager, changes I would never have believed back then. We have marriage equality now, we have protections against discrimination at work and when we use businesses or services under the Equality Act. Lesbian and gay characters can be found on so many different television programs. We have won so many protections and rights under the law this century that it makes our world almost unrecognisable from the one when I first came out.

So we can just relax and sit back, all the work has been done? Unfortunately, no. Homophobia is still alive, it is just not as blatant as it used to be, and the NHS is still not an open and welcoming place to everyone.

In 2016, a British Medical Association (BMA) study found that over 70 percent of LGBT NHS doctors experienced homophobia at work and three quarters of them had not reported it because they feared it would not be taken seriously or they feared reprisals (1). “I don’t think the NHS is an LGBT-friendly environment,” said Dominic, one of the doctors contributing to the study. This type of homophobia isn’t restricted to doctors only.

Last year also saw the unsightly scene of NHS England going to court to allow it not to fund PrEP, the HIV prevention medication (2). If used correctly PrEP is 86% effective (3), far higher than most vaccines. If PrEP prevented heart disease or diabetes we would be welcoming it and there would be no question the NHS would provide it. But PrEP prevents HIV and NHS England felt it could justify not funding it, tapping into the homophobia around HIV.  A Nursing Standard Twitter poll at the time found that 54% thought PrEP should be self-funded and not provided by the NHS (4).

There was a shocking spike in hate crimes following the Brexit referendum result this summer (6). Less publicised was the 147% rise in homophobic crimes in this period (7). Homophobia hasn’t gone away and the Brexit climate seems to be giving it oxygen again.

Brexit also raises another challenge for LGBT people. When Britain leaves the EU, all the EU laws that are also part of our laws will be reviewed and we might lose many of them. EU Article 10 offers protection from discrimination, including on grounds of sexuality (8). The Employment Framework Directive 2000/78 (9) protects people against discrimination at work on grounds of sexuality.

Many in the Conservative party have openly called for the repeal of the Human Rights Act and the Equality Act; Theresa May (the prime minister) has previously spoken of her dislike of the Human Rights Act (10). What laws, what protections will we lose as Britain separates from the EU? The government has given us no reassurances; they barely seem to know what they want from Brexit itself.

In America, Donald Trump’s government has taken a shocking turn. Almost all of his cabinet have previously gone on the record with their anti-LGBT views (11). Already many fear that all LGBT protections will be lost if Trump’s administration passes laws allowing discrimination against LGBT people in the name of “religious freedom” (12).

It is no longer true that what American does today we do tomorrow, but many people in Britain still look to America. People who have been campaigning for the repeal of marriage equality and LGBT protections will be looking very keenly at Trump’s administration, especially if they roll back LGBT equality.

Peter Tatchell once said that LGBT people are the litmus test of how a society respects human rights (13). If a society doesn’t value diversity how will it value anyone? But why should nurses worry about human rights? Because if we don’t, how can we nurse anyone with dignity?

(This was originally published as a comment piece in Nursing Standard magazine)

Drew Payne


Find out more about this short blog series here

Friday 15 July 2022

With Pride, August 2015

Do Unhealthy Attitudes Ever Change?

(August 2015)

During my first year of nurse training (twenty-five years ago) I ran into a wall of homophobia. I was told by some of my vocal colleagues that I only wanted to be a nurse to see naked men, that all gay men deserved AIDS, that I was a danger to children, and that God could heal me and make me “normal”.  I endured it because it was 1990 and homophobia was what I expected as a gay man.

It's now 2015 and our society has changed so much since my student nurse days. We are so much more open, we have so many legal protections now against homophobia; last year my partner and I got married. I thought we had come so far and then I was brought down to earth with a crash.

This month, Stonewall (the LGTB campaigning organisation) published Unhealthy Attitudes (1), their report on the treatment of LGBT health and social care staff, and it was a shocking read. It felt as if I was right back there twenty-five years ago, like nothing had changed.

The report, written following a YouGov survey of health and social care staff, found that one in four people had heard a colleague make negative or homophobic statements about LGBT people and one in five had heard negative statements about trans people. A quarter of them had been the victims of homophobic bullying from patients and service users. 10% had heard colleagues make claims that LGBT people can be “cured”.

These statistics may sound cold and not greatly impressive but the report also carries the realities behind them, it is full of personal quotes. The nurse who was told by another nurse that he should be hung for being gay. The nurse whose manager told her that homophobic comments were “only banter”. The nurse who was ostracised by his whole staff team, at work and socially, when it came out he's gay. And many comments where trans people were called “it” or “she-male”.  Then there were the comments that were themselves homophobic. A healthcare assistant (HCA) who said people are not born LGBT but “choose” this “lifestyle”. A doctor referring to anyone he doesn't consider “normal” as “deviants” whose needs shouldn't be “forced” on the majority.

Yet this report has created little outrage or even comment from our nursing leaders or the wider community. If this report was highlighting racism or sexism surely there would have been an outcry about it, articles in our newspapers or items on the television news. Yet this report barely caused a ripple.

Homophobia still seems to be the prejudice that we most easily accept, it's just “banter”, it's just someone's personal belief or personal views, and any challenge to it is seen as “political correctness gone too far”. But it's none of these; it’s prejudice and it can damage or even destroy people's lives. Why, as nurses, are we tolerating this?

There have been several reports previously from Stonewall highlighting the poor treatment experienced by LGBT people from the NHS and how reluctant they are to be out to healthcare workers. The results of Unhealthy Attitudes only reinforce these earlier findings. How can we offer patients open and non-judgmental care when we can't offer non-judgmental support to our own colleagues?

We have spoken a lot about “person-centred care”, but it seems that if the person is LBGT then a large part of their personality and needs are ignored, at best. LGBT people have their own healthcare needs, more than just using the gender-natural term “partner”, but the evidence is that they are still being ignored.

How have we got to this point? Unhealthy Attitudes has a clear recommendation, staff training in LGBT issues. It found that three in four people haven’t received any training in the needs of LGBT people and only one in four have been provided with any equality and diversity training. Yet the NHS has a legal responsibility to eliminate discrimination.

In the last three years my own equality and diversity training has consisted of one fifteen-minute, online presentation that covered the needs of disabled people, black and ethnic minorities people and LGBT people, but in no depth at all for any of them.

How can we say we focus on person-centred care when LGBT staff’s safety is so bluntly ignored by the NHS?

(This was originally published as a comment piece in Nursing Standard magazine)

Drew Payne


Find out more about this short blog series here