Bridging the Gap: A health inequalities learning resource

Cultural Discrimination

Organisational Culture can be described as 'the written and unwritten rules about how to behave and how to get things done' in an organisation.

 If Rosa Parks had not refused to move to the back of the bus, you and I might never have heard of Dr. Martin Luther King.  Ramsey Clark, 1927 –

Organisational cultures, unless consciously and honestly considered and at times challenged, will inevitably reflect to some degree wider social attitudes, values and beliefs about difference and potentially influence the actions and behaviours that flow from them.

It is worth noting that social and cultural norms and behaviours often lag behind and can even conflict with the law and the positive intention of operational polices, resulting in what we sometimes describe as the 'gap' between policy and practice.

For example:

  • A bullying culture may persist in a team, despite the organisation's Dignity at Work policy, but nobody reports it because they don't believe it will be taken seriously or dealt with, in turn further undermining the policy
  • A member of staff overhears a patient and her visitors expressing homophobic remarks about another patient and knows this is discriminatory, but lacks the confidence to challenge, despite policy commitments to promoting equality of opportunity and good relations. Not acting implies such remarks are acceptable, while their target is left feeling that while the NHS might have glossy policies, the reality is that the staff don't take homophobia seriously 

Pause for thought...

Thinking about your own experience, have you ever witnessed or experienced a tension or conflict between what a policy or procedure says and how things are done in practice?

  • How confident would you be to challenge? Would you find it easier to challenge some forms of prejudice than others? Why do you think this is?

We focus on organisational culture above, but what role do you think 'culture' plays more generally in relation to disadvantage and discrimination? 


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