The NHS employs 1.4 million workers
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Few NHS trusts appear to be meeting legal requirements on race equality, the Healthcare Commission has warned.
A study of England's 570 NHS trusts' websites found that just seven had published information under the 2000 Race Relations (Amendment) Act.
The Department of Health is writing to NHS chief executives requesting a prompt response to the findings.
Worst offenders could be named and penalised if they continue to fail to comply, warns the inspectorate.
Widespread non-compliance
Since May 2002, trusts have been required by law to publish three pieces of race relations information online or in a hard copy.
This, and other race equality laws under the 2000 Act, were introduced in response to the public inquiry into the murder of black teenager Stephen Lawrence.
When the Healthcare Commission's inspectors scanned each trust website, only seven of the 570 trusts had all of the required information readily accessible.
Nearly a third of the trust websites had none of the required information.
An updated plan setting out how the organisation would make race equality central to all its functions was found on 60% of the websites.
Six per cent of the websites included statistics showing the ethnic profile of the workforce. Only 2% outlined what action had been taken to address problems related to race equality rules.
The Healthcare Commission stressed that its test was "not definitive" but that the findings "did suggest a significant problem".
Penalties
Jamie Rentoul, head of strategy, said: "It is not unreasonable to expect legislation to take a little time to bed in. But we were surprised and disappointed by the apparent extent of the problem at this stage.
"The duty to promote race equality is not an optional extra."
Surinder Sharma, the NHS National Director for Equality and Human Rights, said: "The Department of Health takes these findings very seriously.
"I am personally looking to every NHS Trust to give immediate attention to remedying this situation, not just to comply with legislation, but also because race equality remains a core element of our drive to improve access to healthcare, combat health inequalities and develop a diverse workforce."
Nick Johnson of the Commission for Racial Equality said: "These findings reinforce our concerns around the performance of the wider health sector on race equality and we will be considering enforcement action against trusts that fail to meet their requirements.
"This degree of non-compliance shows gross neglect of the very laws in place to guide how public goods and services should be delivered to protect all members of our communities."
Carol Baxter, head of equality and diversity at NHS Employers said: "These findings clearly show that there is a lot of work to be done to ensure that trusts are fully compliant with race relations legislation.
"We are confident though that trusts are fit to meet this challenge."