The National Health Service [NHS] remains one of the most significant employers of minority ethnic groups. However, evidence suggests that members of such groups are significantly disadvantaged in NHS employment. In this article we present research evidence about the recruitment of minority ethnic groups into nursing and midwifery. In case studies of nurse education centres we identified few positive action provisions which were part of a systematic strategy for improving recruitment from minority ethnic communities. The arguments for positive action were neither widely understood nor embraced, and the problem was compounded by the fragmented organizational structure of the NHS. We conclude that what is required is an effective national strategy to build on the NHS's underlying principle of equitable and effective health care for all. This entails linking the moral imperatives of service delivery to a diverse patient community to a business case for equality of opportunity and positive action.