As we celebrate the 70th anniversary of the NHS, we need to pledge that all arms of the service, and other medical bodies, take a hard look in the mirror and reflect on how transparency, fairness, and equality should frame its future….writes Dr Kailash Chand
I am delighted to welcome you at this conference in Manchester, and privileged to be the opening speaker. I came to the UK in 1978, having trained in India. I am one of the lucky ones. I went on to have a successful and rewarding 30-year career as a GP and became chair of Tameside and Glossop primary care trust. I also played an active role in the British Medical Association and am its honorary vice president, chair of Health watch TAMESIDE and co-chair of the equality and diversity shadow board for Greater Manchester. One of the proudest moments of my life was being awarded an OBE in 2010 for services to the NHS. However, many BME communities’ experiences of the health service are quite different to mine, and to those of the white British population.
Manchester is a history steeped in history of equality and justice. In 1862, Lancashire cotton mill workers at great personal sacrifice refused to handle cotton picked by US slaves. This act was acknowledged in 1863 by Lincoln whose words are inscribed in his statue in Albert Square. Manchester was a natural place for movements like Suffragette, birthplace for trade union movements and even the fight against racism in the NHS. Azeez Esmail, professor of general practice at the University of Manchester, has been throwing an unflattering light on racism in the NHS and universities.
And this year is truly historic – we are celebrating the 70th anniversary of the Bevan’s and our NHS. It’s particularly pivotal because this year also brought to sharp focus the glaring racism in the treatment of the Windrush generation, many of whom had helped build the NHS. So it’s crucial that we reaffirm the founding principles of the NHS, of equity and fairness. These principles should apply across the NHS including to its workforce, offering all doctors equity and fairness in their professional lives. Yet sadly we know that racial inequality continues to afflict the NHS.
There has been significant progress – we have so much more information now. From inequalities into entry into medical school. At medical school, with differential attainment between the BME and white students, even those born in the UK, in passing their final examinations.
Differential attainment applies to postgraduate exams, and which therefore inevitably leads to worsening career progression for BME doctors. Independent analysis -Kathryn Woolf- shows that this difference is not caused by any difference in ability. We know that BME doctors disproportionately suffer greater bullying and harassment, and this naturally can affect performance.
They are more likely to be referred to the GMC from their employer and more likely to suffer sanctions. Yet there is not a difference in terms of patient generated complaints BME doctors are significantly less likely to hold senior positions in their workplace. This picture is completely out of kilter, with other professional sector such as IT or business, in which giants such as Microsoft and Google have top management teams populated with BME doctors from the Asian subcontinent, highlight that BME professionals are by nature industrious and bright.
Therefore the fact that BME doctors do not achieve as well in the NHS, and suggests that there is something within the culture of the NHS that does not bring out the best of BME doctors.
While such racial inequality is clearly unfair for doctors, is also unfair for patients and the NHS as a whole, who are being denied the full potential and capability of the medical workforce. We have to go beyond talking about racial bias into proposing solutions on what more needs to happen and change so that we truly have equal opportunity and achievement of BME doctors.
As we celebrate the 70th anniversary of the NHS, we need to pledge that all arms of the service, and other medical bodies, take a hard look in the mirror and reflect on how transparency, fairness, and equality should frame its future. I recognise that there is no silver bullet, and that the solutions will be multifactorial. There’s been plenty of talk, now let’s walk the talk! As Nelson Mandela said, “we have abolished apartheid and slavery, we can abolish racism too”.
(Dr KailashChand is one of the senior most GPs of Indian-origin in the country. He is honorary Vice President of BMA, former deputy chair of BMA council)