British Asian celebrities released a video urging ethnic minorities to take up the Covid-19 vaccine as the BMA headquarters in Tavistock mourned the 100,000 lives lost during the pandemic. Their efforts of creating awareness about the significance of vaccination among the black, Asian and Minority Ethnic (BAME) communities appear after the government’s failure in dispelling rampant misinformation around the ingredients of the vaccine. But BAME doctors, particularly the immigrant staff in the NHS, are once again left to fend for themselves. While some doctors are fortunate in receiving leftover vaccines, other overseas NHS medics treating Covid-19 patients are reportedly being “denied vaccinations because of internal guidelines” which allegedly prevent immunising those without an NHS number.
Speaking out against structural racism in the NHS, Dr. Preeti Shukla, GP and Chair, BIDA, exclusively told Asian Voice, “Structural racism is very common. As an immigrant doctor, one of my colleagues tried to intimidate me by saying that NHS England would like to “see your passport” and tried to dissuade me from taking on my tasks.”
“You need to be thick-skinned and resilient to progress here. There are very few allies even when they actively support the BAME cause on social media or issue public statements. But in reality, very few actually offer support, guidance or mentorship. In one of the NHS meetings, while I was presenting my viewpoint, a white middle-aged person told me that ‘we work differently from the place you come from, our culture is different.’” Ethnicity box still absent on death certificate despite PHE review recommendations Covid-19 has only brought to surface the institutional and structural racism that has been brewing and thriving within the NHS ranks for decades now. The true scale of the impact of the virus on the BAME community is yet, to be determined. There is no concrete data aggregation of the Covid-19 deaths during the second and third wave of the pandemic even as the Public Health England (PHE) review recommended that the government added an “ethnicity” box to the death certificates a few months ago.But doctors had hoped that the death of over 800 NHS staff and social care workers would be a wake-up call for the government in rooting out the decades of injustice and that the Tories would aim to reduce the existing inequalities if not completely iron them out. But what was seen as a patchwork solution, health secretary Matt Hancock in April last year announced a lump sum of £60,000 for the families of health and care workers who died from the virus. The financial compensation did little to address the root causes of workplace discrimination, intimidation or bullying prevalent across the NHS. Worse, yet, migrant doctors are now reporting increased patient hostility as. “A patient interrupted me at the end of consult and said - I am going to be a little bit rude and ask which nationality you belong to? I was shocked. I thought the consult went well. When I said – Indian. She replied - Ah okay - your English is good and disconnected the call,” Preeti had tweeted earlier. She is cautious in not breaching patient confidentiality and does not delve into the case further. But she explains this is not an “uncommon occurrence”. She said, “It is not an uncommon occurrence and happens more often at hospitals than in General Practices unless you are a new doctor to the team. Usually, patients in GPs are more accepting as they have known you for years. “Having said that, we keep hearing comments like ‘Your English is good - meaning that despite being an Indian I can understand you. Where are you originally from? You don’t have that thick an accent as the other doctors do. How long have you been in this country? Why did you come to this country? It is usually such micro-aggressions where they are trying to show you your place in society.”NHS staff relocating because of stringent Adult Dependent Relatives (ADR) rulesEarlier, last week, BAPIO UK along with the BMA, Royal College of Psychiatrists, besides several other medical organisations in association with Trent Chambers solicitors, demanded a change in the existing adult dependent relatives (ADR) regulations. Immigrant doctors constitute, a third of the NHS workforce and according to them, the existing ADR rules have left these doctors with an immense emotional burden. Some of these professionals were forced to move back into their home countries and many chose countries such as Australia, Canada or the US that have a more humane approach as regards to the immigration rules. Sharing her experience, Dr. Preeti said, “I don’t understand government’s logic about declining elderly parents to stay - they are not a burden to society as we pay our taxes and are clear that we won’t need social services support in their case, their family will look after them. As a single parent, it would have been lovely to have their support in raising my 11-year-old son but in current circumstances, it’s not possible.”Medical chiefs and NHS heads have cautioned the government that it cannot afford to lose out immigrant doctors and nurses at a time when the NHS is already short-staffed and at breaking point. But home secretary, Priti Patel, in her address to the Conservative Friends of India, fervently said that “we need to train our own nurses” as opposed to relying on nurses coming in from India. Speaking about the virtues of the new points-based immigration system, she insisted, “India needs their nurses and we have to develop our talent domestically. That is the work we are doing in levelling up and investing in upskilling our talents.” Racism in access to mental health servicesYet, the government has collectively failed in addressing the concerns of the BAME medics and healthcare workers fundamentally around racism. A recent survey by the Royal College of Psychiatrists noted that six in ten (58%) BAME psychiatrists have faced overt or covert racism at work, but only 29% of these incidents were reported. Psychiatrists are also making the case for recording incidents and collecting data on the experience of discrimination across all stages of career progression, as well as developing guidance to support employers to stamp out discrimination and support staff. Covid-19 has also exposed the absence of BAME clinical directors across NHS trusts and hospitals and collating data is only the first step in bringing a “systemic change” in the healthcare system.Need for a cultural transformationTo remember those who have died, the BMA projected a message on to its headquarters in Tavistock Square, in Bloomsbury, London, with the message “we will never forget”. While prime minister Boris Johnson in his daily press briefings insisted that his government “did everything we could” to limit coronavirus deaths and expressed sorrow after the total UK death toll exceeded 100,000 on nearly every metric, he refused to discuss the reasons why it might be so high.Speaking exclusively with Asian Voice, Chaand Nagpaul, Chair of the British Medical Association (BMA) spoke about the need for a cultural transformation. He said, “We have learnt through this pandemic that this inequality is unfair on those affected by it primarily, the BAME doctors, and therefore, has a detrimental effect on the NHS. We need to change the culture of the NHS at its core. The current culture in the NHS is such that a doctor from the BAME background is twice as likely to be bullied and harassed. They are more likely to be referred to disciplinary processes than their white colleagues even though there is no concrete evidence to indicate that they are worse doctors. They were and are more wary of speaking out and challenging the authorities. “We need to look beyond superficial commitments around tick-boxes and namesake appointments. To address the root causes of bullying, workplace harassment and discrimination, we need a cultural transformation in the NHS. We need to transform the way that medical leaders, managers and directors address the subject of institutional inequality. This transformation needs to unleash and maximise the potential of our NHS workforce.” Dr. Nagpaul is optimistic that all NHS doctors will potentially be vaccinated with the first dose of the vaccine by the next month. And perhaps, loss of the 800 NHS frontline staff will steer the government in rooting out the evils plaguing the very system designed to save lives. ----------- .
