Staff fight to cure racism in the NHS

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The Independent Online
THE GOVERNMENT has been accused of failing to tackle "institutionalised racism" in the National Health Service, which is said to be blocking the careers of black and Asian doctors and nurses.

The first personnel strategy for Europe's largest employer, unveiled amid much fanfare last month by the Government, would do nothing to stamp out discrimination, according to equality campaigners. Racism found in British hospitals, they argue, is one of the main reasons for the chronic staff shortages in the NHS as the Department of Health battles against waiting lists. Some of the most talented black and Asian doctors find themselves trapped in the two grades immediately below consultant - two- thirds of all these doctors are from the ethnic minorities.

Dr Nizam Mamode, deputy chairman of the British Medical Association's junior doctors committee, said: "I've seen it again and again; there are very good surgeons who've come from India who know for a fact they will not be given a consultant's job in this country.

"It's out-and-out racism. It's a lot easier to deal with someone who speaks with a British accent than someone who doesn't; I think that's probably the distinguishing feature."

The racism faced by the "overseas" doctors is at its most obvious when they want to progress beyond the associate specialist or staff grades, of which they make up 65 per cent, to the next and highest grade - consultant - of which only 15 per cent are foreigners.

A Commission for Racial Equality report concluded: "Black and Asian applicants were consistently less likely to be short-listed for, or appointed to, senior registrar or consultant posts than white applicants."

But a source close to the Department of Health told The Independent: "I am very sceptical about whether the vast majority of [NHS] trusts are going to move seriously on race unless there is at least a threat of sanctions if they don't deliver."

A report by Unison, the public service union, found that black Britons were put off from becoming nurses as a "direct result" of the racism experienced by those nurses who arrived on the immigrant ship Empire Windrush 50 years ago.

The report also found 75 per cent of those black nurses already in the profession considered leaving the NHS last year. Roger Kline, national health secretary of the Manufacturing Science and Finance (MSF) union, which has 17,500 members who are nurses, said: "The personnel strategy is too much of what you ought to do, rather than this is what you must do. Those [NHS hospital] trusts that are serious about doing something, will; those that aren't will hope it gets lost.

"The NHS is steeped in racism, so black staff are both leaving and not joining. The main reason is the sons and daughters of black nurses decide they don't want to experience the kind of treatment their parents have."

Georgina English, NHS policy officer at the CRE, fears the human resources strategy may be as ineffective as the Programme of Action, a previous initiative. "I have mentioned the Programme to senior people in NHS personnel and they were not aware of it," she said.

Doctors' leaders believe racism can have a direct effect on the care of patients.

"Any discrimination breeds incompetence and incompetent people are getting through the system. This is clearly putting patients' safety at stake," said Mr Mohib Khan, chairman of the British Medical Association's non- consultant career grade committee, which represents doctors who have finished their training but have not yet become consultants.

A survey carried out for the British Medical Journal found that ethnic minority doctors were six times more likely than white doctors to have complaints upheld against them by the Professional Conduct Committee of the General Medical Council.

Studies carried out by Dr Sam Everington and Dr Aneezh Esmail on racist attitudes in the medical profession, reported in the British Medical Journal, show a "foreign" name is a handicap at every stage of a doctor's career.

In their articles, the two equality campaigners claimed that having an Asian surname reduced by half the likelihood of an interview for a junior doctor post as opposed to white applicants.They also claimed that white consultants were three times more likely to be rewarded financially through the merit award system

Case Studies


KAI SUMANA, 54, is a psychiatric nurse who says that the whole course of his career has been shaped by his battle against racism.

He came to the UK from Sierra Leone in 1964 when the National Health Service was advertising abroad for nurses because - like today - it was short of staff.

"I went into psychiatric nursing because I felt a black man would get on better there. Not many white people were keen to do psychiatry because of the stigma attached to mental illness. When I first arrived, I didn't realise I was being discriminated against, because I didn't know the culture.

"After a while I began to realise there was a lot of discrimination at work, in terms of promotion, in terms of allocation of responsibility.

"Even when you have the same capabilities and qualifications as white people, in the health service, black people are mostly overlooked for promotion," Mr Sumana said.

In 1988 a new "clinical" grading system was introduced for nurses, but Mr Sumana was not given the managerial "G" grade he felt reflected the responsibility he had for running a ward. "Unison fought very hard for me. We had to go all the way to Acas [Advisory Conciliation and Arbitration Service] before I got the grade I really deserve," he said.

It was a seven-year battle till Mr Sumana received the "G" grade and pounds 16,000 in back-pay. He now runs a psychiatric ward at night. A Unison report found that nursing staff from the ethnic minorities often believe they are more likely to have to work while their white colleagues sleep.


DR NIZAM MAMODE, 36, has a Mauritian father, although his mother is English and he was born in Britain, but he believes his name and the colour of his skin have exposed him to prejudice.

He encountered problems when applying for medical school. "I had some difficulty getting in; at one point I had all the rejection slips pasted on my wall - it did make me wonder."

Eventually he was accepted by St Andrews University to do his pre-clinical (first three years) training. Of the 20 exams he took, he got four first- class merit awards and 10 second-class. His clinical training was done at Glasgow University. "There is clear evidence of discrimination in medical schools. Certain examiners are well known for failing black students, and sometimes do so. In a clinical exam it's much easier to give someone a hard time if you choose to. I got through OK, but some of my colleagues justifiably felt they had been discriminated against." Dr Mamode came across similar problems when he started work: "There were episodes where I was aware of discriminatory attitudes on the ward. Someone would see my name on the roster and page me, when I turned up they would say, `Oh I expected someone who ...' and then stop - meaning, `I was expecting someone darker, or with an accent'.

"Since then I haven't had any problems with career progression; most people know me by now," said Dr Mamode, who is deputy chairman of the BMA's junior doctor committee and a surgeon with a growing reputation at Glasgow Royal Infirmary.