NEWS: Urgent call to address racism in NHS

As reported by GP Online, Dr. Chaand Nagpaul warns that failure to tackle structural racism, bullying, and harassment could drive more doctors out of the profession, affecting patient care

He highlighted that 42% of the medical workforce is from a black or ethnic minority background and said a failure to tackle structural racism, bullying and harassment would drive more doctors out of the profession.

A GP partner in north London, Dr Nagpaul became the first person from an ethnic minority to chair the BMA in 2017, a post he held until 2022. During his time as chair, the BMA set up a national forum for racial and ethnic equality and conducted a landmark survey to understand the impact of racism on doctors.

Racism in medicine

The survey found that 9% of ethnic minority doctors had stopped working in the NHS because of their experiences of racism, 23% were thinking of leaving the profession, and 16% had taken time off work because of their negative experiences.

‘The workforce plan makes mention of inclusivity and the need for there to be fairness amongst the medical workforce, but doesn’t spell out the reality that racism is wrecking the lives of doctors,’ Dr Nagpaul said.

He said it was also ‘wrecking the NHS’ because of the number of doctors who felt they had to leave or take time off work, as a direct result of their experiences.

‘It is so disappointing and shocking that in spite of all the evidence we saw through COVID – and after Public Health England at the time published reports clearly showing structural racism afflicting the NHS – that we have a government that has actually denied the existence of structural racism,’ Dr Nagpaul added.

‘It’s important for bodies like NHS England to demonstrate their independence of authority and really place eradicating racism at the forefront of its workforce plan.’

Inclusive environment

Dr Nagpaul said that tackling racism was not ‘just about correcting a moral wrong’, it would also help improve patient safety and quality of care.

‘There’s plenty of evidence that organisations that have an inclusive environment where people are treated fairly are much more productive. And the health service would have far better health outcomes for its patients if it actually treated its workforce equally,’ he said.

‘There are so many ethnic minority doctors whose skills and expertise are not being allowed to flourish because the system is either dumbing them down or not allowing them to progress and achieve positions that would benefit patients in the greatest way. So it’s also better for the nation’s health to eradicate racism in medicine.’

As chair of the BMA during the height of the pandemic, Dr Nagpaul was outspoken about the disproportionate impact COVID-19 had on doctors from ethnic minority backgrounds. It was this, along with the Black Lives Matter movement that came to the fore in 2020, that led him to set up the BMA forum for racial and ethnic equality, which he still now chairs.

The forum is aiming to provide a greater voice and visiblity for ethinic minority members within the BMA and help the union challenge discriminatory practices within the health service.

Dr Nagpaul said it was essential that NHS organisations had a culture where people felt able to speak out about their experiences of racism.

Speaking out about racism

He said the BMA’s survey found that seven in 10 doctors who experience racism don’t raise it with their employer either because they believed nothing would be done about it, that they would be seen as a ‘troublemaker’, or it would negatively impact their career progression.

‘In many ways, the true extent of racism in medicine is highly underestimated,’ he said. ‘We need to have a culture where someone expressing [their experiences of] racism should be thanked. The employer or the provider should be saying “Thank you for telling us and let’s find a way to resolve it”.’

Dr Nagpaul said this also applied to GP practices, adding that creating an inclusive environment would enable practices to get more out of their workforce and ultimately improve patient outcomes.

He said practices should be ‘open-minded about taking on doctors from a variety of backgrounds’, particularly international medical graduates.

‘It’s about giving them support and seeing their true potential unfold in front of you,’ Dr Nagpaul said. ‘I’ve certainly got many examples where when practices have given such opportunities, they have benefited, the doctors benefited, and patients have benefited.’