Covid-19 is opening a Pandora's Box on race relations in the NHS

Covid-19 is opening a Pandora's Box on race relations in the NHS

by Jonathan Stanley
article from Thursday 16, April, 2020

IT HAS NOT ESCAPED THE ATTENTION of anyone who has worked in healthcare that there is a devastating impact being suffered by NHS staff from Covid-19. There are doctors and nurses, and auxiliaries dying. There will be more. The problem I have that is it becoming very clear and very quickly that the suffering is not being felt equally across the board.

All the doctors who have so far died are of immigrant background. There are huge differences in race across the profession. It has been known for decades. Access to training, referral to the GMC, exam failure rates, and now likelihood of dying in a pandemic are simmering slowly into a bitter potion for the profession and ultimately for us all.

When the teenager Stephen Lawrence was murdered nearly 30 years ago it unleashed seismic changes in our society in how we consider racial inequality. Are we overdoing it, are we underdoing it, is it in fact quite difficult to achieve racial equality without invoking indirect discrimination in our quest?

None of these are easy questions but for the medical profession I feel we are entering the early days of the biggest public inquiry into race relations within the institutions of our country since the Stephen Lawrence inquiry. Nothing foments venom and zeal among the left like racial inequality. It is for that reason as much as for real justice that conservatives and liberals on the right should appreciate the true impact this pandemic is having and be prepared to be both forensic and forgiving of institutional memory and how it has allowed us to arrive at this point.

In place of blame we must learn, and in place of fear we must explore how to carefully reform our most important profession into being fit for purpose – not just for its patients but for its workforce.

Who has power in the profession? Who gets to give you the thumbs up or down? Who decides who goes to fight on the frontline without the right kit and who gets to direct the troops from behind the front line? Who controls the research grants that are the bottleneck to higher training? Who really is the employer of trainees? Where are these racial inequalities and why are they there and to what extent are they a consequence of circumstance and a consequence of professional inertia? Who gets to rent-seek and play the system of an NHS where sub-consultant grades deliver so much of the high quality care that other European countries deliver through the top grade of the workforce?

These are questions many in the profession feel are too big for politicians to ask and too dangerous for doctors to raise within the ranks. This is a very protectionist and untrusting closed shop and those who rise within it can enjoy incredible success out of controlling limited resources, with security of tenure and prestige icing the lucrative salaries and pensions.

Be that as it may, I think the recent deaths of so many doctors and nurses that were arguably entirely preventable with proper equipment to protect them, are lighting the touchpaper for one hell of a firework display in the next few years. The British Medical Association chair has let off a signal flare here. Let us on the right treat it as a call to arms, not to bunkers and help put wrongs right.

Dr Jonathan Stanley has returned to the NHS to help fight the Covid-19 Pandemic

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