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Independents' Day

RCGP criticised for 'all-white' board in open GP letter

More than 1,100 GPs have signed an open letter to the RCGP, criticising its ‘all-white’ board.

The letter, titled ‘Inclusive leadership cannot be achieved with all-white boards’, was sent to chair Professor Martin Marshall this morning (1 July).

The signatories, led by Dr Naureen Bhatti, said they are ‘appalled’ to see the ‘absence of black and Asian representation in the leadership of the college’, and referred to how BAME individuals are worse affected by Covid-19 and the systemic racism, which was revealed in a Public Health England report as a result.

They said this is despite general practice being 'the most diverse medical specialty since the inception of the NHS in 1948 when it drew heavily on the contribution of South Asian doctors'.

As it stands, GMC data shows that approximately 32% of GPs are currently from black or South Asian heritage or from other backgrounds that identify as not white, with 'half of these' international medical graduates, the letter said.

Calling for ‘compassionate leadership’, it went onto say that unless the RCGP acts in this area, it will ‘remain on the wrong side of history’.

The letter continued: ‘Failure to ensure wider representation in the RCGP leadership perpetuates discrimination. We know discrimination against NHS staff causes low morale and predicts poor patient outcomes.'

It added that 'if the college selection systems cannot address non-representation at board level quickly, the systems that select college boards should be changed', suggesting that this 'may require the introduction of quotas'.

It concluded: 'Maintaining the status quo is no longer acceptable and the college must learn from other sectors where all white boards are no longer permitted.

‘We need compassionate and inclusive leadership in 2020. All white boards cannot achieve this. Without action, the RCGP will remain on the wrong side of history and become an increasing irrelevance in the future NHS.’

In response, Professor Marshall told Pulse: ‘We thank Dr Bhatti for her letter and will be responding to her directly. Last week we issued a statement of solidarity with our black, Asian and minority ethnic colleagues, in which we recognised that the college, like organisations across medicine, needs to do more to identify and address structural racism.

‘This included a commitment to work to improve representation from black, Asian and other minority ethnic communities on college committees and in leadership roles as part of an action plan, which will be released later this summer as part of our wider and ongoing equality, diversity and inclusion work.

‘Our national council elections are now open and we encourage any members or fellows from BAME communities who would be interested in standing for council to do so.’

Dr Bhatti, an RCGP fellow and GP trainer in Tower Hamlets, explained to Pulse that she was already upset by the lack of BAME representation on the RCGP council and trustee board, but that Saturday’s conference messaging was the catalyst to sending the letter. This had seen the RCGP brand Covid-19 as a ‘lifestyle disease’.

She said: ‘I looked up the board last week, and was very shocked that it was all-white and predominantly male, because general practice has always been one of the most diverse medical specialties.

‘A lack of representation leads to insensitive things like the issue of the conference title happening. Younger colleagues have contacted me feeling unable to raise this, even in 2020. As a senior doctor, I don’t feel I can stay quiet about it. Sometimes, you have to have experienced discrimination to speak up.’

Signatory Dr Sabir Zaman, also a GP in Tower Hamlets, added: ‘As a young Asian GP privileged to be afforded a career as a leader, educator, and clinician, I often reflect on the journeys of all those doctors from black, Asian and other minority ethnic backgrounds that came before us, and the sacrifices they made.

‘This generation of forgotten doctors, including my mother, were pivotal in building the NHS we know today. They frequently experienced intolerable discrimination and marginalisation, and were asked to work in undesirable areas where others would not rise to the challenge. 

‘Their stories are equally sad and wonderful and should not be forgotten. They paved the way for us and deserve our gratitude. I am eternally grateful to them all. They are my heroes.’

GP trainees have also sent an open letter on racism to Health Education England, demanding tougher action to combat it during training periods. 

Readers' comments (14)

  • DOI- I would be classed as "BAME"- a term I despise which is riddled with divisive identification, the same as all identification from choice of football team, sexual identity etc.

    I note the slimy self-aggrandizement of Dr Zaman, who doffs his cap for the privilege of being a GP and the holiness of the Trinity of being clinician, educator and leader. We all are aware of the effect of scattered attention in place of focus which leads to sub-optimal multi-tasking, and produces just the kind of material for prominent roles in the RCGP which can justify to one self many good reasons why direct patient contact has to be limited "to achieve higher aims". The allusion to his mother whilst not devoid of truth presents a partial picture- racism abounded but like many who came to the UK to work in many spheres the recognition existed that prospects existed in the UK which did not at home, and on balance the racist bullshit they faced was a price they were wiling to pay at the time. There are also mentions in the article about the "right side of history"- notice how this is appealed to whilst conveniently overlooking how individuals also have a tendency to construct narratives which change with time.

    Racism remains and is a function of identity, producing self (and "mine") vs other. Quotas are a "solution" which misses this reality of human cognitive function, and cynically I suspect many a large ego with a distaste for frontline clinical work (and quite possibly of questionable clinical ability) are able to cement a sense of "worthwhile self" by seeking positions in a defunct outfit such as the RCGP, not even truly earned but instead bestowed through others fearing the charge of racism if they do not accede to a quota system.

    I love to carp and I offer no solutions other than do your job so damn well that it is apparent to all, and in spite of their seething dislike, even the racists are made to keep their beliefs to themselves.

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  • What he/she said above
    "BAME " is bollox

    Mind you, I'm a bit cafe au lait in the summer, and I'm happy to take the credit on behalf of my melanocytes for steering clear of anything to do with the racgp all my life

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  • And Dr Bhatti what is stopping YOU from standing for elections. Please explain that

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  • Vinci Ho

    There are several points for my ruminations:
    (1) I guess that is always the caveat of identity politics : ‘them against me or us with no justice ‘ and it is time for reversal of fortune and even revenge’ . I have interpreted the George Floyd phenomenon in two dimensions : disproportionate targeting on black people but also inhuman police brutality . They are fundamentally two distinctive issues .The latter was demonstrated in the twelve months peaceful-turning-violent protests in Hong Kong last 12 months and they were arguably precipitated by police treating captured protesters same way(kneeling on the neck was only one example )virtually every day for few months . It was not about skin colour.
    (2) I suppose there are two types of discrimination: Actional and Inactional. The former refers to wilful and inimical actions towards those one considers as ‘different’ . And the latter is about deliberate omission and exclusion of their rightful opportunities in our societies. The former is conspicuous while the latter is clandestine. We may not see so much direct confrontation as across the Atlantic(exception is perhaps the racist chanting in football matches ) but undoubtedly some people were excluded at all levels because of their identities. Yes , the interesting question is if these people are then offered ‘new’ opportunities, will they step forward and stand up?
    (3) Then it is about these numerical changes and quotas in representation. Inevitably, it reminds me of Hegel-Engels-Marx’s dialectic materialism where one ‘famous’ argument was : changes in quantity leads to changes in quality . Are we really going to wipe out racism by changing the numbers with the potential risk of generating tribal conflict ( in contrast of class struggle in Marxism ) ?
    Fundamentally , we are dealing with the weaknesses of human beings( seven sins , five giant evils etc )and I would presume all human beings are equal from this perspective.........

    If materialism and utilitarianism is about introducing changes from ‘outside to inside ‘ , Idealism and spiritualism is about making changes from inside to outside instead ......

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  • Vinci Ho

    And for the college , I am afraid that it has fallen into the same category of GMC as far as unconscious bias is concerned . In many other aspects , it also lost credibility in representing your members ( not me) with ambiguous telos. Otherwise , as an ‘examination authority’ to pass or fail and certify GP qualification to work , it is yet to re-establish reputation since the dispute over CSA ( involving a judicial review) a few years ago .
    Furthermore , I would , again, like to quote Michael J Sandel for his definition of justice :
    ‘'Arguments about justice and rights are often arguments about the purpose, or telos, of a social institution, which in turn reflect competing notions of the virtues the institution should reward and honour .''

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  • My Long-standing gripe with the college is the lack of csa examiners from Ireland ( north or south)
    As well as BAME discrimination there may well be a bias against Irish doctors on their examination panel as I have found repeatedly over the years
    It appears to have become “ an old boys club” with mutual patting on backs and a very closed ethos regarding outsiders
    To my my knowledge there are no (NI) csa examiners currently from my rcgp faculty.... why?

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  • Not really sure why anybody would want to join their club ...

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  • An excellent article that embodies the spirit of change. It recognises that there is a lack of representation at board level - and in doing so it highlights the pressing
    need for change and diversity. In not identifying the problem, we fail in finding solutions. All positive change and improvement(s) requires speaking up. Keep up the good work Dr Bhatti et al.

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  • did we have proportional representation at the last election cause i didn't vote for any white males at all, nothing against them but none of them stood out as being representative of my view point and very much status quo in their descriptions. in fact quite dull. can we have more radicals to vote for please including those who may be disabled, have mental health issues and LGBTQ etc, mixture of partners, locum, salaried and portfolio GPs. as the RCGP is failing its members en masse it needs a massive shake up or it will fade and die as a pointless exercise.

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