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Independents' Day

PHE's BAME review missed a vital opportunity

Dr Kailash Chand OBE

‘Justice will not be served until those who are unaffected are as outraged as those who are’ - Benjamin Franklin.

Public Health England (PHE)’s rapid review on BAME deaths from Covid-19 was launched under a lot of fanfare. We had high hopes that this disparity would finally be addressed.

However, the report has turned out to be a damp squib. It provides the statistics behind that impression: black and Asian ethnic groups, it found, were all significantly more likely to die with Covid-19 than those from a white British background. It describes that people of BAME descent are at a higher risk, with those of black African descent at least two-fold; Asian and Filipino descent 1.8 fold and ‘other’ (whatever that is) 2.5 fold.

It then goes on to say that we should all sit down and take stock. No recommendations, no reinforcements for risk assessment, just time for quiet contemplation. Unfortunately, the study incompetently even failed to take into account vocation, comorbidities and obesity levels.

This is a lost opportunity for addressing the unfairness and disproportionality of BAME deaths.

None of the key issues were addressed in the review

Michelle Bachelet, the UN’s high commissioner for human rights, has issued a damning statement, in which she said the disproportionate impact of Covid-19 on ethnic minorities, in the US, the UK and elsewhere, shone a light on ‘alarming’ levels of inequality that have been ignored for too long.

The pandemic has shown high levels of deaths of BAME healthcare workers (of the 12 GPs who have died with Covid-19, 11 were BAME), but we have independent evidence that structural racism and discrimination in the NHS is rife.

Workforce Race Equality Standard (WRES) indicators have worsened over the last two years; the share of BAME staff experiencing discrimination at work from a manager, team leader or other colleagues has climbed from 14% to 15.3%. The latest WRES report from NHS England shows that black and minority ethnic staff are suffering from increasing levels of bullying, harassment and abuse.

Boris Johnson thanking the immigrant nurses who saved his life, and Matt Hancock shedding crocodile tears for the dead immigrant doctors are simply soundbites and political gimmicks.

The inequality is still being felt by BAME doctors from the very beginning of their careers. It seems BAME NHS workers are good enough to die, but not good enough to lead.

The report was supposed to address two key questions: why are people from ethnic minorities disproportionately affected by Covid-19, and what will we do about it? And then NHS England should have focused on what must change in the cultures of NHS organisations.

But none of this been addressed - a true missed opportunity and in fact another nail in the coffin for equality and transparency in the NHS.

Dr Kailash Chand OBE is a retired GP in Tameside

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Readers' comments (3)

  • Be careful not to misconstrue the essence of Benjamin Franklin's quote about justice for all with middle class virtue-signalling with outrage-by-proxy.

    It is already well-documented that South Asians and those of African descent have much higher prevalence of diabetes and cardiac disease in the UK. COVD-19 has been linked to higher mortality in those with pre-existing medical conditions. This affects every nation on earth, not just the UK. I agree that association and causation with those in groups of greater risk would be a helpful study to report.

    Michelle Bachelet has form in issuing damning statements all over the world. This is her exact statement: which is a bit vague and suggests missing data from other (less-developed) nations. Report and be damned!

    There are lots of socioeconomic reasons for disparities between what I will call tribes that cuts across ethnicities and, for your convenience, skin colours. Using the racism card so loosely isn't responsible commentary. We should not be jumping on the US race bandwagon. The UK must be the most tolerant place on earth, but if you look for bigotry you will find it and the perpetrators are not all 'white' by a long way. To call me a racist and suggest 'white' people don't give a feck about darker-skinned people is insulting.

    The WRES report is interesting, but doesn't describe the perpetrators of abuse nor link to racism. Your article has undertones of accusation under the cover of inequality with another partisan swipe chucked in for good measure.

    Rather than moaning and lamenting about a problem why not develop a solution and make use of that OBE other than for political gesturing.

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  • It is rumoured that the report was not (as has been reported elsewhere) redacted; but that there is a second, more important report, that was commissioned by CMO, and which was completed and submitted (presumably at the same time as the epidemiological findings report which has been published); but DHSC has decided not to publish - or even, as far as I'm aware - acknowledge the existence of.

    I cannot provide evidence for the above, but it sounds entirely plausible.

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  • As an indifferent observer, BAME communities wear masks in public in London and others obviously aren't. Maybe out of fear, or wisdom or civic duty. Just an observation, prior to round 2.

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