This site is intended for health professionals only


It’s not just cricket


Short-term boost


You don’t have to be a cricket fan to have seen the fallout out of the racism scandal at Yorkshire County Cricket Club. It was tearjerking watching an incredibly brave testimony in the Commons from Azeem Rafiq, the cricketer who had his whole career taken away from him due to racism.

I strongly believe that it is wrong to say cricket, a sport I love, is reflective of society in this instance. What was happening at that club and others was far worse than the vast majority of workplaces (at least since the 1970s).

But, just like following the fallout from Harvey Weinstein’s crimes, I think it would be remiss not to take this chance to ask whether general practice has anything to learn.

This is a subject close to my heart. In my three years as editor, we have done two cover features on systemic racism, including my very first issue. Before then, my biggest story was on the differentials in performance between white and non-white candidates in the RCGP exam.

So, is there a problem with racism in general practice? The first thing to say is that from Thursday three of the four most powerful positions in general practice will be filled by non-white individuals – health secretary, director of primary care and chair of GPC. There remains a problem with the lack of black people in positions of power in the profession, however.

But I feel the ethnicity of the leadership doesn’t preclude systemic racism. As we have pointed out in previous cover features, non-white GPs have worse outcomes in all areas of general practice, including GMC complaints and investigations, exit exams and CQC inspections. This is equally true when only looking at British-born individuals. There is still no explanation as to why this is the case.

We can also look at policies. Take the new NHS England plan. As RCGP chair Professor Martin Marshall pointed out, the draconian measures in the plan will target single-handed GPs, a disproportionate amount of whom are old, male and of Asian heritage. Of course, you may say that the rules are the same for everyone. But this is the point of systemic racism. Why were these metrics around face-to-face appointments and access? If there was a policy decision to look at overall patient satisfaction and continuity of care – which would be equally valid metrics as those chosen – then the practices Professor Marshall speaks of would score highly.

This is not saying that there is a vendetta against doctors of Asian heritage – far from it. But single handers seem to be seen as collateral damage in the overarching policy in England. Ageism is probably a bigger factor in allowing these GPs to be collateral damage; if they were male and of Asian heritage, but also young, I strongly suspect they would reconsider this policy. But also – and I have no way of proving this – I wonder if more attention would be paid to this collateral damage if single handers comprised predominantly old, male and white GPs.

Take also the RCGP’s response to the row over its clinical skills assessment exam. While their actions were nowhere near as bad as those of Yorkshire CCC, the responses were identical – a refusal to even countenance there was a problem. This is not about individuals making the decisions, and it is not even about NHS England or the RCGP, both of which have many good people working in them. But non-white GPs are still affected disproportionately.

Yet the thing that most resonated with me watching the Rafiq hearing was the micro-aggressions, and this is something I have experience of (albeit nowhere near what he went through). It’s the ‘but where are you really from?’ questions, getting funny looks after an Islamist terror attack, feeling self-conscious about supporting England, people joking about not attempting to get your name right. The recipient of these micro-aggressions laughing again awkwardly because they know no harm is meant, but it is a reinforcement that you don’t belong.

This is absolutely a societal issue, but even with the high proportion of non-white GPs, this still exists in general practice and medicine – something which Nabi has written about beautifully.

I suspect many readers would not agree with what I have written, and I understand that. Systemic racism is complex and you don’t need to be racist (or white) to contribute to it. I am sure I am guilty of contributing to it, and I also don’t think I am anywhere near understanding it. On the whole, I think we can say general practice is better than most professions in combatting it. But the more we think about it, the more just a society we can help establish.

Jaimie Kaffash is editor of Pulse. Follow him on Twitter @jkaffash or email him at editor@pulsetoday.co.uk

READERS' COMMENTS [6]

Sam Macphie 18 November, 2021 6:01 pm

We all need to respect people of all creeds or religion. So why has a recently famous Non-white, former Yorkshire cricketer (who gave powerful testimony to MPs), today admitted, (and admitted he is ashamed), that he made anti-Semitic remarks when he was an adult, although this was some years ago? Are certain religions or races or organisations more prone to make anti-Semitic comments or anti-Pakistani or anti-other remarks. Deep down, we should all know, (Whites and Non-whites) that it is up to everyone as individuals, not just collectively, to treat every human being with respect. Those who live in glass-houses, should they throw stones?
Of course, everyone is influenced by their upbringing or environment, race heritage, religion and other factors. I suppose this Non-white cricketer and some Whites too, have publicly apologised for their errors, and this is something everyone needs to be prepared to do.
Jews do not deserve anti-Semitic remarks, even if you are a Non-white former Yorkshire cricketer and made those chilling remarks when you were younger. Respect for all is the answer.

Vinci Ho 19 November, 2021 12:13 pm

Ambitions of arrogant politicians certainly complicated the issue time to time .
My own example is while I totally disagree to what CCP did in China , potential discrimination against Chinese people (as a result of current US-China confrontation at all fronts) is imminent.

Mrutyunjaya Kuruvatti 19 November, 2021 6:08 pm

Good article. Whilst Azeem Rafiq’s anti-semitic remarks are terrible, offensive and wrong, I am concerned about the implication of these coming to light. I am in no way trying to defend him. My understanding is that these remarks were uncovered by journalists from the Times. For what purpose? Yorkshire CC has been investigated for institutional racism. Highlighting these comments is a distraction from that, and an attempt to undermine his testimony. By all means he should be rebuked and face any appropriate sanction for his vile comments, but please can we look at the 2 issues, as distinct from each other (even though in both cases there was an absence of fundamental respect and dignity for other humans).

Sam Macphie 20 November, 2021 12:19 am

The 2 issues are intertwined, very much so. The Non-white former cricketer appears to have some degree of hypocrisy; I don’t think MPs in Parliament would be so keen to hear his anti-Yorkshire Cricket testimony now that his racist remarks have been discovered. Perhaps the MPs should have checked his social media first. Today, in addition to anti-Semitic remark, we know that he used offensive anti-Blacks terminology on social media. Perhaps Yorkshire Cricket should have looked at his past social media while he was employed there. Are there more racist offensive comments of his out there, yet to be uncovered? What sort of cricketer role model for future White or Non-white cricketers, (or general public, or children), is he?
He is young enough that he should know what comments about race are offensive. Also such offensive comments should not have remained online for years, potentially influencing others in a bad way. People who live in glass houses should not throw stones.
He has let himself down and many other people who would like to offer him respect.
He apologised and he is ashamed. I don’t think he needs anyone to be his apologist.
I hope he will not need ‘other offences to be taken into consideration’. Hopefully, he has sincerely changed. Remember, people hold up banners that read ‘Racism is not banter’, Rafiq.

David Banner 20 November, 2021 10:59 am

Whilst every sentient human wants racism to end, and the impatience of minorities at the glacial pace of progress over recent decades is understandable, I do worry that the current anti-racism tactics are likely to worsen, not improve the situation.
Daily media attention, saturation coverage of the cricket hearing, repeatedly informing non-whites they are permanent victims in a rigged game, whilst all whites are inherently racist and privileged……….the intentions are noble, it all may be true, but is it improving racism in society?
At best, whites will yawn and change the channel, but at worst they may angrily walk into the open arms of the BNP et al. The rise of the genuinely racist far right will then merely confirm the suspicions of non-whites, who will quite rightly organise a resistance.
Those of us who remember the 70s/80s know what endemic racism really looks like, and whilst frustration at slow progress is understandable, the radical tactics and constant scrutiny of today could put us back decades
.Even espousing MLK’s “colour blind” philosophy is likely to see you branded as misguided or even racist at present……is this really the end of “content of character over colour of skin”? Can nobody see the irony in labelling “all whites” as privileged/racist? Again, there may be some truth in the current theories around race, but are these tactics helping or hindering the struggle? I fear it’s the latter.

Patrufini Duffy 24 November, 2021 4:59 pm

You just have to look at the line-up of the England, Australia and South African teams.
It’s not rocket science.