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Does the NHS have a problem with BME doctors?



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I thought long and hard before writing this editorial. As a white man, I didn’t feel adequately qualified to comment. But as a journalist, I saw it as my duty to address the subtext of a lot of the discussions around the case of Dr Hadiza Bawa-Garba.

Because sadly in today’s Britain, race still matters.

Ethnic minorities are under-represented at senior levels across the public sector in the UK; they are more likely to be excluded at school and subsequently unemployed. Race hate crimes are rising. But how does this affect the health service?

Well, BME staff working in the NHS are more likely than their white colleagues to report being bullied or harassed and to experience discrimination. In 86% of acute trusts a higher percentage of BME staff do not believe their organisation offers them equal opportunities for career progression.

Among BME doctors I speak to the perception persists of a system blind to – or unwilling to address – its own prejudices

BME doctors make up 18% of UK-trained consultants and 31% of UK-trained GPs. But of the nine doctors who have been convicted for gross negligence manslaughter since 2004, seven have been BME. No white doctor has been convicted for more than a decade.

UK-trained BME GPs are nearly twice as likely to face a GMC sanction or warning, compared with their white counterparts – and then there are the well-publicised differential pass rates for the GP entrance exam. These are wider than ever recorded and, as with GMC sanction rates, perplexingly still exist between white and BME trainees qualifying in the UK.

Of course, all these discrepancies can be explained away. The GMC says BME doctors are more likely to attract complaints in the first place and more likely to face a complaint from their employer (and so be investigated).

And the RCGP has a High Court ruling to back up its assertion that its exam is fair. But the judge also told the college to redouble efforts to address the differential pass rates; it is adamant that it is doing so, but four years on shouldn’t we be seeing evidence that those efforts are working?

Among BME doctors I speak to the perception persists of a system blind to – or unwilling to address – its own prejudices. Indeed, the international doctors’ group BAPIO believes the ‘pursuit’ of Dr Bawa-Garba ‘reflects the inherent bias’ within the GMC – although chief executive Charlie Massey said the accusation was ‘troubling and without merit’.

But you have to wonder if the constant references to Dr Bawa-Garba’s ‘native Nigeria’ and tabloid images of her in a headscarf – often contrasted with the small white boy who died under her care – influenced the GMC’s decision to crack down on her so hard.

We have to be careful not to seek convenient answers to such a complicated set of events. Jack Adcock’s family and the wider health service deserve answers about how such tragedies can be averted in future. But equally, we should not be afraid to ask whether the doctor’s ethnicity was a factor. Would the GMC and the courts have acted as they did if she were white?

I once read that ‘to be human is to be prejudiced’ and the main thing is to accept it and seek to act fairly. As well as asking this of ourselves, we should demand our institutions do the same, and be seen to do so.

Nigel Praities is editor of Pulse. Follow him on Twitter @nigelpraities. Thanks to Professor Aneez Esmail for his help with this editorial.