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PHE’s BAME review missed a vital opportunity

‘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