Discrimination in the NHS: Matt Hancock tightens policy
Racism against doctors is becoming an ever-increasingly spoken about topic. “28.5% of NHS staff said they had experienced harassment, bullying, or abuse from patients, relatives, or members of the public within the last 12 months”1. Fortunately, many NHS staff from a BME background are realising the fact that discrimination and racism from patients is unacceptable and are finding the confidence to report it.
Practice Business writes that “70% of surveyed trusts have reported an increase in such abuse”2. It doesn’t seem to be just staff though, as medical students have also been calling out the microaggressions that they experience on placement – some reporting being called “golliwog” and made to feel inferior, without any reaction from members of staff3.
Within the past few days, it has surfaced that NHS staff are now equipped with a strengthened power to remove any abusive patients from hospital as soon as their treatment can safely be terminated. This news comes as NHS England reports a 1.4% increase in staff facing discrimination (notably racism) from patients since 2015 – and that shocking data does not even include GP staff4.
However, it seems that many trusts have already implemented similar policies in an attempt to exhibit a ‘zero tolerance’ attitude towards racism. This was exemplified by one such event in the summer of 2019 in which a patient was banned from Wigan Infirmary after demanding to be seen by a white doctor5. In November 2019, a leading Trauma and Orthopaedic surgeon Mr Radhakrishna Shanbhag6 spoke very openly about being asked to be seen by his white colleague – and described feeling “worthless” and “unable to refuse” the patient’s request.
The candour of Mr Shanbhag’s words sparked huge discussion about the abuse doctors face whilst working on a day-to-day basis. To which the Health Secretary, Matt Hancock replied:
'No person should ever feel worthless because of racial abuse. Particularly the extraordinary individuals, like [Mr] Radhakrishna Shanbhag, who have dedicated their lives to improving the lives of others'
North Bristol NHS Trust has recently introduced a ‘red card’ policy7 with the view of deterring abusive behaviour from patients which includes racist and sexist language gestures or behaviour, threatening and offensive language and alcohol/drug abuse. Patients engaging in such behaviour will be issued a “sports-style disciplinary yellow card” as a warning and any continuation will lead to a ‘red card’ in which a patient will be removed from the hospital as soon as safely possible.
It is important to also recognise the necessity of stripping away the endemic structural discrimination against BME medics that is found within the NHS system and medicine. The GMC stated that there is a “statistically significant” discrepancy between pass rates of BME doctors who are in speciality training vs their white colleagues. With average pass rate for UK white doctors being 75% in 2014-15, and 63% for BME doctors – there is a well-defined need for improvement of these statistics and to ‘level out the playing field’. It has also been found that doctors from the most deprived backgrounds received a higher proportion of unsatisfactory outcomes – 13% compared to the average of 5%8.
These sobering figures underline the struggle felt by many BAME NHS staff in trying to feel equal to the rest of their colleagues. It is reassuring, though, to know that not only is this topic being spoken about more frequently, but that there are organisations actively working to combat it e.g. the BMA with its charter to help medical schools deal with racism3. I hope to see all hospitals applying a ‘zero-tolerance’ approach, and that NHS staff from all backgrounds work synergistically to enforce this approach.
Sources:
1 -
https://www.medscape.com/viewarticle/925344
2 -
3 -
4 -
https://www.medscape.com/viewarticle/925344
5 -
6 -
https://www.bma.org.uk/news/2019/november/senior-doctor-speaks-out-about-racial-abuse
7 -
https://www.nbt.nhs.uk/news-media/latest-news/north-bristol-hands-red-card-racism
8 -
https://www.bmj.com/content/354/bmj.i4100







