Intended for healthcare professionals

Rapid response to:


Ethnic minority staff and patients: a health service failure

BMJ 2019; 365 doi: (Published 21 May 2019) Cite this as: BMJ 2019;365:l2226

Rapid Response:

Re: Ethnic minority staff and patients: a health service failure

I wholly agree on the systematic racism that exists within the NHS. I also believe much of it is largely unintentional, unconscious bias. Having only just completed a year in a district general hospital that serves a largely deprived, BAME population that also boasts a high proportion of BAME doctors one would think cultural understanding would also ensue and translate into better treatment.

Unfortunately what often ends up happening is that BAME staff who are keen for professional respect and courtesy are often less sympathetic to patients from a background they share, in what I believe is their effort towards acceptance that they crave from their colleagues. The desire to be accepted is undoubtedly a natural one and as the article suggests those who are not feel bullied and are overlooked professionally. Unfortunately, I have seen this comes at the cost of the patient.

I have to admit, even for myself, it is a conscious battle not to belittle the concerns of a BAME patient. One has to question why that is? I think a large part of it is language and a learnt description of symptoms from medical school. We are often oblivious to the fact we are being taught from a certain perspective, Questions and revision material only add to this by testing candidates on typical scenarios, often racially driven. Are we properly equipped at medical school for the cultural diversity of the NHS?

There are well known stereotypes such as Bibi syndrome or Begum syndrome which are often colloquially used to describe South Asian patients with non-specific complaints. These only serve to undermine patients and as this article points out contribute to health inequality.

The issue is multi-faceted, I am glad data gathering is taking place to identify the issue. So much needs to be done in working toward ensuring the NHS is a service to all.

Competing interests: No competing interests

03 July 2019
Tay-yibah Mohamed
Foundation Doctor