Intended for healthcare professionals

Rapid response to:


BMA has to pay £815000 in damages for indirect racial discrimination

BMJ 2002; 324 doi: (Published 29 June 2002) Cite this as: BMJ 2002;324:1541

Rapid Response:

The Funny Little Quirks of Covert Discrimination

Covert discrimination is a funny thing. For example; if a female
nurse can prescribe a whole range of medicines, then to do so she may have
to diagnose too. It wouldn't be difficult therefore for her to prove that
she is doing much the same work as a GP. The covert discrimination would
lie in the university entrance age and restrictions, this may have
effected her career choice as she chose to have, or try for, children
during her optimum child baring years.

To prove that age restrictions discourage women taking up certain
career paths wouldn't be difficult, especially in light of the fact that
nursing degrees have a much broader outlook on age restrictions and tend
to be taken up by women.

If some time in the future a male nurse suddenly decided; hang on a
minute I'm doing the same job as my male colleague who is a doctor with
none of the responsibility, status, half their pay and no further career
prospects in clinical medicine, what then? All he would need to do is
prove that he was being prevented from moving to that title proper,
because of the discriminating restrictions in universities for women.
There would be other factors taken into account of course, i.e. the actual
role he's undertaking, the stereotypical image of nursing etc.

The discrimination may not be intentional but the vocational route to
doing the doctors work, in this case today's nursing, stops short of the
final conversion. I know it sounds odd but the fact that so many
university medical degree places are taken up by women now is irrelevant
to the point.

In anticipation of an expensive test case happening sometime in the
near future, along with the prospect of huge back pays, conversions
degrees should be being considered and all restrictions lifted on
university courses now. This includes the specified educational year
GCSE's are attained, as this discriminates against who are educationally
disadvantaged through poverty, ill health disabilities and other factors.

The more pleasant outcome would of course be, that the public will
get its doctors and we would have British trained people making up our
doctor shortfall from all walks of life, cultures and colour i.e. as well
as the better trained nurses, pharmacists, psychologist, physiotherapists
and so forth. Their duration of working as doctors may be shorter, but the
quality of their work and their loyelty would by far outweigh the training
of a teenager who has been pushed into such work.

The patients want doctors and time with them. They want a title
associated with making them feel better, they don't care about the routes
it took to get them there. Some nurses obviously want to be doctors too as
their profession is looking further and further at extending their role.
They have long since breached the boundaries of GP work anyway, one only
has to look at NHS Direct as a good example of this.

I'm not sure that people can ever take away discrimination
altogether, but removing silly elitism, pure snobbery and old fashioned
attitude will certainly go a long way to making things better.

All in my opinion as a patient of course.

Competing interests: No competing interests

03 July 2002
Carol A Teasdale