By Nadeem Badshah
THE NHS marks its 72nd birthday on Sunday (5), a welcome celebration after the most challenging year it has endured in its history due to the coronavirus crisis.
For the estimated 118,000 doctors, nurses and staff from south Asia working on the frontline in the battle against Covid-19, it will be a time to reflect on the contribution of professionals from India, Pakistan, Bangladesh and Sri Lanka since its birth.
More than 10,000 medics from south Asia kept the NHS going in its early years and are praised for helping to shape modern general practice.
By the 1980s, 16 per cent of GPs were from south Asia, according to book Migrant architects of the NHS: South Asian doctors and the reinvention of British general practice (1940s-1980s).
They often worked in inner cities and industrial areas in Glasgow, the Midlands, Manchester and East London, which were ravaged by poverty at a time when many UK-born medics chose to
work abroad. Today, people of south Asian origin make up around 30 per cent of medical staff in the organisation.
Dr Chandra Kanneganti, a GP in Staffordshire who came to work in the UK in 2002, said the work ethic of the first wave of migrants needs to be remembered.
He told Eastern Eye: “When south Asians came, they went to inner cities and villages to fill up these vacancies and save the NHS – some of the villages in Wales they could not pronounce.
“Similarly, in 2001 and 2003, they filled up the gaps and vacancies and
saved the GPs in the NHS.
“Their work ethic is of a high standard and they will go anywhere where there is a job.”
Dr Kanneganti, who is national chairman of the British International Doctors Association, fell in love with the uniqueness
of the UK’s health system.
“I had two options – to go to America or the UK. The British High Commission in India put some nice information about what the NHS offers, a universal free care system.
“I remember when my dad suddenly became unwell and life stopped, saving money for an operation, that worry is not there in this country. Nowhere else has that system.
“A unique part of the NHS is General Practice, it’s the jewel in the crown.
“It is a unique speciality and the training is brilliant; you can deal with uncertainty. In India, everyone goes to specialist hospitals.”
He added: “It is very rewarding. The people who treat their GP like a family member is amazing.”
Among the pioneers whose talent and vision helped grow the health service include Dr Shiv Pande, who became the first doctor in Liverpool to employ a practice nurse and co-presented TV series Aap
Kaa Hak where he would answer questions about health in Urdu and Hindi.
Meanwhile, Dr Harbans Gulati, a GP in south London for more than 40 years, is regarded as the pioneer of the “meals on wheels” service.
The British Medical Association (BMA) is even older than the NHS and was founded in 1832. Its current council chair is Dr Chaand Nagpaul.
He said south Asian doctors and healthcare workers have made an immeasurable contribution and the health service has for decades relied on the dedication and skill of these staff and international colleagues to look after the nation’s health.
Dr Nagpaul told Eastern Eye: “For doctors in England, we know around 30 per cent are Asian – with this figure rising to more than 40 per cent for associate specialist and speciality grade doctors, who
are central to providing frontline, patient-facing care throughout the NHS.
“And of course, staff from south Asia provide support across the NHS, from nurses to porters to clerical roles.
“On its birthday, the NHS owes a debt of gratitude to its south Asian workforce without whom we would not have a functioning health service, and importantly to provide it with protection, equal opportunities and a culture of care and respect.”
Another doctors-led organisation campaigning for medics is The Doctors’ Association UK (DAUK), which was
founded in 2018.
Dr Rinesh Parmar, chair of the Doctors’ Association UK (DAUK), said he was torn between a career in medicine or law when growing up in Birmingham, but volunteering in healthcare “cemented
the idea of a career as a doctor.”
He told Eastern Eye: “I was able to see first-hand the dedication of NHS staff to caring for their patients.
“Their selfless commitment to going over and above to ensure patients were comfortable and safe was truly an inspiration to me.
“My interest in the law never really faded over the years and in some part, it is responsible for my desire and sense of duty to campaign for doctors, patient safety and the wider NHS as chair of
the DAUK.”
Among the issues that organisations, including the BMA and DAUK, have been highlighting are the obstacles faced by BAME medics in climbing the career ladder and discrimination from colleagues
or patients.
Figures in 2019 showed that Asians made up just 4.6 per cent of “very senior managers” in the health service – compared to 92.9 per cent among white people – and just 6.1 per cent of senior roles
and 8.9 per cent of middle management positions. And BAME doctors are less likely to raise concerns than their white colleagues and more likely to feel less safe at work.
Dr Parmar added: “While the NHS has a truly multicultural workforce, there remains a lot still to be done to eliminate discrimination of BAME workers.
“Our BAME colleagues are more than twice as likely to be referred to their regulator compared to white colleagues.
“White colleagues remain more likely to be appointed after shortlisting and BAME colleagues make up only 8.4 per cent of NHS Trust Boards.
“More recently, we have seen BAME colleagues disproportionately affected by Covid-19. While these issues remain, my colleagues at the Doctors’ Association
UK and I remain steadfastly committed to fighting for a better NHS for staff and patients alike.”
Dr Kailash Chand has worked as a GP in Greater Manchester, after arriving from India in 1978, and is honorary vice president of the BMA. His family has the doctors’ gene as his wife Anisha was a doctor and his son Dr Aseem Malhotra became a consultant cardiologist and Professor of Evidence-Based Medicine.
Dr Chand told Eastern Eye: “The NHS depends on black and minority ethnic staff to provide high quality, reliable and safe care to patients.
“They enrich the NHS with their skills, enthusiasm and diverse perspectives. On the health service’s 72nd birthday, it’s important to celebrate the contribution of BAME staff – but also to recognise
the racism and discrimination they continue to face.
“I have experienced discrimination after I arrived: I would often compete for jobs with UK graduates who had less experience, but I would still lose out to them. I was called ‘Paki’ and on many
occasions, white patients refused to see me.
“I am one of the lucky ones. I went on to have a successful and rewarding 35-year career as a GP and became chair of a Primary Care Trust.”
The concerns about inequality have been raised by the recent Public Health England study which found that people from a Bangladeshi heritage are twice as likely to die from coronavirus than white
Britons. And people of Indian and Pakistani origin were among the ethnic groups which had a 10-50 per cent higher risk of deaths from Covid-19 compared to white Britons.
Dr Chand added: “I have often said coronavirus isn’t racist, but the pandemic has exposed racism in the system.
“BAME staff are good enough to work for Cinderella services, and good enough to die, but not good enough to lead.
“As we celebrate the 72nd anniversary, we need to pledge that all arms of the service, and other medical bodies, take a hard look in the mirror and reflect on how transparency, fairness, and equality
should frame its future.”
His son Dr Malhotra said his decision to pursue a career in medicine was driven by his faith and family. The cardiologist, whose new book The 21-Day Immunity Plan is being released in August, said: “The idea of being a part of a profession focused on helping others regardless of circumstance, focused on facilitating people leading healthier and therefore happier lives.
“I can’t imagine a more fulfilling job. Medicine, for me, has always been a calling as well as a privilege.
“My older brother had Down’s syndrome and was born with a cardiac abnormality. He died aged 13 and since then I not only wanted to be a doctor, but a cardiologist.”
Tackling inequality has been one of the biggest battles facing the health service historically. Research of cases brought before the General Medical Council between 1982 and 1991 showed that ethnic minority doctors were six times more likely to be brought before a disciplinary hearing compared with their white colleagues. And while the situation has improved, there is plenty of work to be done.
A probe last year found that doctors from ethnic minorities are too often treated as outsiders by NHS bosses and peers and not given the support they need.
Dr Jeeves Wijesuriya, a BMA council member, believes health care workers from south Asian communities have historically made an integral but undervalued contribution.
The GP trainee in London added: “Even now many of our staff, both those who trained abroad and locally from BAME backgrounds, work whilst facing prejudice and discrimination that can be overt and systemic.
“This is something the health service has turned a blind eye to for too long, and is most stark when seeing the racial disparity in senior leadership roles, GMC referral rates and most recently when exploring contributing factors to the increased mortality amongst BAME
staff due to Covid-19.
“Our health service must take this opportunity to listen to BAME staff and finally address the problems within the system that allow discrimination both in wider society and our own health service.”
For the thousands of medics including Dr Wijesuriya, NHS staff, patients and people whose lives have been saved by the health service, this Sunday will be an opportunity to reflect, give thanks by taking
part in a nationwide applause and renew calls for change.
