The Commission on Race and Ethnic Disparities published its findings last month, and suggested structural race inequality is not a major factor affecting the outcomes and life chances of many citizens.
Dr Nagpaul has written to the commission’s chair Tony Sewell to express concern about the report, highlighting it neither reflects the experiences of ethnic minority BMA members nor ‘progresses the conversation about how to address racial inequality at an organisational or societal level’.
In the letter, Dr Nagpaul says: ‘We accept that racism and race equality is an immensely complex issue, but the report appears to be underpinned by a single narrative that attempts to minimise racism in the UK, with, in our view, the flawed interpretation of selected data.
'The BMA, representing more than 150,000 doctor and medical student members, submitted to the Commission’s consultation for the report, and I also provided evidence to the commission’s health sub group on behalf of our association. We do not believe the report appropriately reflected our submission.’
He adds: ‘The report celebrates the “onward march of minorities into positions of power and responsibility in professions such as…medicine”. Yet it provides shockingly little analysis of the challenges faced by many ethnic minority and overseas-trained doctors, including differential attainment and under-representation among the highest ranks within the NHS. In the NHS, there is irrefutable evidence of discrimination faced by ethnic minority doctors at all stages of their career commencing from medical school.’
Disproportionate effects
Dr Nagpaul notes that the report failed to mention that 85 per cent of doctors that died from COVID-19 in the UK were from minority ethnic backgrounds and that BMA member surveys during the pandemic found doctors from ethnic minority backgrounds were more than twice as likely to feel pressured to work without adequate personal protective equipment in high-risk settings, and more afraid to speak out about safety concerns for fear of recrimination or it affecting their careers.
He says: ‘We were also troubled by other parts of the report, particularly the section on health, where there is a failure to acknowledge that it is often root structural inequalities that directly lead to many ethnic minorities being more greatly affected by social determinants of health. Our submission urged the Commission to fully investigate the link between poverty and racism and we do not believe this was satisfactorily done.’
The London GP also calls for clarity around the report’s recommendations – particularly how they will be implemented and who will be responsible for doing so. Dr Nagpaul also questioned whether there are plans to evaluate the effectiveness of the recommendations and the report in general.
He adds: ‘We strongly encourage you to engage with the feedback that this report has received and to engage with stakeholders in reconsidering some of the messages and conclusions in the report. Despite our disappointment in the report, its publication reaffirms the BMA’s commitment to tackling racism in all forms, interpersonal and structural.’
The BMA continues to work on highlighting issues of structural racism in healthcare and will share findings with the Commission.