Rapid Responses to:
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Rapid Responses: Rapid Responses published:
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"not a single leader of the medical profession has taken on the task of lancing this festering abscess."
- Jay Ilangaratne (19 June 2004)
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Racial discrimination: global implications
- Dr.Naseem A. Qureshi MD, IMAPA, LMIPS (19 June 2004)
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THE COLOURS OF THE RAINBOW
- Rita Pal (20 June 2004)
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Racial discrimination in the NHS
- Pradeep Mishra (21 June 2004)
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Racism, stupid!
- mohammad I khalid (21 June 2004)
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Re: THE COLOURS OF THE RAINBOW
- Sanjay M Rajpara (23 June 2004)
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The prejudices of good people
- Malila Noone (23 June 2004)
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Re: Racism, stupid!
- Rita Pal (23 June 2004)
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Re: Re: THE COLOURS OF THE RAINBOW
- Pal Rita (23 June 2004)
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racism, yes and no
- NANCY K O'CONNOR (13 August 2004)
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No matter what their race or the colour of their skin
- Dr. Herbert H. Nehrlich (15 August 2004)
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Jay Ilangaratne, Founder Medical-Journals.com
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Dr Esmail is also a member of the BMA's Equal Opportunities Committee(EOC).Though no specific reference to the BMA had been made,in view of his position in the EOC,it is unlikely that Dr Esmail did not give some thought to the BMA's track record on racism. In his well presented editorial[1],Dr Esmail questions and remarks: "So what should be done? Leadership is critical, and the reality is that not a single leader of the medical profession has taken on the task of lancing this festering abscess." Indeed,the above is highly relevant to the BMA,too. I am personally aware through an answer[2] to a RR65 Questionnaire that the BMA Chairman (Mr J Johnson)had received no training in respect of the Race Relations Act 1976 and Race Relations Regulations 2003.This is a most unfortunate example.How could a leader effectively deal with racism without basic training in fundamental principles of anti-discrimination legislation and its practice? It is more disheartening given that Mr Johnson had been a senior official of the BMA for several years before his appointment as the Chairman. Nevertheless,as Dr Esmail is now a member of an important committee of the BMA, I hope he will be in a better position to put such anomalies right without dealy. References [1]The prejudices of good people BMJ 2004; 328: 1448-1449 [2]BMA Reply dated 17 February 2004 to RR65 Questionnaire of Dr J B Ilangaratne dated 25 January 2004 Competing interests: See Text |
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Dr.Naseem A. Qureshi MD, IMAPA, LMIPS, Medical Director(A), Director CME&R Buraidah Mental Health Hospital, Postcode:2292, Saudi Arabia
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Sir: Racial discrimination has a long history and perpetuated by the leading figures in the world, who were found continuingly harboring the seeds of discrimination and prejudices throughout the history of human races. Discrimination trickles down from top authorities to the bottom line figures including bad people. Thus good people discriminate against good persons and bad people discriminate against bad people but this always may not be true and usually discrimination tracks change from bad to good and vice versa. Overall, all the possible consequences of discrimination are seriously bad and nobody likes to be discriminated in any way. Finally, like Dr. Aneez Esmail if every individual puts his efforts to end discrimination, things may improve but we don't want leaders to facilitate the process of dediscrimination, who more often have double standards. reference: 1.Aneez Esmail. The prejudices of good people.BMJ 2004; 328: 1448- 1449 Competing interests: None declared |
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Rita Pal, Editor www.nhs-exposed.com
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Esmail and his cohorts have spent a great deal of time stating the " obvious". Again the anti racism bandwagon rears its head. It simply seems that one summary after another is repeated through Esmail's articles. What I want to know is this - does he write about anything else? Racism exists in all parts of the world. Indeed, some say asians can be the most racist of the entire population. Their subtle discrimination in not allowing their women to associate with muslim men or their cliques created simply to separate them from the " English". Indeed, we all know the caste system exists where Hindus will not shake hands with those who clean the latrine ( different and lower caste system). Their treatment of women who are known as " substandard citizens" who should be married off at 16 and be seen and not heard. Discrimination within this group of individuals is rife. Some people are indeed stuck in the backdrops of the Last Days of the Raj. Times have moved on and even though institutional racism does indeed exist, enough information is around to combat it. Do we really need another paraphrase Aneez? Can we just move on and write about something else like Discrimination in those who are unfortunate enough to be poor etc? The lustre of anti discrimination articles is lost with the repeated beat of the distant drum in the same tone. The "them and us" attitude never improves matters. Integrated social systems matter and will be the only way to effectively combat prejudice. The last issue I wish to address concerns the issue of psychiatric patients. I am fully aware of the report and implications. The point though is this - patients who are paranoid, violent and difficult to control have to be dealt with in a certain way. The use of force that caused the death needs to be criticised. My own feeling is that no matter what colour that patient was, he would have met with the same fate. While we all beat the anti racism drum and expect " special treatment" - there is a view that is rather important - caucasian people are subjected to an awful lot of prejudice by those who are from an ethnic minority. My friend's daughter was beaten up recently because she was in a asian area and apparently as a caucasian she did not belong there. These incidents are shoved under the carpet never to be seen again. On a more amusing note - Vikram Seth's book " A Suitable Boy" is all about discriminating against different sorts of " suitable boys" to find one that is indeed the " right one". It is also a very big book best used as a footstool for Indian women who find their men tower above them without giving them the opportunity to speak. That may well be after they have decided on the most "suitable boy" being the one who is " rich, has a Mercedes, whose father is a consultant and whose mum has chandeliers and leather sofas" :) and not the " white, dark haired, good looking caring suitor" who has nothing but his " dedication, his ford fiesta and a job at Tescos". Prejudice works both ways - it is time to work as a multicultural society not as a seggregated one. Dr Rita Pal www.nhs-exposed.com PS Last time I presented this view on the BMJ, I was hatemailed by a number of asian doctors. On this occasion, if you don't like what I write then switch the computer off. PPS Personally, for the record - I would go for the man with the Ford Fiesta:) Competing interests: Asian in origin. British by nationality Experienced racism between the age of 10 and 16 featured in the Independent Newspapers in an article called " Spat at and Threatened" Feb 2000 |
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Pradeep Mishra, Locum Consultant Physician Whiston Hospital, L35 5DR
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The Editor,BMJ. Sir, In response to the article by Aneez Esmail,one should try to look at the broader picture.Following points should be raised: 1.Discrimination is wrong wherever it occurs. 2.Discrimination is a part of behaviour where a powerful person or society tries to impose their rules on the weaker person or society whether it is right or wrong. 3.Discrimination is almost a human nature or should it be called 'animal instinct' which leads to cruelty towards other persons or society. 4.Discrimination can not be removed by making laws, only its effect can be modified.It requires change of hearts and minds and better understanding of ourselves as human beings. Will NHS ever become completely free of institutional racism? The simple answer is 'never'.In fact, several police chiefs have, at least,admitted that racism is present in their department. Has anyone from the NHS had the courage to do so yet? So, you see, the NHS is more institutionally racist than the police force.Let us all pray for the welfare of the NHS in these hard times and get on with our lives. Things are unlikely to change.So, please Aneez, forgive me if I say don't live in a fool's paradise.But,I whole heartedly support your spirit. Competing interests: NOne |
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mohammad I khalid, locum consultant cardiologist Rochdale OL11 5QD
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Dear Sir I congratulate Aneez Esmail for writing such a hard hitting and brave editorial piece in the recent BMJ. Institutional racism is rife in the NHS and has been so for a number of years. Virtually all the doctors and others working in the NHS who belonged to ethnic minorities have experienced some kind of racism at some stage of their career. Esmail has cited a few examples how racism works in the NHS. I would like to add a few more examples. Dr. White and Dr. Brown met while both were sitting their MRCP. Both passed their exams. They applied for SPR rotation in medicine. Dr. White got the rotation. After a number of unsuccessful applications, Dr. Brown decided to take up a staff grade post in Medicine in a district general hospital. He met Dr. White again while he was completing his SPR rotation. They both worked in the same hospital and in the same speciality and shared the same rota. Dr. White has a future and he destined to become a consultant. Dr. Brown has no future and he is destined to do, in the words of an SPR s**t work for the rest of his life. Dr. Black came to the UK in early 80s, passed PLAB, struggled to pass MRCP but eventually succeeded. He tried to find a training job in medicine but failed. He joined a university in Scotland and did M.Sc in cardiology and paid from his own savings for this course. Once again having failed to find a training job, took up a staff grade for two years. Disillusioned and frustrated by the system, he went overseas and worked there for a few years. He returned to the UK and applied to the STA for recognition. Despite having attained experienced three times the requirement for accreditation, he was told that he was not ‘trained.’ He continues to work as a locum consultant doing exactly the job his substantive colleagues do, sharing the same rota but can not be appointed as a substantive consultant because he is not ‘trained’ and therefore is not on the specialist register. If someone is wondering why these valuable members of NHS staff are being treated so unfairly, it can be described by slightly modified version of US Democratic Party’s famous election slogan of nineties, ‘racism stupid!’ The names in the above examples are fictional but the events are real and can be found in every district general and teaching hospital up and down the country. M I Khalid
Competing interests: None declared |
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Sanjay M Rajpara, SHO, Dermatology Royal Liverpool and Broadgreen Hospitals NHS Trust. Thomas Drive, Liverpool. L12 8SR
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I just wanted to reply about above article. Being a hindu i don't accept the comments present in the above article. I wonder does author have any experience of living in India in the past 2 decades. The prejudice of not shaking hands and not allowing women to study or to speak have gone a long ago. In present India girls and women are studying more than boys. Increasing number of women are professionals. The so called lower casts are taking active part not only in the day to day businesses but also in the government.In fact currently more number of our brothers and sisters from so called lower casts are progressing well in the professional careers at regional and national levels.About rights of the women, India was the second country to have lady prime minister.As such with increasing urbanisation and modernization the calss system is between rich and poor, but they don't show any prejudices to each other. thank you. Competing interests: I am Hindu Patel by cast. |
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Malila Noone, Consultant Microbiologist Unversity Hospital of North Tees, Hardwick, Stockton on Tees. TS19 8PE
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Dr. Aneez Esmail calls for action to be taken against institutional racism in the NHS. NHS Trusts are likely to have comprehensive equal opportunities policies but these have been shown to fail with neither the good nor the bad taking individual responsibility for their actions. Evidence emerging during Industrial Tribunal proceedings, where doctors have successfully sued Trusts, show how easily consultant members of the Appointment Advisory Committee (AAC) pull the wool over the lay-chairman's eyes siting "professional" obstacles to the appointment. These Consultants who have clearly ignored equal opportunities legislation continue to hold high office and continue to participate in AACs when appointing consultants. NHS Trusts, and separately the Royal Colleges have a statutory obligation to ensure that the law relating to equal opportunities is upheld. It is imperative that these bodies now specify what action will be taken against their representatives on an AAC when the AAC has been shown to have contravened equal opportunities legislation. Will an internal investigation take place? Will disciplinary action be taken against the individuals concerned? Competing interests: Committee member of the NHS Consultant Association which actively supports equal opportunities in the NHS. www.nhsca.org.uk |
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Rita Pal, Editor www.nhs-exposed.com
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Just a very simple observation here - there are many reasons why people do not get the jobs they apply for. When I have failed to get a job in the past, the first thing I look at is whether my ability could be better. The first thing most asians look at is " they did not get the job because they are Dr Brown". The whole of England is not racist. Caucasians are indeed allowed to make judgments on people on the grounds of their ability. In addition, degrees doth not maketh the doctor. Sometimes I am actually pleased that interviewers look at other aspects of presentation, whether you are caring, whether you are intelligent and whether you have good patient communication skills. Sometimes, interviewers simply do not like the overall " package" of the person sitting in front of them. It has nothing to do with colour. All studies done by the Kings Fund etc are perceptions of doctors who say they have suffered from racial discrimination. I wonder whether the Kings Fund would like to do a study on how many asian consultants take their " fellow indians" as opposed to the caucasian doctor. Discrimination with respect to caucasians is a important issue with the numbers of asian doctors increasing in the NHS. Dr Rita Pal www.nhs-exposed.com Competing interests: I am a Dr " Brown" but I look on myself as being Dr Pal - who happens to have a few more melanocytes. |
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Pal Rita, Editor www.nhs-exposed.com
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In response to the Indian gentleman of the "Patel" caste. I have worked in India as a medical student and I have also visited India repeatedly. The level of discrimination never ceases to amaze me. I once shook hands with a person on the Calcutta streets who was apparently a latrine cleaner. We sat at the same table, she told me about her life and the hardship she had undergone. I also noticed the number of people who left around me. Later I was to find out why. The gap between rich and poor in India is huge. While things have improved since the days of the Raj, I suspect you will find that age old attitudes still remain. Women are supposed to be married off at about 16 and if you are not " married" there must by default be something wrong. Men are responsible for much of the oppression in India. In England ofcourse, these men build little Indias. This behaviour can be seen medical societies. Even the BIDA and its clique of asian consultant gentlemen in their Mercs shows evidence of building the " little India". Why aren't there any caucasian doctors there anyway? In this day and age, the Hindu and Muslim divide is more than ever. If that is not discrimination, I have no idea what is. Inequality in asian culture is self evident for anyone who attends at asian party. Your views as a woman are discarded. You have to sit with the "other women" discussing saries and gold because your views on politics are not wanted or taken seriously by menfolk. In my view, it is time Asians looked at their own culture of discrimination before pointing the finger firmly at caucasians. A "them and us" attitude never helps at all. I prefer to have friends of many colours. That is possibly why I am disliked by asian cliques. Then again it is harder to be a individualist than it is to be a conformist. Had I been a caucasian, many asian folk would have shouted " racism". I hold these views on behalf of my caucasian and asian colleagues who have the diversity of perspective. Dr Rita Pal www.nhs-exposed.com Competing interests: None declared |
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NANCY K O'CONNOR, Pawhuska Indian Clinic Pawhuska OK 74056
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Racism is not always the problem. The lack of cross cultural understanding is also a problem. Something as minor as standing too close (or too far) from a person can cause anxiety. This is why the Indian Health Service in the US has "Native American preference" and often allows the tribal authorities to dismiss or vote against hiring personnel: sometimes merely because the personality/attitude of the physician will cause people to avoid coming to the only clinic in many isolated areas for care. If one works with a culture, one needs basic understanding of subtle and not so subtle cultural clues to practice medicine successfully. However, true racism, alas, does occur. As a physician I have avoided referral to certain physicians because of their open dislike and rudeness to patients because they were retarded/senile/Catholic/American Indian/Hispanic etc. Competing interests: None declared |
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Dr. Herbert H. Nehrlich, Private Practice Bribie Island, Australia 4507
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Lancing this festering abscess? A leader has not received any training in race relations etc. ? Pardon me if I sound naive, but the abscess of racism will not benefit by being lanced, even if done with the innocence of stainless steel, the healing of this must come from the inside out. Either one has what it takes to overcome this accumulation of pus and poison or one does not. Education and training will only do so much, the basic goodness of the person will always be the deciding factor. I was a racist, briefly, in my younger years, believe it or not, my motive was simply the seeking of acceptance by my new-found peers in the (Brave) New World of America that I had been allowed into. Then, I kept running into real people from other races who were 'the exception'(as my friends assured me) until, finally, the penny dropped.To a German's great surprise, even the Jews were genuine people! America has, in my opinion, grown up a bit in the racism department, not a whole lot but it's getting there with snail pace. Australia, my new home since 1986, still seems to have a festering, deep- seated abscess that is so encapsulated that no cure will be easy. I do admit that I still find it shocking to discover a real person, full of normal human values, behind the unkempt, filthy and incoherent residents of the parks of Aboriginal Australia.But, unlike the structures of Potemkin, there are people behind the façades. Competing interests: None declared |
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