Covid-19: Leadership doors need to open for Asian doctors shoring up NHS
Ummul Choudhury is the co-founder of international sports charity Capoeira4Refugees and of development tech start-up Frontline Aid.
ummul choudhury, development consultant, middle east specialist, sports charity consultant, charities consultant, start-up consultant, united nonsense book, Capoeira4Refugees, capoeira charity, Frontline Aid, NGO specialist
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Covid-19: Leadership doors need to open for Asian doctors shoring up NHS

I wrote a short piece about racism in the NHS. The statistics clearly show that non-white people are not wanted at senior management level.

I find a lot of parallels in the situation with the NHS and what is happening in international aid. Except, in the case of the NHS, clear, and transparent statistics are available on ethnicity. Such data is much harder to come by for the international aid sector, as it is not under the remit of any one oversight body.  

See article below.

The NHS has relied on ethnic minority doctors to run day-to-day operations for years. They are not recognised, face racism and are kept out of leadership. After Covid-19 is over will anything change for them?

A staggering 31% of senior doctors on the NHS are from a South Asian background, but they only make up 7% of the working age population. These healthcare workers are represented by a majority white leadership, as 88 % of all NHS Trust Board Members are white. This is a stark figure, displaying the disparity of power, based on skin colour, that is present in today’s NHS.  

NHS facing staffing crises

British Medical Association data shows that intake to UK medical schools are decreasing year on year. A four-year dispute lead by junior doctors was resolved in 2019, perhaps to be reignited again. Senior consultants faced a recent furore about pensions, which lead to an immediate shortage of consultants as government tried to up taxes on pensions. The NHS has chronic hiring and retention issues, and is willing to extend immigrant visas to keep medical professionals in the UK to help deal with Covid-19. Only a few months ago the Home Office was actively stopping foreign doctors getting the opportunity to help staff an NHS in desperate need of more resources.  Staffing issues, cynicism around immigration and race, are issues that are not about to go away, and Covid-19 is only serving to highlight. 

Leadership and race

The trend to keep non-white people out of leadership positions is reflected across wider UK society. According to a report by the Chartered institute of Personnel and Development Black and minority ethnic (BME) individuals in the UK are both less likely to get in and get on in the workplace compared with their white counterparts. One in eight of the working-age population is from a BME background, yet they occupy only one in sixteen of top management positions.  The data shows what on a day-to-day level it is uncomfortable to talk about. When it comes to leadership, race is an issue.

Immigrant communities tend not to have inherited wealth to shore up young people entering the medical profession. Even so senior doctors of Asian heritage are the ones who are statistically more willing to put in the extra years of training to get to consultant level. Shouldering an economic burden, alongside up to eight more years of on the job learning, studying and exams, before reaching consultant level.  

There are other hurdles that Asian doctors face. Up to a third of NHS staff are off on stress leave at any one time during their years of training. BAME communities often cannot give the necessary support that young doctors need on a mental health level. Asian doctors show enormous resilience to get to the top of their professions. That strength of character, drive, as well as talent, is not seen because of ‘unconscious bias’. A catch all term that uses language to justify evidence-based data that show race is an issue in NHS leadership.

Populism, right wing nationalism, islamophobia are all issues of our time. Assuming that the human journey is one of a better and more equitable word for all, to see a way through we must have the courage to look at the data, and call ourselves out on what it shows us. 

Open doors to leadership 

It is ridiculous that a profession that sees almost one in three senior doctors is from an Asian background has a representation of less than 7% at Board level. It is easy to cite lack of ambition. Perhaps these doctors simply do not want these positions? This is the type of argument businesses state when speaking about a perceived lack of talent coming from ethnic and minority communities. Yet, these doctors are obviously incredibly ambitious. They have fought through economic hardship, stress, and dedicated years of their lives to training to get to the top. It is not that they do not want to walk through the doors of leadership, it is that those doors see colour.

Perhaps when COVID-19 is over the NHS will choose to recognise the sacrifices of its frontline staff. Of its Asian doctors who make up just 7% of the working age population, but are a staggering 31% of all of our senior doctors.

 This recognition needs to take the form of at least 30% of leadership positions, senior management, governing and Board member positions being reserved for non-white members. Those who are putting their lives at daily risk deserve the right not to have their skin colour used against them.

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