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Britain: Asian doctors, nurses on the frontline

London - Healthcare professionals have been working extended hours and dealing with situations when not much was known about the virus.

Several studies have concluded that people from non-white communities — termed BAME (black, Asian and minority ethnic) in official discourse — have been disproportionately impacted by the pandemic. BAME health professionals also comprise one-fifth of the NHS workforce and it is notable that the first 10 NHS staff to die from Covid-19 were from these backgrounds.

Doctors and nurses from South Asia have been in the forefront of treating patients, taking on extended hours and dealing with situations when not much was known about the virus and ways of dealing with it. A new parliamentary report says that there is some evidence that even within the frontline roles, BAME staff was more exposed to the virus than their white colleagues. For example, the Health and Social Care Committee was told that in the first wave of the pandemic, non-white NHS staff faced greater difficulty in accessing appropriate Personal Protective Equipment (PPE) that fitted correctly. According to the British Medical Association (BMA), 21 per cent of all staff is BAME — 63 per cent of healthcare workers who died were BAME; 20 per cent of nursing staff are BAME — 64 per cent of nurses who died were BAME; and 44 per cent of medical staff is BAME — 95 per cent of doctors who died were BAME.

Latest figures show that doctors who gained their medical qualifications in south Asia comprise the second largest group in the NHS, after those who qualified in the UK: currently there are 30,315 doctors in the NHS who qualified in India, 15,854 in Pakistan, 3,364 in Sri Lanka, 1,926 in Bangladesh and 394 in UAE. BMA surveys have consistently found disparities in doctor’s experiences by ethnicity, with doctors from BAME backgrounds reporting feeling less confident that appropriate adjustments have been made to mitigate risk; feeling less confident about PPE provision and feeling safe to report PPE shortages; and higher rates of bullying and harassment during the pandemic period.

Doctors from South Asia and elsewhere have long worked in the NHS, filling vacancies in deprived, inner-city areas where white British professionals were loath to serve, and elsewhere, achieving recognition for their expertise and work, but there are also continuing concerns over allegations of racism and unequal treatment. Such cases involving doctors from south Asia and elsewhere are often highlighted by the groups such as the British Association of Physicians of Indian Origin.

Doctors from south Asia have been often hailed not only for their contribution to the NHS over the last 73 years but also for their central role in its development as “architects” and “lifeblood”. Educated under medical syllabus influenced by the legacy of the British Empire, south Asian doctors came to the UK to train and settled to pursue careers in the NHS. They are also reflected in popular British culture, for example The Indian Doctor, BBC’s five-part television drama set in a south Wales mining village in the 1960s, which starred Sanjeev Bhaskar and Ayesha Dharker, telecast in 2010.

Julian M. Simpson, author of Migrant Architects of the NHS: South Asian Doctors and the Reinvention of British General Practice (1940s-1980s), says: “Doctors from the Indian subcontinent were not just contributing to the NHS; they were its very lifeblood. We should acknowledge they were among the architects of the NHS. The NHS evolved during its first four decades into a system based around general practice and primary care. By becoming family doctors, South Asian doctors prevented a GP recruitment crisis. It’s important to also remember that the NHS was established to make healthcare accessible to those who could not afford it. And for millions of people, particularly in working class communities across Britain, accessing that care meant going to see a GP from the Indian subcontinent.”

The Covid pandemic reinforced the key role of doctors and nurses from the subcontinent in the NHS. Adds Mayor Lachine, president of the Royal College of General Practitioners: “General practice in the UK would not be what it is today without the hard work, innovation, and courage of our predecessors...Indeed, without them, our profession and the NHS might not even exist at all. Not only were they doctors, but they became highly valued members of the communities in which they practiced. Whilst many faced incredible challenges, our exhibition also documents the overwhelmingly positive and lifelong relationships they forged with their patients.”