Partha Kar: Diversity in the NHS matters

The world we live in is in a fascinating space at the moment. Tolerance seems to be at a low ebb—whether that is due to the rhetoric fuelled by the Donald Trumps of this world or not—it has created a climate of interesting proportions. Against the backdrop of this febrile atmosphere, came a speech by Jeremy Hunt, England’s health secretary, at the recently concluded Conservative Party conference.

He announced a plan to create more medical school places, which on its own cannot be anything but lauded. There is no doubt that the UK needs more doctors—so surely that announcement would be welcome, wouldn’t it? Unfortunately, our pasts do define us, and for a health secretary who has just come through a bruising battle (perhaps yet to be finished) with some of the most hardworking staff in the NHS, this was only going to be wishful thinking. Rather than leave that positive announcement there, and have a debate over how to attract new medical students given the fact that medicine is not necessarily the most attractive career option at the moment, the talk veered into an area open to interpretation and perhaps most importantly, one that gave fodder to the media who needed a story.

Jeremy Hunt spoke about his aim to end an over reliance on overseas doctors—again on the face of it—a noble aim. Why “poach” doctors from other countries where they are also very much needed? But combined with home secretary Amber Rudd’s speech about UK companies employing too many foreign workers, and set in the basking light of Brexit, the touch paper was lit. In this post Brexit world where racial attacks and slurs have gone up, this was not necessary. Social media, on cue, erupted and there was a genuine sense of outrage that overseas doctors were so slighted. The desire to “have our own” seemed to have blinded the effort, work, and hard graft that thousands of doctors have put into the NHS over many years. If one looks at the General Medical Council report on the number of overseas doctors working in the NHS, then 1500 new UK doctors will not actually replace many of the overseas doctors. To be sustainable the UK will need far more than 1500 new medical school places.

From a personal point of view, I will be very clear. Racism in the NHS never went away—it’s a part of life, which many like me have lived with. You only have to look around the top positions in the NHS and you will know what I mean—it’s a fact of life. It’s also a fact that not everyone who voted Brexit did so due to racism. But the vote to leave the European Union and the rhetoric that surrounded the run-up to the vote did suggest to some that overt racism is now “ok.” The NHS has always depended on and always will depend on overseas doctors. When you live on an island and use the word overseas—pause to reflect—it’s actually the rest of the world that you are referring to, not just an Asian person or a Polish person whose accent you struggle to understand. Medicine amongst other things has and always will be a global field. At a time when three British scientists have won the Nobel Prize in Physics working for an American university you know how daft the rhetoric sounds. Most sensible people know the lack of relevance of such statements, but it should not result in silence, as that allows the minority to believe that xenophobia is acceptable.

It has been heartening to see many speaking up, and a clarification from Hunt has also been welcome. However, words need to be chosen carefully. Why issue a clarification if we can avoid the need for it in the first place? Low morale is an issue in the NHS workforce—let’s not burden it further by making someone like me question whether I am welcome anymore. This is my country, I work here, I try my best for the patients that I see, and I do that irrespective of where I come from.

The NHS is going through tough times and needs all the help it can get. In the words of Sun Tzu: “There are not more than five musical notes, yet the combination of these five notes gives rise to more melodies than can ever be heard.”

Diversity matters—and the NHS is no different.

Partha Kar is a consultant diabetologist at Portsmouth Hospitals NHS Trust. He is also Associate National Clinical Director, Diabetes.

Competing interests: None declared.