Playing the white man

It was difficult to know whether to laugh or cry as leaked government documents showed that more cuts are in the pipe line for the NHS.

• There will be a shortage of GPs and nurses in four years' time, but the NHS will have to shed hospital doctors
• The prediction of a shortfall of 14,000 nurses was included in the Department of Health paper
• There will also be 3,200 extra consultants that the NHS cannot afford to pay,
• The document also suggested a new grade of sub-consultant be created to save money. (BBC)
  

It was the last statement that caught my eye. A "new grade of sub-consultant" is to be created to save money.This is of course another example of “dumbing down”; of doctors who are not able enough to become consultants none the less being employed to do consultant work. But there is a much more insidious and unpleasant agenda on which the NHS already has “form”.

“A new grade of sub-consultant” does not need to be created. It already exists. And it has been cynically used by the NHS to force doctors, many of whom are qualified to be consultants, to do consultant work for less money. The correct and official title may be “staff-grade” but within the NHS, it is known as something else. It is know as the "wog-grade".

That may sound offensive. Indeed, it is offensive.

The sad and shameful fact is that the "staff-grade" position has been used as a parking place for doctors, many of whom are highly trained and highly experienced, but not felt to be … er … “suitable” to become real consultants. They are probably not welcome at the local golf-club either and I doubt many of them are Masons. Or Rotarians.

Is Dr Crippen being cynical again? Surely such racism could not exist in the NHS?

Sadly it could, and it does, and it has been well documented by, amongst others, but in particular Sam Everington and Aneez Esmail. Over ten years ago, Everington and Esmail submitted a number of identical but bogus applications for medical jobs. Identical that is except for the names of the doctor. Some were headed with Anglo-Saxon names, some with Asian names. Guess who got the jobs?

A successful candidate stated:

"After I'd got the job, I asked the consultant how he normally short-listed for the post. He told me that he put all the CVs with English names into one pile, and all those with non-English names into another pile, and looked at the English pile first."

The NHS would not have survived had it not been for the large number of doctors who have come from the Indian and African sub-continents to work in the UK. And yet, many of them have been treated shamefully.

In 2003 the NHS had to pay £635,000 damages for racism in NHS to a doctor who was unfairly sidelined into a staff grade job. (The Guardian)

Trevor Phillips said:

"Doctors from ethnic minority groups have tended to be offered more junior or less secure positions such as staff grade or locum posts, rather than becoming consultants or GPs." If they got senior appointments, these were more likely to be in unpopular parts of the country, less prestigious institutions, or less popular specialties. There are only a handful of chief executives or managers of trusts from ethnic minorities, he said. (Trevor Phillips, Chairman of the Commission for Racial Equality 2005)

Surely, the doctors' Trades Union, the BMA, would not allow institutional racism of this sort. Sadly, the BMA itself has a poor record.

"Last year the BMA took a battering on the issue of racial discrimination. The association was accused of institutional racism by one of its senior members; had to pay out almost £1m ($1.9m; 1.4m) in damages, costs, and interest to one Indian doctor; and was forced to settle another five race discrimination cases for an additional £130 000"

And do Asian doctors get recognition for excellence? White consultants are three times more likely to get NHS merit awards than Asian or African doctors.

As the government struggles to save money, and extends the “staff grade”, watch carefully to see what the racial balance is between “staff grade” appointees and “real” consultants.