The British Medical Association (BMA) has called for systemic change and support for Black, Asian and ethnic minority people (BAME), and the transgender community.

The virtual meeting of the BMA’s Annual Representative Meeting (ARM) was marked for obvious reasons by the ongoing pandemic, and by the need to resolve structures of systemic racism raised by the global Black Lives Matter (BLM) movement.

Acknowledging the disproportionate impact that coronavirus has had on the BAME community, and in reflection of the BLM movement, a motion was approved which included: an increase in funding for public health “to tackle ethnic, geographic and gender inequalities”, a “transparent recruitment system”, and “training on diversity and unconscious bias” for those working in NHS recruitment.

Delegates also called on the government to allow trans people to self-identify “by witnessed, sworn statement”, and to enable them to receive appropriate healthcare, and access facilities in the spaces aligned to their gender identity.

Asides from the motions passed, other discussions centred on other long-rumbling experiences of inequality, and new challenges for patients, and for medical professionals, and sought to develop strategies to resolve them.

More data needed on sexual and gender identity

Coronavirus has “exacerbated” already existing inequalities said Michael Brady, national adviser for LGBT health, saying that “we know from the NHS staff survey that lesbian, gay and bisexual staff report worse experiences when compared to heterosexual colleagues”. The solution to this on-going problem Dr Brady explained was for a more robust collection of data on sexual and gender identity to fully understand these experiences, both for staff and for patients.

Access to the NHS for disabled patients and staff has also been adversely affected by the particular type of personal protective equipment (PPE) said neurology registrar Helen Grote, who has helped lead a campaign for the introduction of clear face masks.

She said: “Time and time again disabled people are forgotten, and the pandemic has only served to widen pre-existing health inequalities." One in seven people in the UK have hearing loss and may rely on lip-reading, which is made impossible by current face masks.

Dr Grote continued saying that many deaf patients have avoided hospital during the pandemic due to this reason, and many talented deaf doctors have been redeployed to no-patient facing roles during the pandemic.

Further oversight of PPE was also voiced by Mark Pickering, vice chair of the NHS religion equality advisory group, who highlighted the conflict surrounding PPE and certain aspects of religious identity. Although in response to this conflict Professor Farah Bhatti, chair of the Women in Surgery forum said that better education is required for those who may challenging staff over PPE, and that there is suitable alternative PPE for those concerned.

Motions passed during the conference addressed experiences of systemic racism within the medical profession and access to treatment for transgender people. These two social issues were further developed by speakers at the conference who spoke about the particular importance of these matters for medical health professionals.

Two pandemics of coronavirus and systemic racism

“With the first 10 doctors to die from Covid-19 being from ethnic minority backgrounds, this was something that was more than a coincidence,” said Olamidé Dada, founder of African and Caribbean medical students. This tragically disproportionate impact was also being felt over the wider BAME community “with black patients being four times more likely to die with Covid-19 than white patients”.

Ms Dada highlighted the killing of George Floyd, and the BLM moment as a turning point in the discussion of the challenges of systemic racism. She added that these challenges have implications for the whole medical profession, as “anything that affects the NHS, anything that affects the way we care for patients or treat our colleagues, requires our attention”.

Although Ms Dada said she was hopeful for the future, she added: “I am not naïve… although we have been taking steps in the right direction, more still needs to be done.”

‘Rowing back’ of trans rights

Grace Allport, from BMA Northwest Regional Council, echoed similar feelings of solidarity with patients and colleagues in terms of the transgender community, saying that “it’s so disappointing to hear the statements and leaks coming from the Government, threatening to row back the rights of transgender people”.

She continued that the right for trans people to self-identify had been delayed for far too long, and that the current procedure is “lengthy and costly”, and also that the threat by the government to deny treatment for gender dysphoria for those under-18 was the reason why “it’s important for us to pass this motion now to protect the rights of transgender and non-binary people”.

But the need for balance was expressed by Angela Dixon, a GP from Scotland, who told the meeting that the BMA should not be supporting medical treatment for gender dysphoric children as the intervention at this stage lacked evidence, and the use of puberty blockers could cause irreversible damage. And, that self-identification could conflict with “provisions to ensure that women can access healthcare safely and with dignity”.

The BMA said that the discussions in the conference and the motions passed gave voices to those seemingly ignored in the rush to combat Covid-19, to those who have experienced long-standing issues accessing and working in the NHS, and has also opened up space for further debate about how these challenges can be further resolved.