Health organisations need to work together to end structural racism in the NHS and stop a major exodus of doctors of ethnic minority backgrounds, according to a new British Medical Association (BMA) report.

The report found that nearly one third of doctors surveyed have considered leaving the NHS or have already left within the past two years due to race discrimination, with 42% of Black and 41% Asian doctors in particular having considered leaving or having left.

The survey, one of the most comprehensive of its kind on the experience of racism in the medical profession and workplace, paints a picture of institutional barriers to career progression, dangerously low levels of reporting of racist incidents, and a building mental health burden on ethnic minority doctors.

Dr Chaand Nagpaul, BMA chair of council, said: “The NHS was built on the principle of equality of care for patients whoever they are, but this report shows that the NHS is shamefully failing in this principle for its own doctors, with those from ethnic minorities reporting alarming levels of unfair treatment and racial inequality at work.

“It is deeply concerning that so many of those surveyed did not report racism, either out of fear of recrimination, being labelled a troublemaker or a lack of confidence it would be properly investigated. This means that doctors are suffering in silence, and the true extent of racism is neither exposed nor addressed.

“What all this this adds up to is a tragic waste of potential as doctors of ethnic minority are held back, dragged down or simply walk away from the profession."

The five themes under which the report’s recommendations come are:

  • Being explicit about the need for change
  • Improving racial literacy
  • Investment in root cause analysis and evaluation of interventions
  • Improving reporting processes
  • Increased accountability

Medical training should also include health inequalities

The Royal College of Physicians said the results of the survey make for painful but essential reading. Nobody should come to work and experience discrimination and racism.  

Sir Andrew Goddard, president of the Royal College of Physicians (RCP), said that to hear that so many of those discriminated against don’t report their experience for fear of not being believed is incredibly concerning. Healthcare organisations must have independent processes in place so that staff feel safe and secure in reporting concerns.     

He added: “Our own surveys of newly qualified consultant physicians show that those from ethnic minority backgrounds are consistently disadvantaged when applying for jobs so it’s clear that discrimination continues to affect clinicians’ careers at all stages.  

“We agree medical training should also include health inequalities because tackling racism also requires improving our knowledge and understanding of ethnic inequalities in health outcomes for patients. 

“We also fully agree that taking long-term action on discrimination starts with improving transparency at all stages, including asking organisations that are responsible for the progression of doctors to publish their outcomes by ethnicity.  For our own part we know we have more to do to support this agenda. This includes publishing postgraduate training outcomes by ethnicity and other characteristics in greater detail and acting on disparities, which we will address through the Federation of the Royal Colleges of the Physicians of the UK and our own Education team.”