EXCLUSIVE: Asian doctors angry over ‘shambolic’ Covid response

By Barnie Choudhury

SENIOR south Asian doctors have accused the government of failing to protect the most vulnerable frontline health workers.

Their comments came during an end-of-year virtual roundtable on the government’s handling of the pandemic.

Board members of the British Medical Association (BMA), the doctors’ union, told Eastern Eye, that they and some of their south Asian colleagues had yet to be vaccinated for the virus.

“I really think that it would be a dereliction of duty if doctors and other healthcare workers who are at highest risk are left delayed in not receiving the protection they need through being vacci­nated,” said the BMA chair, Dr Chaand Nagpaul.

“What I and others are doing is putting real pressure on those sys­tem leaders in our local areas and government that they have to pri­oritise the doctors who are most at risk of this virus and other health care workers.”

According to government data, the Covid virus disproportionately affects black, Asian, and minority ethnic (BAME) groups.

Dr Farah Jameel, a north Lon­don GP and member of the BMA’s general practitioners committee, described the government’s ap­proach as “shambolic”.

“I have not seen enough studies which suggest what is it about being BAME that makes me more at risk of developing a significant illness when I do contract Covid and being at a higher risk of things like mortality.

“They (the government) acknowledge that BAME individ­uals are at a higher risk, but then they do not acknowledge or ex­plain why they haven’t put us at that front of the queue. And I think I’d want to be asking questions about that.”

Chair of the BMA staff, associ­ate specialist and specialty doc­tors committee, Dr Amit Kochhar, said lessons from earlier lock­downs had not been learned.

He had not been vaccinated when he spoke to Eastern Eye, despite being in a high-risk group.

“I don’t know why there is a failure to recognise that these groups, and it needs looking at, because we have been through so much,” said the ear, nose and throat (ENT) surgeon from Lan­cashire. “I personally knew five of the first 10 doctors who died, and to speak to their families was heart breaking. It is not only a loss of an NHS worker, it is a loss to the whole NHS and a loss to that fam­ily forever.”

South Asian doctors felt under­valued by the government, ac­cording to the panellists.

“You also know that some of us have beards. One of the consult­ants who died in the Midlands was a Sikh doctor. You can’t have PPE (personal protective equip­ment) that doesn’t fit the beard appropriately, so you need other measures,” Dr Kochhar said.

“These have to be arranged if you value that doctor’s life and that doctor’s contribution, and sometimes it does feel as though we were not valued. When the vaccines prioritisation list is being drawn up, where are the BAME doctors? Where are the BAME staff? They haven’t been priori­tised as yet, not to my knowledge.”

Throughout 2020, the BMA chair wrote to the government pointing out that health workers were dying unnecessarily because of a lack of protection.

More needed to done to protect the most vulnerable groups, Dr Kochhar said.

In the past month, Dr Nagpaul wrote to the head of the NHS, Sir Simon Stevens, asking him to look into the arrangements.

The first letter was sent just be­fore Christmas (December 21), followed by a second letter on December 29, reinforcing the message that 90 per cent of doc­tors who died were BAME.

He blamed the lack of a “sys­tematic approach” in dealing with the pandemic for GPs and hospi­tals forced to do “their own work to try and protect their most vul­nerable healthcare workers”.

That is still happening today, Dr Nagpaul said, when it comes to vaccinating patients in his own surgery. He told Eastern Eye that 40 per cent were BAME and most of these were south Asian.

“We had 1,000 vaccines for over 80s, and there are 10,000 over 80s in our population. We prioritised the first 1,000 to those who were over 80 and were from a BAME status and who had other medical conditions, such as diabetes.

“So, in fact we prioritised from a commitment we had to our community to protect those who are the most vulnerable and those have been largely BAME patients.”

What annoyed south Asian doctors was the government’s in­consistent messaging in recognis­ing that BAME people were dis­proportionately more likely to not only contract Covid, but also die from it.

They point to the contradiction between two government reports.

The Public Health England review in June said that racism and inequality could have been increased risk factors for BAME communities. Yet in October, the race disparity unit’s quarterly re­port did not once mention racism as a factor.

Later, during a briefing, a gov­ernment adviser ruled out struc­tural racism being a feature.

“I find it extraordinary that the government can, at a stroke, ig­nore that the recommendations from an esteemed body of specialists who looked at this, which said there was structural racism, and to just ignore it and say that now suddenly it doesn’t exist; well, of course, it exists,” said the BMA chair.

“There are clear structural as­pects of our health service that have resulted in unequal treat­ment, unequal experience for some of our healthcare workers, who are from a BAME background – the evidence is clear cut.

“So, I don’t quite understand how the government can ignore the recommendations and simply talk about another report from the race disparity unit in October.”

Another concern for south Asian doctors is a culture of fear among BAME health workers in the NHS.

According to the BMA, survey after survey reveals the lack of confidence to complain about systemic unfairness.

“BAME doctors have reported between two to three times as much as their white counterparts feeling under pressure to see pa­tients without protection.

“They have reported to us feel­ing less able to raise concerns in their workplace to go to their managers to say, ‘I feel worried about whatever it might be during the Covid pandemic’.

“What they’ve told us is they’re much more concerned that if they do speak out, they may have re­percussions, including issues around career progression. That is not a health service, any of us want to be part of where they may actually suffer disadvantage by speaking up because of their skin colour. That all needs to end.”

Dr Nagpaul said he wants the government in 2021 to demon­strate they “have their backs”.

“It really should not have taken 90 per cent of doctors who have died coming from a BAME back­ground to show the government just what the BAME healthcare workforce does for the nation.

“But now that tragically that has happened. In the coming year this is what the government must make sure it delivers on, which is showing proper valuing of its workforce, in particular, those who’ve come from all around the world, including those who also were born here, who are from a BAME background.”

The government accepted that BAME groups were dispropor­tionately affected.

Its prioritisation guidance states, “Good vaccine coverage in BAME groups will be the most important factor within a vaccine programme in reducing inequali­ties for this group.

“Prioritisation of persons with underlying health conditions will also provide for greater vaccina­tion of BAME communities who are disproportionately affected by such health conditions.”

A government spokesperson said, “All health and social care staff have been prioritised for the Covid-19 vaccine since the start of the programme, along with those of older age.

“Throughout the pandemic, we have prioritised protecting the most vulnerable in our society and have invested more than £4 million into research into Cov­id-19 and ethnic disparities so that we can go further.

“We are supporting the NHS and have committed £3 billion to maintain surge capacity and safe discharges over winter, on top of a record cash funding boost of £33.9 billion extra a year by 2023-24.”

‘Failure of leadership’

Speaking exclusively to East­ern Eye, Burnham said the race disparity unit quarterly report in October report lacked credi­bility. “These may be things that people don’t want to face up to, but they have to face up to them,” he said. “Hard questions have to be asked. Why has Cov­id-19 hit some communities so much harder than others?

“One reason around (is) peo­ple’s professions. But there’s another; in terms of the quality of housing, overcrowded hous­ing, poorly regulated housing in the private rented sector.

“These are the issues, and it’s because we have an unequal society where there isn’t fairness in terms of access to op­portunity that many people are trapped in jobs that don’t sup­port them to have good health and housing, which equally doesn’t promote good health.”

Khan said his team had giv­en the evidence of more south Asians being disproportionate­ly affected by the virus. He told Eastern Eye that “without a doubt” this was a failure of leadership. “Anybody who’s ex­amined the data from Public Health England, and also the data that councils have pro­duced, and we’ve produced, can’t but conclude there is structural institutional racism still in 2020 across the United Kingdom,” Khan said.

“For the government to be in denial about this is frankly shocking, and it beggars belief. What I’d say to the government generally, is look at the data speak to the experts and recog­nise there are big problems, structural problems, that still ex­ist in our country, I’m the first person to accept and be proud of the progress we’ve made. We’re not the same country we were 10, 20, 30, 40 years ago, but there are still challenges.