A doctor wearing an isolation gown sits aside his patient in the office and discusses.
Revealed: Anger among vulnerable Asian frontline medics who have not been vaccinated
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 regarding the government’s handling of the pandemic.
Board members of the British Medical Association (BMA), the doctors’ union, told Eastern Eye, they and some of their south Asian colleagues had yet to be vaccinated.
“I really think it would be a dereliction of duty if doctors and other health care 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.”
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, said the panellists, felt undervalued by the government.
“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.
Lack of systematic approach
In the past fortnight, Dr Nagpaul has written to 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 Tuesday (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.”
Culture of fear
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’ve 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 what 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.”