NHS Wales could 'collapse' if racism within medical industry is not tackled, warns doctor

• Watch the video report by ITV Cymru Wales reporter, Kate Lewis.

Around 35% of medical staff in Wales are from ethnic minority backgrounds, but a new report has warned that many could quit due to persistent and intolerable levels of racism faced at a personal and institutional level.

A landmark report into racism in medicine by the British Medical Association has 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.

Professor Keshav Singhal is Chair of British Association of Physicians of Indian Origin Wales and an Orthopaedic Surgeon at Princess of Wales Hospital in Bridgend. He believes that if things don’t improve "urgently" then the NHS in Wales could face "collapse".

'If we take out the BAME doctors and nurses the Welsh health service will collapse'

"I think it's fair to say if we take out the BAME doctors and nurses the Welsh health service will collapse. It's as simple as that.

"I think over 35 percent of all staff in Wales is BAME background and I think they provide an absolute incredible service particularly in areas which are far off where a lot of colleagues don’t want to go which are inaccessible. West Wales, rural west Wales, north Wales. Some hospitals have over 60 percent of their staff as ethnic minorities."

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.

The report identifies systemic failure which will need every health organisation to work together to bring an end to structural racism and rectify the disproportionate outcomes in careers and job satisfaction faced by different ethnic groups.

​​"I see indications from all health boards in Wales that they are taking this very seriously. Each health board has created a BAME champion, a BAME network and Cwm Taf Morgannwg have been at the forefront of all of this, but what is important is how this translates into actions and how we devise a reporting system saying this year we've made these changes this is the effect of those changes and so on year by year.

"I think the most important thing in my opinion is to make sure there is a senior representation in proportion to the workforce at the senior management level and board level as until that senior there is not going to be that voice which feeds into the decision making process."

The report comes just a week after the Welsh Government announced plans to make Wales an Anti Racist Nation by 2030.

A Welsh Government spokesperson said: "The Welsh Government is taking immediate action to make Wales an anti-racist nation by eradicating all forms of racist discrimination and harmful behaviour at work. Work is ongoing with NHS employers and trade unions to establish Speaking Up Safely framework to improve NHS Wales workforce confidence in reporting incidents of racism.

"We have begun the process of auditing NHS Wales employment policies through an anti-racist lens, and to improve the quality of workforce data to ensure any disparities and discrimination in workforce experiences are highlighted and addressed.

"These actions are progress against our Anti-racist Wales Action Plan (ARWAP) published last week, which aims to tackle systemic and institutionalised racism. Drawing on Black, Asian and Minority Ethnic communities' experiences of racism, and race inequality, the Plan sets out a series of actions from across Government to make a real difference to the lives of people in Wales."

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.

"Our report depicts the scale of their suffering - being overlooked for promotion, forced to change their chosen specialty, feelings of isolation and exclusion. With 60% Asian and 57% Black respondents seeing racism as a barrier to career progression, patients are failing to benefit from the full skills and talent of an ethnically diverse workforce.

"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.

"Experiencing racism is extremely distressing, with nearly two thirds of doctors we surveyed saying their mental wellbeing had deteriorated as a result, with many suffering depression, low self-esteem and anxiety. There is evidence that incivility can affect the cognitive functioning of doctors, and consequently this is having an adverse impact on patient care.

"Racism is wrecking the lives of many doctors, affecting patient care and threatening services. The time for talk on this is over. Our report makes a range of clear recommendation for change which demand action across the health system, from Government to NHS organisations, leaders and other institutions." 
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