Junior Members Forum: Health problems of ethnic minorities

Abstract

What can a group of white professional people do to improve the availability of health care to the ethnic minorities in Britain ? Should the system be changed because 4-5% of the population have problems caused by language and social and cultural barriers ? It was generally agreed at the Junior Members Forum last month access was inadequate and the medical profession must bear some responsibility for this. The topic had been chosen as a result of some remarks made by His Royal Highness The Prince of Wales when he was installed as president of the BMA.1 I believe, he said, that we should not expect people to have to alter their lives drastically to be able to fit into the system happens to exist. But as soon as a particular group, particularly if coloured, is picked out for special treatment then there are accusations of racism. The forum was told, for example, of a gynaecologist who had conducted a separate clinic for immigrant women and was reported to the Commission for Racial Equality. Yet he had acted on entirely altruistic grounds, believing in this way he could devote time to them because of language and other difficulties. The deputy chairman of the commission, Mr Clifton Robinson, pointed out all the disadvantages ethnic minorities faced. He refuted the widespread but inaccurate assumption because the National Health Service was free to all at the time of use it was equally available to all. Many sections of society found the NHS insensitive, inappropriate, and often irrelevant. The Service's response was to label them as problems rather than admit the system was at fault. Ignorance, compounded by linguistic difficulty and social and cultural differences, made it difficult for them to avail them? selves of the service. When they did they often faced prejudice and racism. It was estimated 70% of Pakistani women in this country did not speak English. Mr Robinson pointed out that, as a large proportion of the ethnic minorities were young, the women were of childbearing age and used the general practitioner, paediatric, and maternity services. But many disliked being examined by men or women. He put to flight two commonly held myths. Firstly, there was the myth the NHS could not discriminate against coloured people because so many of its employees were Afro-Caribbean or from the Indian subcontinent. But most of them were among the lowest paid workers and suffered discrimination themselves. Secondly, it was believed members of the Health Service professions who belonged to ethnic groups were repositories of information about the countries from which they had come; often, however, there were wide social gaps between the professional workers and the patients. What would happen to the immigrants when they got older, Mr Robinson asked. In their countries of origin they were accorded more respect the older they got: in this country they might be placed in homes for the elderly, and might cause psychological problems. Turning to unemployment, Mr Robinson said doctors had long been worried about its effect on health; they ought also to consider the effect on health of belonging to an ethnic minority. He hoped the weekend's discussion would lead to doctors reappraising their attitudes and perceptions; otherwise the meeting would have been a waste of time.