Racism in the Medical Profession
This section describes my work on Racism in the Medical Profession and in Higher Education.
Racism in the NHS
Much of my research is based on the premise that the medical profession remains largely unaccountable for its practices in relation to how it controls entry into the profession, the way that it allows career progression, handles complaints and rewards its members. Through the exemplar of racism, my work has shown that there are a lack of mechanisms for monitoring, a culture of denial and a lack of clearly defined pathways of accountability in the NHS, the professional bodies in medicine, universities and the General Medical Council. The work has a direct bearing on the current debate on how to make the profession more accountable, revalidation and governance. For universities, it informs the debate around access for students from under-privileged backgrounds.
The impact of this area of work has been considerable. Not only has my work in this area been cited over 100 times in publications listed in the science citation index but it has also had a significant impact on policy developments. Almost all of this work has been published in high impact factor journals. (Some articles on racism can be accessed at the BMJ site, search for articles under my name).
My work on the GMC resulted in the organisation instigating a 5 year review (led by Isobel Allen from the Policy Studies Institute) of its processes for the handling of complaints. Processes to improve accountability and transparency in the GMC were implemented directly as a result of my work in this area.
My research on medical school admissions resulted in the Council of Deans of Medical Schools making all information related to medical school admissions freely available. As a result of this work, the Commission for Racial Equality (in 1999) asked all medical schools to review their admissions policies to ensure that they did not discriminate against ethnic minority students. Monitoring mechanisms have been implemented throughout UK medical schools because of this work. In 2013 I published ground breaking research which highlighted the problem of differential attainment in postgraduate exams between white and ethnic minority candidates. Most of the Royal Colleges of Medicine undertook major reviews of their postgraduate examinations because of the problems highlighted through this research. The GMC now publishes infomration realted to differential attainment in postgraduate exams on its website.
My work on distinction awards contributed to the reform of the Distinction Awards and Discretionary Points scheme. This is a scheme where consultants in the NHS are paid significant sums of money over and above their basic salary, ostensibly for contributions to the NHS which are deemed meritorious. My research has resulted in better monitoring of the system and greater transparency in its operation. There are still significant problems with this system and I continue to research and campaign for its abolition.
In 2014 I was part of a small group that campaigned for and got agreement from the NHS to implement the Workforce Race Equality Standard (WRES). This is the first time that the NHS has introduced a mandatory requirement to achieve certain stadards in relation to workforce equality - for example on the composition ot its boards, the number of staff in management grades and on bullying and harassment.
I also provide independent advice on accountability mechanisms, on an ad hoc basis, to organisations, which have included the General Medical Council, the British Medical Association (where I chaired its Equality & Diversity Committee between 2004-2007), the Department of Health and the Law Society. My membership of national committees is a reflection of this work.
Apart from its policy implications at the national level, my work has been the subject of numerous media articles and television documentaries. These include several items on the Radio 4 Today programme, The Colour Bar (London Weekend Television-, 1994), A case to answer (BBC 1994), The Practice (Channel 4 1997), An Unhealthy Practice (BBC 1997) and From Raj to the Rhondda – Asian doctors in the NHS (BBC 2003). Some of the work has also been used in Employment Tribunals as evidence by individuals who have successfully challenged NHS institutions in areas covering the lack of accountability in career progression, complaints and reward mechanisms.