Junior Members Forum: Health problems of ethnic minorities
Authors: L. Beecham
Journal: BMJ (1983)

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.