NHS cracks down on racism

Many ethnic minority staff have experienced racism from patients

Doctors and nurses are being encouraged to report racist incidents under a zero tolerance policy.

Hundreds of thousands of NHS staff are to be trained to deal with aggressive or abusive patients.

The NHS will also pursue criminal cases against the worst offenders.

One trust has told the BBC it is refusing to treat non-emergency patients if they subject their staff to racial abuse.

Dr Malcolm Stewart, deputy medical director at the William Harvey Hospital in East Kent told BBC Radio 5 Live patients who are racist are told to go elsewhere.

One doctor's report to doctors.net If I had the guts I would make it clear to the patient in this situation that if they weren't willing to be treated by the team available, then they should go to another hospital.

"The trust is committed to taking vigorous action over the issue.

"I have asked patients, on more than one occasion, to continue their care elsewhere, when they have made overtly racist remarks.

"The health service is dependent on the contribution made by our colleagues from the ethnic minorities. This is true of all hospitals and all trusts in the United Kingdom.

"If patients are not prepared to accept that our colleagues from the ethnic minorities make an equally valid and equally important contribution to their care, then, where possible, it would be better if they sought care in a different setting."

'Blatant'

Dr Sarah Chissell, a gynaecologist at the hospital told how, before the zero tolerance policy was introduced, she had witnessed an incident on a nightshift where a patient in her 20s who needed an emergency operation, but was refusing to be treated by black or Asian doctors.

She told BBC Radio 5 Live: "I was just livid. I just thought this was absolutely appalling that somebody in this day and age, somebody of her age, should be so blatantly racist.

"I asked my colleagues what they thought and I was quite surprised at how some of them seemed to think 'oh well, we should just get on with it, do the job and get rid of her'.

"I didn't want to do the operation, I didn't want to be involved with her at all. I just found it all abhorrent."

One black doctor at the hospital, speaking anonymously, that black and Asian staff had to "let it go" if they were the subject of racist abuse.

But he said if patients wanted free NHS care, they should be prepared to be treated by whoever was on duty.

Court cases

Sir Nigel Crisp, head of the NHS, said major incidents of racism were already recorded, and individual staff were best placed to decide if they were the subject of harassment in more minor incidents.

He added: "We've got two duties in the NHS. We have a duty of care to our staff, to ensure they have a safe and good environment in which they can give of their best.

"But at the same time, we've also got a duty of care to our patients - and those balances are very difficult."

Comment to doctors.net My simplistic rule of thumb is this - any verbal abuse, racist or otherwise, directed at me or A&E staff means and the patient forfeits their right to treatment in our department.

Sir Nigel said it was permissible to refuse treatment where patients were not suffering life-threatening illnesses.

"Where people are using the NHS, they need to use it with respect, just like our staff have to respect our patients."

Dr Kailash Chand, a GP in Greater Manchester, told the BBC that the Stephen Lawrence case exposed how racism was present in almost all institutions including the NHS.

But he said he did not believe refusing treatment was acceptable.

"I don't think that is a viable possibility."

He added: "We have to look at the causes of racism, rather than coming to knee-jerk reactions.

"Racism is rife in society, and it comes into the NHS as well."

He said it was not always worth reporting incidents because it was difficult to secure prosecutions.

"My colleagues in the past have complained to the police, but nothing much happens."