Doctors accused of "institutional racism"

A governmental inquiry into working practices has criticised doctors for "institutional racism." Produced by an all-party Social Security Select Committee, the report contained evidence that people from ethnic minorities are subject to discrimination during medical consultations.

The report examined the work of the Medical Service and its Examining Medical Practitioners, the doctors who examine claimants for the Government Benefits Agency. It follows a recent admission from Mike O'Brien, a Home Office minister, that his department is "institutionally racist".

One doctor expected the eight-year old son of a patient to interpret during the consultation. In a separate case, another doctor refused to remove his shoes upon entering the prayer room of an Asian patient, resulting in the consultation having to take place in the hallway. The report also cites several examples of crude stereotyping: one doctor made allusions to an Irish claimant's alleged alcoholism without having any evidence that the patient was a drinker.

There are also examples of offensive racial terminology that, despite the guidelines issued by the Benefits Agency over two years ago, is still being used by Examining Medical Practitioners. The report recommends that doctors who demonstrate cultural insensitivity should ultimately be dismissed.

"It is unfortunate that doctors have made inappropriate references to claimants' ethnic origins in reports, and it is clear why this has given offence," the report comments. "What is perhaps more worrying is the suggestion that, despite under- takings having been made, effective guidelines and training on the issue had not been given." The report also states, "We believe that Medical Services could be laying itself open to the charge of institutional racism in two ways: in failing to train doctors adequately in issues of cultural awareness; and in failing to make claimants aware that they may request the service of an interpreter. We expect it to address both issues as a matter of priority."

Commenting on the overall quality of the Medical Service, the report calls for the Benefits Agency to take urgent steps to achieve better treatment of all claimants.

"The Family" (above) by Jon Buck is part of Sculpture 2000, an outdoor sculpture exhibition in the grounds of Milton Keynes General Hospital and the Saxon Clinic, Milton Keynes. Works at the exhibition include pieces by Lynn Chadwick, Peter Randall-Page, and Glyn Williams. It lasts until 31 October.

Siân Knight, Nottingham


studentBMJ 2000;08:175-216 June ISSN 0966-6494