AIBU to think refusing treatment from non-white medical professionals should have consequences?

[MrsBennetsPoorNervesAreBack]

There has apparently been a significant rise in racism towards NHS staff, with a growing number of people refusing to allow non-white NHS staff to treat them. This is sad but not surprising given the shift in society as a whole towards people expressing their racism much more openly.

https://news.sky.com/story/nhs-staff-experiencing-unconscionable-levels-of-racist-abuse-survey-finds-13569575

I have always admired the commitment of NHS staff who treat all patients with care and compassion, even when those patients are rude and abusive. But if people are actually refusing to let certain staff provide treatment, surely there should be consequences for this?

AIBU to think that everyone has the right to refuse treatment if they so wish, but if a patient refuses treatment from a medical professional simply because they don't like the colour of that medical practitioner's skin, then they should then forfeit the right to receive that treatment on the NHS. So they can either go without or find the money to be treated privately by a medical professional of their choice?

There would need to be signs warning people of the consequences of their choices, of course, but if someone doesn't want a Black or Asian radiographer carry out their x-ray, then fine... they just don't get an x-ray.

Yes well anyone with any empathy would not- they might be racist but you are a psychopath.

Ah, calling an HCP a “dirty foreigner” or a “monkey” is actually code for please speak slowly. You numpty.

For the same reason you are I assume - it’s a public forum and we can all respond to what we choose to.

Yes, it's a complex issue. And to be honest, I don't really trust the NHS who are quite willing to gaslight people when it comes to transwomen being allowed onto women only wards.

My elderly dad was being treated by a nurse who was explaining something to him. She had a very strong Jamaican accent and he could not understand her at all. She made little attempt to communicate clearly with him so he had to keep repeating his questions over and over again. No doubt if he'd complained or asked to see someone else (which he would never have done as he was always very left wing) that would have been perceived as him being racist.

Do you acknowledge the point? Many women who have experienced sexual violence from men want their intimate care to be from women, not men (including men who identify as women).

There is quite a lot of crazy stuff on this thread! Stuff about the death penalty and way too much focus on accents. I am a brown doctor, born and brought up here and trained in the NHS. I work full-time for the NHS, have not called in sick for my 20 years as a consultant, and I’m good at my job. You’ll have to take my word for that ;-)

Of course people should be able to understand their HCPs. If someone does not know the language well enough to communicate the health or care needs of patients, they should not be employed. Communication is everything. When I am unwell, I want to talk to HCPs who can speak English well enough. There is nothing racist about that. And that is not what the OP was about. I think it does nobody a favour to hire people who can’t speak English properly. Nobody gains.

As I said before, in an emergency, we should save everybody’s lives. That is black-and-white. It would be indefensible to allow someone to bleed to death after a car accident if they were shouting abuse at black or Asian staff, or homophobia or sexist insults. We have to save them.

There is more of a fine line in circumstances where the care is more elective rather than life-saving. It’s fine to ask for a female HCP in my view. Or male if someone prefers that. Also, there may be specific circumstances where someone cannot see someone of a certain background. I have looked after people with PTSD who have for example rejected an interpreter because of the part of Serbia or Kosovo or Albania, they come from, because it reminds them of trauma sustained in war. I think we should discuss and accommodate that if we can.

If someone simply says I don’t want to see that doctor or nurse because they are Asian or black, or Jewish. Or gay or disabled etc. I don’t think we should rush to accommodate that as it sounds like pure prejudice. It should be assessed on a case by case basis, for example is there a mental illness or a neurological disorder or dementing illness to explain this behaviour.

In my own practice, I have not had anybody refuse to see me because of my skin colour. I have an English name, because my parents gave me an English first name and I married an English man! So occasionally when a patient comes to see me, I will see a little look of something in their eyes, and I sometimes wonder if it is surprise or disappointment that I’m not the white English doctor they expected. But anyway, once they see that I am extremely professional and caring and can do the job, it’s never been an issue.

I have just realised that from tomorrow, when the new resident doctor starts, my team will only have UK trained, brown-faced doctors. So any racist patients are going to face a bit of a dilemma!

In general in the NHS, we have to treat the patient in front of us. In my 20 years of being a consultant, I have treated rapists, murderers and paedophiles and everything else. I have been as professional and pleasant to them as I have with all my patients. That’s just how it goes.

And of course many of my patients may have been racist, but they have managed to keep those views to themselves so all is good. They may also be homophobes, antisemites and misogynists, but as long as they don’t refuse to speak to me or my colleagues, we will continue to treat them. Having said that if someone called me a dirty monkey, I would need a very good reason to see them, and make no apologies for that.

The bar for refusing to treat a patient is extremely high. I have not seen it in my 30+ years of being a doctor in the NHS in London.

And that shouldn’t be taken that women who request a female HCP should be grilled about why. All women should be able to request a female HCP for intimate care and if one is not available they should be treated with respect and dignity and have their options explained to them. But really if at all possible they should be able to have this. It’s not just a “preference”, many women will self exclude and some of them are going to be “non-white”.

I can see a situation where a non white doctor does something patient unhappy with unrelated to their skin colour and white patient too scared to say something in case accused of racism

I could easily have been that person on the one occasion I had to report a nurse who assaulted me, @IHateRainbows. They happened to be black, but then so were most of the other staff on the ward, and though I pointed out that the overall care had been brilliant, still I was subjected to some pretty clear insinuations about what my motive in reporting them actually was

Because their veiled accusations were baseless they simply ended up making fools of themselves, but it was an interesting window into just what some NHS staff will bring to bear if the least criticism is raised

Thank you for this sensible post!

You know what? Go for it racists. Least that's one way to shorten the waiting list for us normal people who couldn't give two hoots about the skin colour, faith or origin from the wonderful NHS staff tho treats them.

Ive seen kids who hsve called s black TA worse than anything alluded to pn here bit you know what she was tolx that she just had to suck it up because she wzz6 the professional and thr student was ND and dysregulated.
How does this tie in with this debate where patients are frightened ill and in pain?

I have asked to be seen by a different GP than I was offered because communicating with a particular African doctor was too difficult due his poor English. Nothing to do with racism.

Their choice.

There are posts on this thread implying that asking for a different doctor shouldn’t be allowed as it’s a way to “get round” exposing yourself as racist. Which it may well be, but I don’t think we can make that assumption and we’re into thought crime territory.

Did he actually ask her to repeat herself, talk slower etc? If so and she still didn’t make an effort to help him understand - or get someone else herself - then a request or even a complaint might be appropriate. If she’s not communicating effectively she’s not doing her job.

How dare you come barging in here with your reasonable comments and nuanced views. I bet you're just like this at work, too, aren't you? 😉

Last week I had to call the language line for a Turkish interpreter. The irony was that when I spoke to the admin person to link me up with the interpreter, I could not understand what she was saying due to her accent. She asked me the same question three times and I could not understand what she was saying. I felt so stupid and embarrassed!

I’m a Dr. I can understand why your proposal could seem attractive, but I disagree with it. It’s all a bit virtuous and more about appearing to be so, rather than effective or supportive of those who might be victims of racism. I don’t think it will achieve anything- it won’t change a single racist persons view, it will be fuel to those who are already agitating race relations, and it will be very difficult to implement (who decides who gets denied care, and how is that documented etc).

It is also fraught with danger for the patient, the individual HCP and the health service- what do you think the impact will be when something inevitably goes wrong- which it will (and probably sooner, rather than later)? For example, I can quite easily foresee a situation where someone mistakenly accused of racism and denied care who then comes to serious harm; or someone with a valid reason to request an HCP not of a particular ethnicity. Just watch the shit hit the fan. The patient in question suffers, their family too possibly. And the person who made the call to deny care? Hung out to dry, would be my anticipated outcome- whether they had followed procedure or not. And if they are HCP their professional registration and career will be on the line. Why would I want to be put in that position? No thanks. And those with an agenda- manna from heaven for them.

Racism is a terrible scourge and I don’t condone it. However, as a Dr I would like all of my patients to be comfortable with the person providing their care. I would not want to be treating someone who did not want me to treat them- for whatever reason that might be- and most especially when it comes to physical examinations. That is not solely for their comfort, though that is important (even if I disagree with their reasoning and find it immoral)- it’s primarily because if they are clearly uncomfortable with me, that in turn makes me very uncomfortable too. Such patients are far more likely to be a difficult consultation and far more likely to complain. Even if later that is dismissed, it isn’t great to deal with. It’s just not good for either party.

I would say that there are lots of reasons why some people may not be at ease with the HCP- gender being the most obvious one. But in some cases, race is an issue due to that persons background.

I can also foresee a very grey area- how many patients would actually say “I’m not seeing Dr because I only want a white one?” Vs “I’d rather not see that Dr because x reason” (not a racist one)- you might suspect but cannot prove it. Additionally, I think you create a situation where patients with a valid reason to ask for an alternative HCP worry about refusing care from any non-white HCP because they fear being accused of racism- so they endure treatment from someone they are not confident in or avoid seeking treatment altogether.

Oh goody a race to the bottom! And the final destination is a load of racist and abusive service users wondering why no one wants to “serve” them.

I can only read what you wrote and I've explained how it initially came across and that I now understand you meant something different.

As I already said, and you already said, it's subjective. I stand by my point that it is dangerous not to question your own assumptions, though, and I think you're making some very sweeping ones.

I'm not particularly criticising your initial assumption that these were all spoken by white people, because I made the same one. I probably am criticising your unwillingness to step back and acknowledge it as an assumption when someone (who also pointed out out to me) points out that it's not backed up by any actual evidence in the text or any underlying data.

This.

Ok whilst racism is absolutely not ok and abhorrent can we stop with the all NHS staff are wonderful line. They absolutely are not.There are some great amazing NHS staff and some pretty shit NHS staff that are anything but wonderful- the same as in every profession.

Well said.

More of this bloody reasonableness that I suppose we're just expected to put up with! What is it with you doctors?!

I agree it’s necessary to question our assumptions, and I agree it’s possible some of the quotes were not from white people, though my reading of the language is that they are. My interpretation is based on the words as written and my experience of racism by white people and racism between non-white groups.

For example, even without the white man being described as such, only white people describe others as ‘ethnic’ as if they themselves are of no ethnicity.

Of course, I may be wrong.

What I object to is your assumption that I think only white people are native Brits. That goes way beyond ‘reading what I wrote’ and is you bringing your own rather strange interpretation. So yes, all things are subjective but perhaps take your own advice and step back before congratulating yourself on doing so.