Immigrant, Londoner, overly-specialist medic. Work in NHS (day job), RCP (journals) and NHS in Wales (inclusion). Tweets sent in a purely personal capacity.
Wow. When I was a child, if we wanted this level of racism we had to rely on the British National Party and the national Front.
Now we get it from the Dep Chairman of our governing party. Great days
Irritated at the abuse of privilege of this colleague:
1. Most people have poor job security / care responsibilities & can’t afford to be ill when there’s an effective vaccine
2. You’re using a prominent platform to fuel anti-vaxxers
3. You cut across female colleagues speaking
"The science isn't strong enough".
Watch the moment an unvaccinated hospital consultant challenges Health Secretary Sajid Javid over the government's policy of compulsory COVID jabs for NHS staff.
📺 Sky 501, Virgin 602, Freeview 233 and YouTube
I was delighted to help provide ward cover during the trainee doctor strikes in 2016, and will be proud to do so again if that’s what is voted for.
Burnout is not just a term to wheel out for presentations - it is real, influenced by long hours, poor pay & variable training.
If you want to understand the problems in general practice, here’s the story in one graph.
Recruitment and retention of GPs has to be the biggest show in town.
So, I keep my deeply-held (and I hope carefully-informed) feelings about certain things quiet on here - religion, monarchy, family and personal matters. But I am at a tipping point.
This recurring dog whistle 🙄
EDI posts account for 0.03% of NHS jobs. Bear in mind
#NHS
is the largest employer of BME people in Europe, 1/3 million people. National WRES team is currently 10 people (2 part time & 2 researchers on short contracts). (1/n)
When your comrades suffer, you suffer. And in the case of these colleagues, the wider NHS and patients suffer too.
We just can’t treat people like this.
We can’t afford to lose such talent.
But, we will persevere.
First, race affects everything. If you’ve not noticed that it does, then it’s because you’re fortunate enough to have that privilege where it doesn’t impact how loud you speak, where you walk, what you wear, how you shop.
So, at the end of April I leave NHSE.
I was honoured to be appointed by
@Prerana_Issar
, and lucky to work with
@WRES_team
, the *best people that I've met in 35 yrs in the NHS.
Sad to leave them, but the work remains.
Start: Finish
That this photograph could be published is a sign of how appalling the UK discourse is.
Anyone who doesn't rage against this depraved image is drawn into complicity.
Understanding the ethnicity pay gap for doctors and dentists.
Next, we're doing it for all the workforce, and going to explore the vital intersection with gender.
Exercising the right to strike when negotiations break down is a fundamental liberty, but not one that doctors use lightly. A strike is called as an attempt to bring the government back to the table. (1/n)
Reflections at the end of latest
#JuniorDoctorsStike
.
At a practical level, junior doctors carry an organisational memory that makes them extraordinarily efficient workers. Temporary agency replacements are expensive not only in financial terms, but also patient outcomes. (1/n)
Please consider signing & sharing this petition seeking reduced leave-to-remain fees for international educated nurses from £2389 to £243. These colleagues are essential to keep the NHS afloat, and as per WRES data are victims of the worst discrimination
I support all colleagues who have been driven to take strike action. Providing safe care requires us to adequately pay highly skilled staff.
And yes, there’s a race disparity on the impact of low pay. 30.4% of our nurses are from a BME background. (1/n)
To those hospital colleagues who don’t get why standing with GP colleagues matters, two things. 1 - we could not function without the risk-holding that GPs undertake. 2 - these commentators are coming for you next.
I would strongly urge
@NHSEngland
and clinical colleagues to come out strongly against such rhetorics
Do what needs to be done - but too many people have chosen to be silent - or too afraid to say what’s needed
This isn’t what our GP colleagues deserve
We must do better
The
@NHSPracHealth
debacle is a reflection of so much that is wrong with
@NHSEngland
.
A decision made to close a service *before* doing a review and impact assessment.
(1/n)
Last meeting of my day was with a(nother) BME medical colleague who whistle blew and was then bullied, traduced, referred to the GMC and has essentially lost their career. Such colleagues are not just statistics, they are what galvanise us to do our job in
@WRES_team
That’s not the lived experience for many of us. So, if we talk about racism, it’s history and it’s daily impact, that’s because it undermines us and our contribution to society.
A few days away and I come back to see my union playing politics with the career & safety of a black doctor
#DrOki
.
@TheBMA
needs to explain itself or alienate many of us who need a strong union, now more than ever.
Meanwhile, there’s this too
This is nonsense.
If I had seen similar events attended by medical leadership at the time, I wouldn’t have felt my morale rise. Quite, quite the opposite.
Which leads to the second point: my form of identification requires me to criticise my group in order to improve it. I don’t hold with uncritical glorification, based on nostalgia and an ahistorical perspective; this implies superiority, and leads to nationalism.
We have a major problem with discrimination in the
#NHS
, especially racial discrimination. Bad news: It’s not going away on its own. Good news: neither are we
@WRES_team
💪🏾
#FromDataToAccountability
This is important. Filipino staff in
#NHS
can identify their ethnicity specifically on the electronic record (ESR). This is a key step in establishing the particular burden experienced by distinct ethnic groups, and allows us to develop targeted actions to help uplift.
The WRES data report for
#NHS
trusts is released today
The data is uncomfortable in the main, and to serve its purpose, it must trigger the taking of corrective action
Long clinical day and appalled to read of this bill.
It’s plainly a desperate plea to an extreme faction of potential Tory voters - this cannot be the will of the majority of the UK.
Any MP voting for it is my enemy, not the people in the boats.
Very unhappy this morning. The round of applause as I started the ward round was only 2 minute long, the strewn rose petals were stale, the cries of ‘Encore!’ at the end we’re not echoed by all and the decanters in Drs Smoking Room were empty.
.
@MattHancock
says in some antiquated corners of the NHS nurses might still have to stand up when doctors enter a room. He says "doctors should stand up for you. After all, who is running the hospital at 2am?"
#CNOSummit
Hi
@DrAseemMalhotra
What persuaded you to (thankfully) delete your tweet which I won’t amplify?
Insight about the delusional intensity of your anti-vax views?
Doing some research about the deceased’s med history?
Fear of breaching
@gmc
social media rules?
Shame, crippling shame?
Here is something to cheer you up on a Sunday morning...Johnson getting his ass handed to him!
[This is Professor Leslie Thomas KC, on behalf of FEMHO. I have cut out as much of Johnson's waffling as I could. Enjoy!]
It’s
#RaceEqualityWeek
, and as the largest employer of BME people in Europe (>300,000 people) it is key to recognise that the obligation is to dismantle the processes of structural racism. Action derived from data, not just rehashing ‘educational’ initiatives.
In moving towards an anti-racist
#NHS
the first action
@NHSEngland
will take over the next years is to overhaul recruitment processes - and this will impact beyond race to other protected characteristics.
#ExecutiveSuite
webinar
The Workforce Race Equality Standard 2021 data report for
#NHS
trusts has been published.
There are some positive signs and areas progress still needs to be made. Report and supporting data:
#WRES
#OurNHSPeople
Following the recent failure to understand the specifics of anti-blackness, I penned this
At this point, failure to understand the specific problems faced by black people is willful ignorance
We are all drowning in reports - but if you work in the NHS - in whatever capacity - please do read this 35 page report. It tries to reflect the experience of staff while also pointing to the actions that health leaders can take to effect change.
The Workforce Race Equality Standard 2021 data report for
#NHS
trusts has been published.
There are some positive signs and areas progress still needs to be made. Report and supporting data:
#WRES
#OurNHSPeople
I attended the
#RCPEGM
in person. I came to a conclusion within an hour but sadly was not chosen to speak. I will use this thread (sorry) to explain.
1/n
Got into a warm discussion with a non-BME leader about their view that there ‘is’ equality in the NHS based on the fact that there are proportionally twice as many BME people in the NHS as there are in the population. (1/n)
Please read this thread.
What Rachel 💪🏾gets, and Mr Streeting seems not to, is that the NHS has always depended on staff feeling part of the whole, part of a social justice process to better society. We’re not trying to profit from human misery - we’re trying to alleviate it.
Many thanks,
@wesstreeting
.
Have to say I really didn't have "stop exploiting those patients you see dying in corridors in horrifically overwhelmed A&Es" on this year's Christmas list.
Please consider reading this short thread in response to your Sunday Times interview. 1/n
Made a conscious decision to step away from here as I took my leave from NHSE. And much as I miss my comrades there, there is relief.
The work remains vital – just this week I was contacted by 4 colleagues from 4 regions in England with reports of discrimination / bullying. (1/n)
Following several staff reports in recent weeks where Black and Asian staff have been accused of not ‘
#beingkind
’ it is more clear than ever that the hashtag is a way of harming these staff.
(1/n)
I was honoured to be invited to join the launch of Too Hot To Handle this week. I have not messaged about it until I had a chance to read it carefully.
It is an essential read for all NHS leaders.
My meagre thoughts on it are here
Many of us will have had a restless weekend in light of the Letby case
So many aspects of it are distressing, and MUST lead to change in our whistle blowing protections in duty for those lost lives
Solutions: safety-first no fault culture, board scrutiny, exec accountability
In the last week I’ve received many messages about how I’m a race baiter, and don’t belong in the country I’ve lived in and tried to contribute to over 45 years.
Abhorrent anti-black racism by Rupa Haq. Correct to be punished.
Also amused to see the right wingers who normally dismiss this sort of thing as ‘woke’, suddenly seem converted to the cause of equality. Welcome to the bright side everyone - time for consistency now, eh?
It’s the system that burns us out, not the people who suddenly combust. This notion of personal resilience is the lazy alternative to real focus on conditions, team building, flexible working. And when clinicians disengage from this fatuous training, we’re termed ‘hard to reach’
Resilience training for NHS clinical staff - what is it good for? Why not put the effort into improving their working conditions instead and providing more support for staff when they are at work?
Delighted to launch the WRES in the NHS in Wales today - do join if you …
The intention is to begin implementation from the start - no period of admiring the data. We need to act directly- people are suffering now
Almost 80% of BME staff in the NHS are at band 6 and below. How do we change this: sponsorship is key. Party of an excellent symposium run by
#teamCNO
#RisingUpandLeaningIn
An EDI advent calendar. Day 1: the trust which has had an ethnic minority network >10 years and which is an exemplar in how that network influences culture in a real way for staff and patients. Examples of their actions below, but many others on board accountability, funding, etc
As a black parent, would you encourage your child to go into medicine when this is what faces them post-graduation– from the GMC report released today an 18% reduced likelihood of exam pass compared to white counterparts, and 7% less than Asian ones.
(1/n)
My thoughts on WRES report 2023
Before getting into the data, congratulations to
@WRES_team
for producing this at a time of upheaval in
@NHSEngland
. These are stalwart people who have undertaken the huge task of data reporting while their own futures hung in the balance 👊🏾
1/n
A week of productive meetings about racial equity with leaders in systems and trusts has left me reflecting on how detached the media narrative about 'woke' is, how misguided and ultimately wrong
45 years today since the murder of Steve Biko, architect of black consciousness and midwife of my activism.
Rooted in knowing one's history, his legacy remains relevant – resistance and pride in the face of widespread oppression. 👊🏾
@ed_itu
Thank you so much for doing what you are doing to support this colleague. And for putting this in the spotlight. This lack of induction is something we’re addressing in the
@WRES_team
. It is dangerous and brings dishonour to the service.
Would you message me please?
Happy independence day to all Filipino sisters & brothers.
At >26,000, they represent the 3rd largest group in our NHS, and many have been here >20 yrs. Yet they remain grossly under-represented in senior positions. Yet they endure - with good cheer & unparalleled wok ethic👊🏾👊🏾
"How many of you here - raise your hands - have been stopped and searched by police? How many of you have been stopped and stripped-searched?"
Cross-party peer Lord Woolley raises his hand and says "you ask Child Q if it's funny"
What extracts I’ve seen are strongly reminiscent of the reports from BME staff in
#NHS
. To experience these aggressions is bad, to be told you’re being ‘sensitive’ is worse, to see the offending colleagues/organisations promoted is the limit.
A potentially pivotal report towards racial equality in the
#NHS
. Pleased to be representing
@people_nhs
at launch of this
@BAPIOUK
report, centred on a 10 point plan.
@OrthopodReg
Nah
@thetimes
This was a misstep, driven (presumably) by the intoxicating fumes of the reaction this man’s letter evoked.
Giving further airtime to these abhorrent views goes from ‘illustrating the problem’ to being a part of it.
We are looking under the bonnet at this. Midwife data: in two of the 7 NHS regions there are ZERO BME midwives above band 7. We are now coupling this with experience of BME obstetricians (including LED and
#SAS
Drs) to get a clearer picture, and see how that links to outcomes.
Black women often have the worst experiences at work and some of the poorest health outcomes. R these related?
@AntonEmmanuel2
@parthaskar
@Halima_Begum
Miscarriage rates over 40% higher in black women, study suggests - BBC News
What are your feelings when you read this shaming thread?
If they’re anything other than recognising the systematised nature of discrimination against black people, then you are part of the problem.
I was one of those two women, thanks
@Toddpodd
. I am furious and heartbroken by what I saw on Monday. Photos/video stills shared with parental permission.
A thread 🧵 1/n
Back from leave to a Twitter and a flurry of messages that I’m ‘constantly playing the race card’ and a ‘reverse racist’.
To the 1st I say ‘educate yourself, race affects everything’. I’m playing the ‘lived experience card’.
To the 2nd, listen to
@aamer_rahman
What support will existing hard-pressed managers have to do this work? All evidence points to the need for subject expertise in organisations which are serious about improving equality.
And how do you expect anything to improve when there’s no accountability for the agenda? (2/n)
And in the face of so much central ‘anti-woke’ rhetoric which empowers people to ignore the agenda. You can’t set fire to the building and steal the extinguishers and then look for evidence of why fire measures aren’t working. (3/n)
The question is how much are we, the public, prepared to pay for our inevitable need for healthcare if the NHS didn’t exist. The idea that our taxes would fall if there was no NHS is an illusion.
For me it’s simple - workers of the world, unite.
(end)
Ahead of
#Windrush
day on Tuesday, I have written a (first) blog, giving a little background to the longstanding
#NHS
dependence on internationally-trained staff
And what does ‘value for money’ mean? How do you quantify the value of staff not being offered fair progression? Of each staff member subject to inequitable disciplinary process?Of each worker bullied or assaulted? All of these happen disproportionately to minoritised people. (4)
As a public, we have a choice of loudly expressing our support of health workers forced into industrial action. Addressing their demands enhances our nation, rather than diminishing what’s available for others. (10/n)

Feel awkward but deeply touched at the excessively generous messages.🙏🏾
Tasks:
Make the data accessible & reflect individual experience
Research & publish what works to achieve equity
Embed work with regulators & willing trusts
Ensure local accountability
3 out of 4, B minus
Black history month is round the corner. And we’re delighted to invite you to this event from
@WRES_team
. No need to register, just join 6th October 12:30.
‘Data to Action’ is the title - in line with the BHM theme for 2022, ‘Actions not Words’
In my 2.5 years of dealings with FTSU guardians, I never encountered one who was an exec.
Combined with the decision to move Ms Letby to a role in the risk and patient safety office, it seems, in my view, intentional to conceal.
Aneurin Bevan famously modelled the NHS on the Tredegar Workmen’s Medical Aid Society.
He said that Britain was doing 'the most civilised thing in the world' putting 'the welfare of the sick in front of every consideration'
#NHS75
(1/n)
This is not a coincidence – the relationship between workforce experience and health outcomes is clear.
With that in mind I am delighted to start in the role leading implementation of a WRES for health and social care with the Welsh govt. (6/n)
Astonishing numbers:
#Filipino
staff account for an astonishing 1 in 50 members of NHS workforce. Even more astonishing, they tragically account for 1 in 4
#Covid19
deaths.
To those who don't believe there is a specific enduring strain of anti-black racism, please educate yourselves - look at the red lines in these graphs.
Yes, you guessed it, black nurses and midwives.
A few days away and I come back to see my union playing politics with the career & safety of a black doctor
#DrOki
.
@TheBMA
needs to explain itself or alienate many of us who need a strong union, now more than ever.
Meanwhile, there’s this too
In >200 cases shared with me by BME staff experiencing racism in the NHS, there are 2 extraordinary features.
not one incident was an alleged white staff accused of bullying asked to sit in front of a staff member and apologise to the BME person…
I am immensely touched by the warmth and good wishes offered. I am a bit nervous to ensure that I do justice to the importance of the job, but absolutely dedicated to the cause. It’s clear that I’m working in the strongest of teams at NHSEI, as
@RCPLondon
and
@uclh
GI physiology
This is wonderful news!
We're delighted that our very own medical director of publishing
@AntonEmmanuel2
will be leading the
@WRES_team
and helping to remedy the racial disparities that we know from our research still exist within the NHS.
'No one ever wants to talk about the thousands of Gypsies killed by the Nazis, because no one wants to talk about the positives'
The sick racist
@jimmycarr
in his new Netflix special
Unanchored capitalism has led to this - over years, not overnight.
The impact on health inequalities is inevitable - would be interesting to correlate COVID outcomes with the inequality index.
And what’s the morality of bringing in health workers from LDCs to such inequality?
NEW: income inequality in US & UK is so wide that while the richest are very well off, the poorest have a worse standard of living than the poorest in countries like Slovenia
Essentially, US & UK are poor societies with some very rich people.
A thread:
This is a desperate human consequence of what happens in a bullying culture.
Couple that with the regulatory bullying of cases like Dr Udoye, Mr Kumar, etc.
And finally the national estimate of ~£2.3 billion per year on bullying and discrimination cases.
This is unbearable
Outstanding junior doctor burnt out through work and criticism
@uhbtrust
took her own life.
Vaish Kumar had previously been chief registrar
@SWBHnhs
and worked through the pandemic
Scripted pandering with a racist joke. Is this what’s needed, alongside raging against ‘woke’, for a BME person to be selectable?
This trickles down to people not in public life. I was steered to this clip by someone passing their same comment to me as acceptable, based on this.
This is what systematised racism looks like.
POLICE chokehold and pin a pedestrian.
PARAMEDICS oversedate and don’t listen to him.
MEDICS don’t perform a complete autopsy.
LAWYERS work to conceal revised autopsy.
MEDIA reports the killing in a passive voice.
#ElijahMcClain
NEW: The Adams County Coroner’s Office in Colorado released Elijah McClain's amended autopsy report after several news organizations sued for its release.
Signposting vulnerable staff to local services is asking traumatised individuals to seek help from within the organisation that is often the source of the trauma.
Like our speaking up processes, it therefore is likely to not be accessed by those most in need.
(end)
Many thanks for inviting me to this. It’s not easy to talk about this stuff, I know. But this was a brilliant session, with true candour, moving beyond pledges and self reflection to thinking about how we operationalise change.
#CAHPO22
🚨 Tomorrow at the CAHPO conference, an absolute must attend for all
@WeAHPs
🚨
➡️ Anti-racism: the journey ⬅️
A privilege to work with the inspirational
@ruth_mhlanga
to develop. Can't wait to watch the discussion unfold 🙏🏼
I’ve been off-line for a fortnight – holiday and trying to absorb first-hand the impact of the current situation in the NHS. It has given me a chance to synthetise some thoughts about the use of the term intersectionality in the NHS.
(1/n)
This is a landmark document. The presented data may not surprise you. But it will act as lever to demand development and implementation of accountable actions. Credit to all those with a vision to demand this data, especially
@RaoMala
and
@Prerana_Issar
The first ever report on race equality for doctors has found the number of
#BME
doctors in the
#NHS
is the highest on record.
More than 53,000 doctors working in the NHS are from a BME background as of 2020 ��� up over 9,000 since 2017.
This is the last week of HEE and we are looking back at what we have achieved over the last 10 years.
Share your memories by commenting below with your memory or achievement of working for HEE using
#HEE10
Find out more here:
#HEE10Event
There’s a swathe of public figures trotting out their humble backgrounds (busdriver or toolmaker parents) and past experience.
The intention is to make you disbelieve your eyes - that the system is rigged to keep certain people oppressed.
(1/n)
'How dare you gaslight your own people?!'
@SangitaMyska
reacts to Rishi Sunak's claim that the racism he once experienced 'would not happen to his children now'.
Can’t remember a tweet I have wanted to agree with more emphatically.
The intention is not to cause upset, but if you are serious about righting the wrongs, you have to be prepared to truly feel the discomfort of the marginalised
When your day starts with a coffee in the sunshine with Partha, you’re set up for whatever follows.
We have the data, we have the plan, we have the team, we have the allies and at the heart of it all we have intent 👊🏾
A lovely catch up with
@AntonEmmanuel2
Setting down all the plans- and awaiting final green lights from stakeholders (
@TheBMA
@gmcuk
@AoMRC
@NHSEmployers
)
Plans to tackle
#MWRES
data inequities
How serious is the system in tackling this issue?
We are due to find out 😊