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From Socialist Worker, No. 113, 15 March 1969, p. 3.
Transcribed & marked up by Einde O’Callaghan for ETOL.
A LETTER from a consultant surgeon, Mr Nigel Harris, alleging that some overseas doctors working in Britain were unfit to practise, highlighted in a particularly unpleasant way the problems of immigrant doctors in the National Health Service.
The letter which started the row was sent to a patient who complained about the treatment he had received from a foreign doctor at St Charles’ Hospital in London, where Mr Harris also works.
It seems from the subsequent statement by the hospital management committee that Mr Harris published his comments without bothering to check his facts with the doctor concerned or examining the available medical records.
Not deterred by minor concerns about accuracy, sections of the press used the incident as their cue to indulge in a series of slurs against immigrant doctors by generalising from a few specific cases.
It was suggested that both the ability to practise medicine and to communicate in English were lacking in immigrant doctors.
It is well known that the NHS relies heavily on immigrant doctors to staff its hospitals. The latest figures show that of 13,532 junior hospital doctors, 6,015 came from overseas.
It is estimated that a further 500 to 600 Commonwealth doctors come to work in Britain every year. The majority are used to fill the kind of vacancies scorned by their British counterparts. Many finish up in geriatrics, casualty departments and the most junior posts in specialities like orthopaedics and opthalmology.
This process is yet another example of the drain of desperately needed resources – in this case trained manpower – from the third world. Doctors are drawn from the areas of greatest need to fill the gaps in the medical service of an advanced capitalist country.
Indian and Pakistanis form the largest single group of immigrant doctors. More than 4,000 work in Britain at the moment.
Most of them come for three or four years and then return home when they have taken their higher exams. Some stay on and settle, but for most of them promotion to higher posts is effectively blocked.
Why do they come? It is partly a legacy of colonialism. Most of the senior consultants in India and Pakistan who have done their post-graduate training in Britain, favour those with similar degrees as themselves when it comes to promotion.
In spite of the efforts of the medical schools and governments of India and Pakistan to popularise the specialist post-graduate degrees issued there, the mystique of qualifications from the old colonising power remains.
There is also a very real feeling among those who come here that they will gain the opportunity of working in a more technically advanced medical environment. This is true for a fortunate few.
But for many, their illusions will be left to wilt in bleak geriatric wards, buried in slum hospitals.
What truth is there in the suggestion that a significant proportion of immigrant doctors lack a command of both English and medical skills?
Medical training for the biggest group, Indian and Pakistani, is conducted in English, though initially they often lack a grasp of English idiom and dialect.
Given goodwill on the part of the patients, this would be a minor problem. But all too often patients confronted with a foreign doctor deliberately make themselves difficult to understand, to the embarrassment of one and the detriment of the other.
General Medical Council, the body responsible for licensing doctors, recognises the degrees issued by Commonwealth universities and has the right to check on the competence of these institutions.
There probably are a few incompetents among the thousands of immigrant doctors in Britain – just as there will be incompetent British doctors. To stigmatise all immigrant doctors by the alleged incompetence of a few is the very essence of racialism.
There is a smaller group of immigrant doctors from countries such as Egypt, Greece and Spain where a very real language difficulty may arise. The medical degrees from these countries are not recognised for practice in Britain but doctors may be issued with temporary registration, which is renewable annually.
Some of these doctors do have difficulty with English. But an Indian doctor has explained in a letter to The Guardian that in his experience preference is given to white doctors over coloured, whatever their respective medical and linguistic merits.
One solution to the problem would be the provision of courses in common English usage and British medical practice for those entering the country.
At present the only scheme that exists consists of allowing newly-arrived doctors to work without pay in a junior post for a month. They do much the same work as they would with pay and not surprisingly this generous offer is rarely taken up.
The immigrant doctors form a cheap labour system used to make up the medical needs of the country.
Successive governments have failed to provide the facilities to train enough doctors.
The most blatant example of this was the actual reduction in the number of medical students in 1958 following the Willink Committee’s suggestion that we were ‘overproducing’ doctors.
The medical establishment have also contributed to the shortage on occasions by resisting increases in medical school places on the grounds that standards would be lowered. They ignore the fact that there are dozens of qualified applicants for every available place.
If dockers or car workers had made such a suggestion there would have been uproar in the press about ‘restrictive practises’. But when respectable, highly-paid members of an upper class profession speak, the press toes the line.
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