I often ask my patients where they are from or the origin of their name. The reasons include genuine curiosity, educating myself and breaking the ice with another human being. On the wards last week, I saw the facial expressions of two individuals, both UK residents for several years, change for the worse when I asked. A sadness kicked in that I haven't yet been able to shake, when I realised they thought I was deciding whether they should be charged for healthcare. Being an NHS doctor, despite many problems, is a privilege. As a cardiologist, I am able to provide care based on need, with humanity and without prejudice, regardless of an individual's demographics. When I studied for a Masters in Public Health in the United States thirteen years ago, and when I teach on similar courses today, the NHS remains a global paragon of equity and universal healthcare coverage. The reputation and the trust of patients in the NHS are totally undermined if clinicians become a vehicle for immigration data.
Three out of the eleven patients attending my clinic mentioned their disgust at delays in the system, resource shortages and NHS pressures, which they mostly attributed to immigrants. Since starting medical school 21 years ago, I am yet to hear anybody working in a hospital, whether doctor, nurse or manager say that the NHS is under pressure due to too many immigrants. The extra £350 million per week which would become available to the NHS if the UK left the European Union seems to have disappeared from the political landscape. An analysis of the UK's Office of National Statistics data confirmed 30 000 excess deaths in 2015, compared with 2014, citing a strong possibility that wholesale cuts to health and social care budgets had played a role. At best, inaccurate data, and at worst, lies, have led to wrong perceptions and wrongful blaming of immigrants for the under-resourcing of our health service. The actual cost of health tourism is far less than the hype, and efforts would be better focused on the real causes of healthcare deficits, such as austerity.
A few months ago in the aftermath of the Brexit vote, a Caucasian lady in her sixties asked if she could be seen by a British doctor in my cardiology clinic in central London. Only partly placated by my birth in East Yorkshire and my medical education at Oxford, she attributed the two-month delay in her heart surgery to too many immigrant NHS staff. Overseas doctors came to the UK because "life was easy" and "they were never as good at English or doctoring" in her view. The irony was not lost on the son of a GP who arrived from India in the early 1970s when the NHS was struggling to recruit doctors. My father worked across northern England for 35 years where local trainees could not be retained. Immigrants usually come to the UK for opportunity, but health professionals from abroad have been, and continue to be, actively pursued to fill gaps since the inception of the NHS. To blame them for the gaps is laughable. Moreover, these doctors have to meet stringent General Medical Council standards in order to practise in the UK. I have lost count of the foreign doctors and nurses (EU and non-EU) I have worked with over the years, who have had to live in poverty while waiting for exams or jobs in this country. Sometimes they have been forced to eat at soup kitchens or work in kebab vans to make ends meet. Hardly an easy life.
On "One Day Without Us", 20 February, the contribution of migrants to the UK was honoured around the country. In the current culture of "othering" which is plaguing this government's explanations of NHS crises, it is not only immigrant patients, but also immigrant doctors, who are unjustly and unjustifiably evoked as causes. The history of immigration to the UK, including health professionals, should be common knowledge in order to avoid the rewriting of facts, and to avoid manipulation for political expediency. Denial of the debt that the NHS owes to its many overseas staff is not just unfair. It will directly and indirectly damage its reputation as an employer and as a world-class healthcare provider.