Muslim NHS workers have told HuffPost UK how Islamophobia is rife in the organisation, with their own colleagues making disgraceful comments and denying them opportunities to progress or even socialise.
We teamed up with the British Islamic Medical Association (BIMA) for a flagship, in-depth survey of more than 100 Muslim health workers – one of the most significant of its kind.
A shocking 81% revealed they had experienced Islamophobia or racism within the NHS, 69% felt it had got worse during their time at the organisation and more than half – 57% – felt Islamophobia had held them back in their career progression within the NHS.
Many Muslims voiced a culture of “swallow it up” in the NHS, leaving people fearful of reporting Islamophobia in case of repercussions for their job or career progression.
One Muslim female consultant said she felt that “you may as well flush your medical degree down the toilet” rather than reporting Islamophobia from a colleague or manager. She described the NHS as a “family which will close ranks to protect their own against those perceived as outsiders”.
Being “visibly Muslim”, such as wearing a hijab or having a long beard, made it more likely for Muslim NHS workers to face Islamophobia. One woman said she stopped wearing the hijab as it was “like wearing a sign saying ‘kick me’.”
Meanwhile, alcohol – forbidden in Islam – has been described as a “social glue” in the NHS, with many Muslims believing they have missed out on career and bonding opportunities because socialising outside work revolves around drink.
And while there are many incidents of outright bullying and harassment, it is the subtle, more difficult to prove Islamophobia within the NHS that is the “most dangerous discrimination”, say Muslim healthcare workers.
A staggering 43% admitted they had considered leaving the NHS because of Islamophobia.
Our survey conducted in conjunction with BIMA had 133 respondents from all over the country working in various NHS roles including consultants, surgeons, GPs, pharmacists and medical students.
One Muslim NHS worker said: “I think Islamophobia has increased in society at large and this is reflected in the NHS.”
Salman Waqar, general secretary at BIMA, who is also a doctor, told HuffPost UK: “It reflects a wider societal unease about religion and the way spirituality and belief is seen as a problem.
“Some Muslims will not make a fuss because of fear of retribution. But making small compromises causes turbulence and unease internally.
“This creates a sense of not belonging for Muslims in the NHS and biological weathering. They feel they have to put on their uniform, turn up for work and justify their existence to colleagues.”
Hina J Shahid, chair of the Muslim Doctors Association, who is also a GP, said: “We see people celebrating diversity in all its forms in the NHS – but people generally don’t want to talk about religion. It is like a taboo subject.
“Belonging to a religious group is almost seen as going against the scientific nature of being a doctor.”
Hijabs
“In the NHS, you realise there’s something about the hijab that really riles people,” says Kiran Rahim, a paediatric registrar in London. “People make assumptions about you. When people first see me, they presume I don’t speak English, or I have an accent.”
She says judgements are made about women in hijabs and she is asked questions by colleagues like: “Does your husband make you wear that?” and “Do you wear your hijab when you shower?”
“I would expect people I work with to be more clued up. I am as British as they come, but my religion is part of my identity.”
Muslim women told HuffPost UK they were often perceived to be less educated due to wearing headscarves, and received backhanded compliments such as surprise at how well they spoke English – even when they were born and raised in the UK.
Zineb Mehbali, 32, a registrar in obstetrics and gynaecology, believes a culture exists within the NHS where people are discriminated against for being different.
She wears a hijab and experienced overt Islamophobia at one hospital when her locker was vandalised and had the word “hijab” scrawled across it.
“I’m quite resilient, but there have been situations where I’ve cried at work,” she said. “When my locker was vandalised for being Muslim, it made me feel vulnerable but also very hurt as I knew a colleague had done that.”
Many Muslim women told HuffPost Islamophobic attitudes to the hijab are hidden behind infection control. Even when they’ve been given permission to wear hijabs in theatre and wash them at the same temperatures as theatre caps, they are persistently challenged.
Mehbali was once shouted at by a member of operating staff who described her as “a hazard to patient safety”. “She was really aggressive and intimidating and made me feel incredibly humiliated.”
On another occasion, Mehbali was working on a labour ward wearing a clean hijab and scrubs when it emerged a CQC inspection was going to take place. A boss told her they would have to hide her away. “It made me feel like a blot on the landscape and was completely unacceptable.”
Zineb admits her job in the NHS would be a lot easier if she didn’t wear a headscarf. “I feel I’ve had to work a lot harder, especially as I’ve moved up the ranks.
“When you become a registrar or consultant, I feel it’s harder if you wear a headscarf. People have to take notice of you as their colleague.”
Ramsha Hanif, 27, a pharmacist in Derbyshire, doesn’t ordinarily wear a headscarf but was shaken by a former manager’s reaction when he saw a photo of her wearing one.
“He really stared at my driving licence photo then told me I looked scary,” Hanif said.
“I thought he meant I had a stern expression. But after a while, he said: ‘It’s that thing,’ and told me the headscarf made me look scary.
“I was shocked as no one had ever said anything like that before.”
The manager then questioned Hanif about the application she was filling in, asking: “It’s not to join ISIS is it?”
Ramsha reported the issue. The manager began calling in sick, then officially retired, so no action was taken.
Ramsha said: “What hurt most was his whole opinion of me changed from seeing one picture of me wearing a headscarf.”
A female A&E doctor told HuffPost UK she wore a hijab for many years. She said that, while non-practising Muslims who went out drinking were seen as “one of the gang”, those considered “too orthodox or religious” were viewed as a problem.
At one hospital, a Hindu colleague warned her consultants and registrars were saying Islamophobic things behind her back. But he was unwilling to go on record for fear of repercussions. “It was not about being brown – it was Islamophobic,” she said.
“I’ve gone as far as saying I’m agnostic and am from the Indian subcontinent. If I reveal my identity as Muslim or Pakistani, I know I’ll be treated differently.”
The A&E doctor revealed she has become less open about her faith throughout her career and no longer wears a hijab or tells people she is Muslim. “I’ve gone as far as saying I’m agnostic and am from the Indian subcontinent,” she admitted. “If I reveal my identity as Muslim or Pakistani, I know I’ll be treated differently.
“There are Islamophobes within the NHS who are intelligent enough to hide their hatred of Muslims under other guises such as picking on a doctor’s professionalism.
“As a Muslim, you have to work twice as hard and never make any mistakes as you know they’ll be magnified.”
People now openly make Islamophobic remarks in front of her, not realising she is a Muslim. “It’s really opened my eyes to the horrifying Islamophobia that exists in the NHS,” she said.
But she added: “Wearing a hijab in the NHS was like wearing a sign saying ‘kick me’. I just don’t have room in my life for that kind of stress.”
Sabeeta Farooqi, 36, a trainee GP in Leeds, who is from Pakistan, recalls a sign on a board while she was taking a medical exam allowing her to practice in this country that read: “If you wear a face covering, it’s very unlikely any NHS employer will give you a job.”
Khadija, 21, a medical student in Bristol, was told by her mentor, a Muslim GP, that if she wanted to get far in medicine, she really needed to remove her hijab.
“I was shocked,” said Khadija. “She was trying to warn me of the difficulties that lay ahead. But I didn’t want to feel forced to choose between my religious and cultural identity and my career aspirations.
“I’m not going to stop wearing the hijab because other people have a problem with it. That’s their issue, not mine.”
Even at this early stage of her medical career, Khadija has witnessed the impact Islamophobia has. “Unfortunately, I know a couple of medical students who have been badly affected by Islamophobia,” she said. “One has left the course and completely foregone a career in medicine. The other has removed the hijab, stopped practising her religion and lost contact with her family.”
“I’m not going to stop wearing the hijab because other people have a problem with it. That’s their issue, not mine.”
- Khadija, a medical student in Bristol
Shahid has been researching the effects of Islamophobia on Muslim doctors and says women are at greater risk of discrimination.
“If Muslim women wear a headscarf, they stand out as being different and are more likely to feel discriminated,” she said.
“Many have reported feeling stressed, anxious and depressed. This affects their future choices. If they have a negative experience in a hospital setting, they’re more likely to choose a non-hospital setting or even leave the NHS.”
‘Just banter’ – terrorists, bombs and bacon
Sometimes Islamophobia in the NHS is subtle and discreet and hidden under the guise of “banter”, many Muslims told HuffPost UK.
When Mahdiyah Bandali, now a graduate paramedic in Birmingham, first began working for the ambulance service, she noticed the lack of diversity and realised she was the only hijab-wearing woman. “The first time I walked into an ambulance station, there was an attitude of: ‘What are you doing here?’ – I stuck out like a sore thumb.”
Colleagues would ask: “Why do you wear that?”, “Do men control your life?” or even: “Will you get married off after you graduate and not work?”
During Ramadan at one ambulance placement, Mahdiyah recalls colleagues eating bacon sandwiches in front of her while taunting her: “Are we breaking your fast?” or urging: “Go on, eat a piece of bacon.”
Madiyah would be greeted jokingly when entering an ambulance station with: “Here she comes! What kind of bomb have you got for us today?”
She said: “While I laugh it off, I can see how other people might find it offensive or how it could lead to them leaving the NHS. At the end of the day, it’s a type of bullying.”
One hospital doctor told how he was carrying a lot of bleepers when a colleague said: “You look like a suicide bomber.”
Many Muslims say a lot of Islamophobia goes under the radar. “It wouldn’t be admissible in a tribunal as it’s subtle undermining which happens on a daily basis,” said one doctor.
“There is plenty of racism affecting people from all BAME backgrounds, but there is a specific anti-Muslim agenda among some NHS colleagues.”
“One hospital doctor told how he was carrying a lot of bleepers when a colleague said: “You look like a suicide bomber.””
Many Muslims in the NHS keep quiet when it comes to reporting Islamophobia, for fear of repercussions or impacting career progression. Paediatric registrar Kiran Rahim said: “Medicine is very hierarchical and the people you complain to may also be the ones responsible for your progress. So, many Muslims keep the peace and don’t feel empowered to pursue discrimination further.”
One worker said in the survey: “The NHS pays lip service to diversity and racism but in reality has no interest in addressing these problems genuinely and just wants to appear to be doing the right thing.”
Prayers
“Praying for a practising Muslim is like food and water,” says Emma Wiley, a microbiology consultant in London. “It is a necessity, something they need to do.”
But many Muslims face barriers to praying at work in the NHS. Emma, 38, was told she couldn’t pray in an empty office and had to use the main prayer room.
“When you’re a busy medic, time is very poor. Walking to another place takes time,” she said. “Not allowing me to use this empty room for five minutes to pray seemed unnecessarily obstructive.”
On another occasion, Emma was praying in a cloakroom when a laboratory scientist “with his face full of rage” told her to find an alternative place to pray.
One Muslim NHS worker revealed he wasn’t allowed to go to the prayer room at his hospital as it would “take too much time to walk there”. He also wasn’t allowed time off during Ramadan or allowed to operate while fasting.
Another doctor described how he was constantly bleeped during prayer time and asked: “Doesn’t your God know you have jobs to do?”
Medical student Usman, 25, who lives in Scotland, told HuffPost UK he was given permission to be regularly late to class to attend Friday prayers – yet would be hauled up and asked why he was late almost every week.
“I feel a lot of it stems from a lack of understanding,” he said. “Many people in the NHS – particularly consultants who supervise students – believe medicine comes first and everything else second.
“They cannot understand why anyone would put their religion before their medical classes.”
Alcohol and career progression
Climbing the ladder in the NHS often occurs through social cohesion, which involves drinking in pubs, several respondents said. One explained: “Alcohol is a social lubricant and many Muslims are left out of career progression as we avoid places associated with the sale and consumption of alcohol.”
A female Muslim doctor said she was bullied mercilessly by two other doctors after she declined to sit at a table where alcohol was served. “They began picking on me. Their biggest issue was the fact I didn’t drink.
“It was horrendous. They refused to teach me, and spread rumours about me. One told me I wasn’t cut out to be a doctor and to give up.
“They were very devious and made me feel it was all in my head. It was like gaslighting.”
A Muslim doctor in emergency medicine heard a fellow trainee frequently bragging about opportunities he’d gained while drinking in the pub with a consultant.
Waqar from BIMA said: “Alcohol is a huge part of British culture, but for the majority of Muslims it’s not permissible. When it comes to career progression, that can be difficult.
“A lot of career progression and mentoring in the NHS takes place outside the work environment. Awards events often happen in places where alcohol is served.
“If you’re a person who feels uncomfortable being at a table with alcohol, you’ll feel conflicted. Some might not go, so miss out.”
It’s not just alcohol that leads to Muslims in the NHS missing out on progression. Mehbali says, when she was training, she wasn’t given the same opportunities as white colleagues.
“There were times at training opportunities when white people more junior than me were allowed to operate and I wasn’t.
“Even though I was competent and knew how to do the procedure, I wasn’t allowed to do the things my peers were doing.
“I spent eight months with a particular consultant before I was allowed to operate, while others were allowed to straight away. I feel it was because I am visibly Muslim with a hijab.
“It’s very disheartening to feel sidelined. When you’re learning practical skills, you need training opportunities or you’ll fall behind.”
One male Muslim doctor said: “The career progression of Muslims in the NHS is far more stunted than their white counterparts. The hurdles are more difficult and challenging.”
Why is there Islamophobia in the NHS?
The stark lack of Muslims in leadership roles within the NHS has been cited as one of the reasons behind Islamophobia affecting the organisation.
“Even if you get some who are Muslim or BAME, they’ve often had to neglect the cultural and religious aspects of their identity to get to their position,” says medical student Khadija, who also believes negative portrayals of Muslims in society and media exacerbate Islamophobia.
“Until the management within the NHS is reflective of its workforces, it’s going to be incredibly difficult to root out and address Islamophobia,” said one Muslim hospital registrar.
“I would argue the reason there’s so much Islamophobia in the NHS is because Muslims are repressed from leadership roles and find it more difficult to climb the ladder.
“So it becomes a vicious circle – they can’t support juniors facing the same issues.”
But he added: “There are some very supportive and open minded line managers. It’s not a problem with everyone.”
YingFei Heliot, a lecturer in organisational behaviour at Surrey Business School, published a report on religious identity and working in the NHS. She found Muslims faced the worst discrimination of any group.
“Everyone recognises Islamophobia exists, but they don’t want to talk about it because it’s so sensitive,” she said.
Tarek Younis, researcher and psychologist at Middlesex University, researches Islamophobia. His latest publication is on the issue within the NHS.
“When people think about Islamophobia, they focus on hate crimes,” he said. “But by doing this, they miss the wood for the trees.
“We neglect how certain policies and political rhetoric formulates the bedrock of how racial discrimination takes place.”
He says it’s important to realise NHS professionals are just people – and as such can hold prejudices. “The Brexit campaign succeeded on a lot of radicalised logic. A lot of middle-class and healthcare workers voted for it.
“We know the healthcare setting is not a place where people just drop all their prejudices when they enter, be that patients or healthcare staff.
“What is important is to recognise what’s not being done about it.”
“We know the healthcare setting is not a place where people just drop all their prejudices when they enter, be that patients or healthcare staff.”
- Tarek Younis, researcher and psychologist at Middlesex University
More crucial, says Waqar, is ensuring the board understands the importance of an organisation where people can “bring their whole selves to work”.
“This is a systemic issue and there’s no simple fix.” he said. “The solution isn’t just putting staff members on a course. It will take years to see a cultural shift.
“Sometimes, Islamophobia stems from ignorance and doesn’t come from a bad place. But there are more serious incidents which come from a pernicious place as people within the NHS are believing the anti-Muslim narrative.”
Habib Naqvi, interim director for the NHS Workforce Race Equality Standard at NHS England, said: “While this survey represents only a snapshot of the 40,000 Muslim colleagues who work in the NHS, it is unacceptable for anyone to be unsafe or to be treated unfairly, either because of their religious belief or any other protected characteristic.
“The NHS belongs to us all, and as part of the NHS People Plan, NHS employers are committed to increasing Black, Asian and minority ethnic representation across their leadership teams.”