COVID19 and the BME community: Interview with Dr Ameen Kamlana

By Just Treatment Organiser Maryam Asaria.

The creation of the NHS is arguably one of our greatest achievements - providing free and accessible healthcare to everyone. It is definitely one of the best and most treasured healthcare systems around the world, and rightly so. If COVID19 has shown us anything, it’s just how valuable our NHS really is. During this pandemic, we are all worried about our loved ones affected by COVID19, but it seems that the families of black and minority ethnic men and women have more to worry about than others. 

The recent ONS report looking into coronavirus deaths by ethnic groups found that after taking into account age, black males and females are respectively 4.2 and 4.3 times more likely to die from a COVID19-related death than white ethnicity males and females. It found that Bangladeshi and Pakistani, Indian and mixed ethnicities had a statistically significant raised risk of death from COVID19 compared with their white counterparts.  

Health equality is at the core of what we do at Just Treatment so we’ve been keen to learn more about this alarming feature of the pandemic. COVID19 has highlighted a range of issues - including structural racism - that are leading to the Black and Minority Ethnic (BME) community having worse health outcomes than the rest of the population.

Recently, the government announced plans to increase the NHS surcharge for migrants while also locking out many key migrant workers from the leave-to-remain scheme. This, once again, will have a drastic effect on many BME families in the country. 

To find out more about the impact of COVID19 on the BME community, and how we can learn from it, I spoke to an expert - Dr Ameen Kamlana -  a GP who has dedicated his life to the NHS. Here’s our conversation:  

Data shows that COVID19 is disproportionately impacting the BME community in England, and has resulted in more deaths than would have been expected in the BME community. Why do you think this is the case?

These figures should come as no surprise. Health injustice in the UK isn’t new; BME communities have always faced daily racial and class bias and discrimination. This makes people mentally and physically ill, and cuts their lives short.

The life expectancy of a man living near to Grenfell Tower is 22 years shorter than that of a man living near to Harrods (both within the same Royal Borough of Kensington & Chelsea).

It’s tragic that it’s taken a national epidemic for health injustice to receive media attention and enter public consciousness. As Sir Professor Michael Marmot says, “The slow burn of injustice, and avoidable health inequalities, is less dramatic…but no less profound, and more enduring.”

People aren’t inherently ‘vulnerable’. They’re rendered vulnerable because they are targeted. Nobody wants poorly paid, unsafe work environments with insufficient PPE, or insecure, overcrowded housing that makes it impossible to self-isolate.

Yet around half of all health & social care workers in London (a COVID19 hotspot) are BME, and around one third of Bangladeshi households in the UK are overcrowded (compared with 2% of white British households). 

Although we’re all weathering the same storm, we’re clearly not all in the same boat.

Many NHS staff members that I have spoken to have suggested the increased number of deaths in the BME community is to do with systemic problems within the NHS. What are your opinions on this? 

The NHS is a reflection of wider society. As such, racial bias and discrimination do exist within it. 

Just 8 out of 277 NHS chief executives are BME (that’s less than 3%). But racial bias and discrimination is not just about a lack of representation in positions of senior leadership.

BME patients are deterred from accessing healthcare due to hostile government policies, such as charging for services, Home Office data sharing, and the Prevent surveillance programme. And those that do manage to jump the hurdles receive poorer quality care; black British women are five times more likely to die in childbirth than white British women.

BME staff aren’t safe either. Carol Cooper, head of equality, diversity and human rights at Birmingham Community Healthcare NHS Trust says, “BME staff feel that they are being put on COVID wards over and above their [white] colleagues…and they are terrified.”

What is the government currently doing to address the issue and what are your opinions on this response?  

I’m really worried about the Prime Minister’s recent announcement to ease the lockdown. It leaves people on low incomes - including BME communities - with little choice but to return to work, putting them at greater risk of exposure to COVID19. 

Despite the fact that, before COVID19, life expectancy had stalled for the first time in over 100 years (and even fallen for the most disadvantaged women in society), we’ve not seen this government respond in any meaningful way to this crisis in health.

There is no political will among ministers to address structural racial discrimination and bias. 

What do you think needs to be done in the short term to decrease the impact of COVID19 on BME communities, and what long term strategies are required to increase health equality for the BME community within the NHS? 

There are several strategies that could help to create a fairer, healthier society. Poverty drives ill health so sorting wider issues like paying a genuine living wage, and the rocketing price of rent would be really important steps. Policies that stop people accessing healthcare must be ended, like NHS charges, Home Office Data sharing, and the Prevent surveillance programme.

In the longer term, we need anti-racism training in our schools, universities, and across the NHS. We need to build more social housing, and set targets to improve ethnic minority and working class representation in workplaces. 

Finally, we must devolve power, decision-making, and resources for public services - including the NHS and Public Health - to representative local community organisations and networks.  An effective response to COVID19 required this.

Things don’t have to stay as they are. The future is what we collectively demand, and we must demand fairness and justice. Sure, we need more data. But we also need radical action, and we need it now.

The good news is that we can collectively work to fix this injustice. Right now, Just Treatment is crowdsourcing demands for a New Deal for the NHS. We want to have conversations with people all around the UK to understand what’s important to them about the NHS - and then fight to win a New Deal for us all. 

There is no easy solution, but collectively we can win. Will you join us? Sign up to volunteer now.