I’m meeting George for the first time. Everyone tells me how great he is. ‘Good old George. He really is the salt of the earth. A retired docker. Always has a smile on his face. Brings us a tin of chocolates every Christmas. Everyone loves George.’ After ten minutes with George I can’t help but agree that he’s a nice old boy. He’s in his late seventies and, apart from a bad hip, he is basically fit and well. Cheery and friendly, we have a bit of a chat about the misfortunes of the local football team and he reminisces briefly about the good old days. After a bit of a look at his hip, I suggest that he might want to consider seeing the orthopaedic doctor as he could benefit from a hip replacement. ‘Well, if you think it might help, Doc… One thing, though, I won’t see no Paki doctor, will I?’
I hate it when this happens. You meet someone you think is nice enough and they turn out to be a raging bigot. It’s so much easier to hate racists when they fulfil my expectation of being all-round arseholes. What do I do now? Do I confront a man in his late seventies about his life-long racist beliefs and try to re-educate him? Perhaps I could accidentally forget to make the referral? Some might argue that as patients are now encouraged to have ‘choice’ over which consultant they see, I should follow his request and find him the white British surgeon he wants. Remember it’s not my job to judge, simply to treat and serve my patients to the best of my abilities.
‘Some of my best friends are Asian doctors and they are also very good at their jobs,’ I say firmly. ‘If you want the referral to be made, then you’ll get which ever doctor is allocated to you. We don’t make allowances for racism.’ George looks a bit taken aback.
‘I’m not a racist or nothing. It’s just I saw that Dr Singh bloke with my bad knee and I didn’t understand a word he was saying.’
My friend Chirag is a GP and was born in Wembley to Indian parents. He has a London accent, is good-looking, dresses slickly and is a bit of a charmer. He is well liked by even some of his most hardened racist patients. My friend Anil, however, was born and brought up in India. He moved to the UK seven years ago after qualifying from medical school back home in Bangalore. Anil has a moustache, a side parting, unfashionable clothes and a thick Indian accent. He struggles to understand anyone with a strong regional accent and couldn’t give a monkey’s about beer, football or regional rivalry. He is a very good and dedicated doctor but the patients tend not to warm to him and he has suffered from quite a lot of active discrimination from both patients and staff.
The Georges of this world appear to have made some changes with regard to their racism. In my experience they are now more tolerant of the colour of someone’s skin as long as the person speaks with a good British accent and can join in with a joke about Geordies or Scousers or the England football team. The other development is that patients tend to recognise that it is no longer acceptable to publicly verbalise their bigoted ideas, although they will still make a few sly racist comments if they think they can get away with them. I’ll leave it to you to decide if these changes are any form of improvement or not.
It seems such a shame that racism has remained a deeply ingrained tradition of white working-class culture in certain parts of this country. Over the last 50 years or so overall prejudice has reduced and I think that the NHS has done more than any other institution to help transform racist ideas. There are a great number of different nationalities working within the NHS and has been for so many years that lots of people have had their only exposure to non-white people while going to hospital or seeing their GP. There is a story about an Indian GP who moved to a small Scottish Highlands town back in the 1960s. Initially, he and his family were met with some suspicion, but after a short period he became a much-loved member of the community and the attitudes of the local people were changed for ever.
Some people, unfortunately, are beyond help. I saw a fat middle-aged white man from the local estate who was requesting a prescription for some Viagra. He hadn’t worked for years, citing his bad back, but his real disability was his enormous gut and the deep resistance he had to getting up off his sofa. I was happy to prescribe him some Viagra but explained that it wasn’t available for free on the NHS and that he would be charged for his prescription. ‘I bet the Pakis and immigrants don’t have to pay, Doctor? You’d give me the pills for free if I was one of those asylum-seeking suicide bombers,’ he retorted. I desperately wanted to point out that, first, it was unlikely that al-Qaeda make explosive suicide belts that would fit his enormous 64-inch waist and, second, that were anyone to demand a prescription while strapped with many kilograms of high explosives then, yes, I would undoubtedly write them the prescription of their choice completely free of charge. My reasoning for this would be my natural instinct to avoid getting myself blown up rather than because of a government policy that favoured non-whites as he appeared to be suggesting. I kept my mouth shut but did take great pleasure in writing out the private prescription, knowing that this racist heap of lard would have to pay for his erections while mine still came completely free of charge.