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Issues Raised By NABA with the Department of Health, May 2005  


NHS WORKFORCE:

a)          There is a long history of Arab professionals working within the NHS and has increased given the greater reliance placed on overseas medical staff working within the NHS.  The National Association of British Arabs (and the British Arab Medical Association) receives requests from such bodies as the General Dental Council regarding the numbers of Arabs and advice on the possible introduction of ethnic profiling on their individual record bases.  We also give advice to other bodies such as the BMA, BBC and other media on those professionals that we know of but it is extremely difficult when numbers are not known.

b)         There are a large number of doctors in training who are first generation British Arabs.  These will be a valuable asset to the NHS because of their unique knowledge about their own culture in addition to being fully integrated in British society.  

d)         There is an absence of any monitoring for employment at senior levels in the NHS especially at consultant level. The lack of data is the result of current ethnic profiling classifying Arabs under others/others. There are others indicators that point to higher numbers of Arab doctors failing to make the grade. On the one hand there is a bias in the selection for training posts, the accreditation and when all these are available, considerably longer delays in getting jobs.  

c)         There continues to be racism within the NHS both from within the profession and from patients.  Much of this has been fuelled by recent Middle East history.  It also stems from a lack of awareness of Arab culture and pre-conceived falsehoods, which stem from negative media stereotyping.  There is evidence of specifically targeted Anti-Arab racism but this is often not brought forward by victims because of fear of further discrimination.  Presently, any incidents are identified solely on the basis of ‘racist’ attacks.  Correct identification is required and this can only be achieved by the inclusion of Arab as an ethnic profile within human resources questionnaires.

 PATIENT CARE SERVICES:

Need to identify patients of Arab origin for following reasons:

a)         Need to assess both numbers and concentrations of the Arab population in the UK for the purpose of assessing specific needs within the NHS such as the number of translators necessary for hospital, GP services and social services.  Currently it is only hospitals within central London where health authorities have taken steps such as translations of health guidance material in Arabic and the provision of translators in hospitals to cater for this population.  However without more accurate data, such services will remain haphazard and does not extend to GP or social services.

b)         There needs to be specific health guidance material aimed at Arabs in UK as is currently undertaken for the other nationalities eg south Asian etc.  Without knowing their numbers and areas of concentration this is going to prove impossible.

c)         Need to assess particular health needs in the Arab population regarding disease that might show a higher prevalence among this population ie diabetes, heart disease etc.

d)         In respect of both health care and social services, there needs to be training of staff to understand the particular cultural, religious and social needs of Arab patients.  There is presently no guidance given to health workers but rather, where thought is given to the subject, there is a presumption that guidance relating to those of the Muslim faith will apply equally to cultures and nationalities.  This is not the case.  There are vast cultural differences between Arabs and, say, Asian Muslims.  Neither is consideration given to those Arabs who are Christian and who often resent being automatically identified within a faith group (usually Muslim) because of the lack of adequate ethnic profiling.

e)         Ability to access funding for particular projects in respect of health needs of Arab communities (ie radiotherapy video being undertaken by Addenbrookes Hospital which British Arab Medical Association has not been successful in finding funding for).

f)          In terms of social services there are almost no provision for families who care for elderly and seriously ill relatives in terms of respite or long-term care.  This puts an enormous burden on families who culturally take on the role of carers but often at great cost both financially and more significantly, psychologically.

            It is also important to highlight that racism can exist as an inter ethnic problem and not necessarily arising from the indigenous population.

Solutions

Ethnic profiling of Arabs in the NHS including training posts, awards, etc.

- A retrospective and prospective audit of training/employment to identify the size of the problem.  
- Fund studies on health problems in the Arab community.  
- Monitor suspensions  
- Monitor racist attacks.  
- Addressing the lack of studies on health problems in Arabs.  
- Addressing the social/medical issues of the elderly population

 
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