Feature

All white now?

New disciplinary procedures may end the costly, distressing situation of suspended consultants waiting years to have their cases resolved – but too many people have already suffered medical racism for too long, reports Aneez Esmail

In a letter to the BMA on 23 January 2003, setting out his proposals for a new consultant contract, health secretary Alan Milburn wrote: ‘We will introduce new improved disciplinary procedures from April 2003...This will ensure faster, fairer and more effective procedures that benefit trusts and consultants alike and discard the existing discredited arrangements.’

So now it is official: the existing arrangements are unfair, ineffective and discredited. Take the case of a young British-born Pakistani surgeon. He was delighted when he got the consultant ophthalmic surgery post at a famous teaching hospital. Trained in this country, he seemed to have bucked the trend that saw many colleagues from the same minority ethnic group end up in consultant posts in district hospitals.

Things seemed to go well but personal relationships between him and his head of department weren’t as good as they could have been. He was the only minority ethnic group consultant in the department and, on reflection, admitted he didn’t ‘fit in’. His colleagues didn’t accept him as an equal and there were several incidents that made him feel he was being treated differently compared with his white colleagues.

Then, without warning, he was called in to see the trust’s medical director and told he was being suspended because there were concerns about his clinical competence. Apparently there were problems with his post-operative complication rate and staff had expressed concerns regarding his clinical competence.

He was sent home on ‘special leave’, on full pay, while his case was investigated. He contacted me in my capacity as a trade unionist and I advised him on how to deal with his case. He put in a claim against the trust for racial discrimination on the grounds that he was treated differently from other consultants who may have been in a similar situation.

He then sat at home for almost18 months while the trust apparently investigated, trying to build a case against him. Luckily he had a supportive family – and the resources to employ good lawyers. When his case was heard at an employment tribunal, the chairman halted hearings on the fourth day of a case listed for three weeks. He instructed the trust to reach a settlement because it was apparent the surgeon had been treated differently and was almost certainly the subject of discrimination. The terms of his settlement mean the final cost to the health authority has not been disclosed.

But we can speculate on the likely costs to the NHS. In the case outlined, the consultant’s own legal costs exceeded £130,000 and we can safely assume the trust’s costs were similar. He could not operate for 18 months and will now have to be re-skilled, which will take at least another six months.

And the case against him? We will never know but there was no comparative audit to compare his post-operative complication rate with that of his colleagues. If there were concerns, he feels he was certainly treated differently from his colleagues – some of whose complications resulted in deaths of patients. Due process was non-existent: he was not even told about the concerns against him or who instigated them.

I know of numerous cases like the ones I have described. For example, there is a consultant sitting at home tending her garden while her trust tries to concoct a case against her (in this case because she allegedly swore at a member of staff).

Some of the consultants have successfully challenged their trusts in the courts; most have not been able to prove discrimination. All the people involved have been damaged by the experience. For more than ten years we have had procedures that, at the stroke of a pen, are labelled unfair, ineffective and discredited. So it’s all right now, is it?