NHS at 70: Valuing the rich history of black and minority ethnic staff
On the 70th anniversary of the arrival of the Windrush we explore the history of black and minority ethnic staff (BAME) working in the NHS through their voices.
Since 1948 the NHS has recruited 1000s of staff from all over the world to sustain and develop its services. In 2018 a quarter of nurses and midwives and around half of hospital doctors have BAME heritage. Only recently has attention focused on the significant contribution these individuals have made to the NHS.
British hospitals experienced staffing crises long before the establishment of the NHS and often recruited nurses from Ireland. During the Second World War, a large number of women were attracted to hospital domestic and nursing work as it was seen as vital to the war effort. The national post-war labour shortage particularly affected public services. Government-led programmes recruited workers from Britain’s colonies and former colonies in the West Indies to work in the NHS and other public services like transport. The first ship from the Caribbean, The Empire Windrush, arrived in Tilbury Docks on 22 June 1948. It marked the beginning of the multicultural and multi-ethnic society we live in today, here in the UK where more than 170 faiths are practised and more than 300 languages spoken. But the history of BAME staff is complex and not well understood.
Entry to the UK became increasingly difficult over the period, particularly from the 1970s onwards. Whilst staff shortages in the NHS prompted successive recruitment drives from overseas, controls around immigration and medical registration were tightened. Workforce planning was hampered by a lack of data about migration, immigration, recruitment and retention of NHS staff. Racial discrimination has been a common experience, although since the 1990s, equal opportunities legislation and new recruitment regulations have helped to reduce this. Despite these significant challenges, BAME staff have worked with ambition and passion across all parts of the NHS, often in the most challenging locations such as deprived inner-city areas, and have shaped the way many specialties and services are delivered. The joint 70th anniversary of the arrival of the Windrush and the birth of the NHS has created a platform for celebrating the core place of these individuals in wider NHS history.
The voices of our interviewees shared here tell inspiring stories across the generations. Experiences of moving from their birthplace to work in the NHS; responding to the needs of new migrant communities by developing new services for patients; experiencing improved opportunities for women in medicine and nursing; facing the challenges of racism and discrimination; benefitting from innovations in practice like nurse-prescribing; comparing the NHS to other health systems; acknowledging difficulties caused by staff shortages; noting increased incidence of diseases like diabetes; and sharing the joy of caring for patients. Each story is different. Together they show the vibrant diversity of people who have created the NHS of 2018.
Professor Dame Elizabeth Anionwu (cousin of Elaine Unegbu) is Emeritus Professor of Nursing at the University of West London and a Patron of the Sickle Cell Society. Born in the UK with Irish/Nigerian heritage, Elizabeth spent her early years in a Catholic children’s home and was inspired to be a nurse because of the exemplary care she received from one of the nuns who treated her severe eczema. After nurse training she became a health visitor and worked as a Community Nurse Tutor in Brent Health District, London. During this time she became aware of sickle cell disease—an inherited anaemia that has a high incidence in the African and Caribbean populations—and this led to the first Sickle Cell and Thalassaemia Information, Screening and Counselling Centre being set up in Brent in 1979. She reflects on her determination to fight racism and injustice for BAME patients and the symbolic significance of the Mary Seacole statue that was installed at St Thomas’ Hospital, London in 2016 for the 1000s of people with BAME heritage who work in the NHS.
Ngozi (daughter of Elaine Unegbu and cousin of Elizabeth Anionwu) was born in Withington Hospital, Manchester and moved to Nigeria with her parents in the 1970s. She qualified in medicine in Nigeria and returned to Manchester and London for postgraduate training in paediatrics. In 2002 she became a consultant neonatologist at St Mary’s Hospital, Manchester. She reflects on the improvements she has seen in survival of premature babies over her career, attributing these to factors like standardising care practices. She shares her experience of juggling her career and family and speaks of the improved opportunities for women from earlier generations.
Immigration and the National Health Service: putting history to the forefront
Stephanie Snow , Emma Jones | 08 March 2011
Emma L Jones and Stephanie J Snow, Against the Odds: Black and Minority Ethnic Clinicians and Manchester, 1948 to 2009.