The summer of July 2021, is a tumultuous one for the big, little island of Great Britain. Along with the heady excitement of the delayed Euro2020 where the English team was just one step away from winning finals beyond its wildest dreams. There was also the wildcard return of Andy Murray and what is described as ‘Freedom Day’ when there is a promise for lockdown restrictions to be lifted forever.
In the backdrop some of us in the health service hold back our enthusiasm as we watch the steady rise of the community prevalence of COVID-19. The delta variant (first isolated in India) is now raging through some of the northern towns and younger people. Schools bravely keep open in their extended bubbles and their faith in the strength of ‘COVID-safe’ measures. There are those in the public health sector who are championing the role of airborne transmission of the virus and the ineffective role of ‘surgical masks’. Majority of the healthcare buildings have ageing infrastructure built around conserving heat by packing humans close together in under-ventilated spaces. Schools and offices are no different. How are we then to prevent transmission in essential work spaces? There is also rising concern about the mental health consequences of lockdown on families, friends and communities. Everyone is particularly worried about the younger people who are bored and frustrated that their music festivals and raves are cancelled. In the midst of this football fever and tennis mania, we have the distant beginnings of the delayed Tokyo Olympics.
At any other time, summer of 2020 (now delayed to 2021) would be a fantastic festival of all that is great and good about modern human civilization. A real ray of hope but there are clouds on the horizon. There have been some events in the healthcare sector in the UK that are a cause of serious concern. Even before the country could recover from the damming ‘Cummins files’ we have the closeness of the ‘Hancock embrace’ which led to the untimely stepping down of the UK Health and Social Care. Before the country could prepare for vital decisions on whether total lifting of restrictions in the face of the delta deluge was wise, the health service lost its CEO. Rt Hon Sajid Javid, previously a contender for premier, then a short stint as Treasury secretary before stepping down on high principles gets the nod for taking on the helm of the Department of Health and Social Security. Many claim that he has little knowledge or insight of the challenges that are facing the health service.
Little before this unplanned and unceremonious change of guard, the country heard of the stepping down of Simon Stevens after a brilliant time steering the NHS through its most challenging year. The country is on the lookout for a new CEO for the NHS, the jewel in the crown of the UK and the envy of many. One of the most public hats in the ring is of Dame Dido Harding. Dame Harding approaches the aspiration of becoming the CEO of this £130 billion department at a time of its most need. She brings with her the expertise of running large corporations (not too well, we are told), the publicly discussed challenges of the much maligned ‘NHS Test & Trace’ system where £43 billion of public funding was utilised.
What is really challenging for this potential appointment is the recent public revelations of Dido’s plans for saving the NHS by ‘reducing the reliance on foreigners’. This one quoted and perhaps misrepresented phrase caused more excitement in the medical twitter firmament then the much more damning ‘Cummins files’ or ‘Hancock embrace’. One wonders why?
BAPIO, BINA, BIDA and many of its 52 co-voluntary professional organisations that represent the voice of the 37% of doctors and 22% of NHS staff who were either born on trained overseas or are descendants of immigrants who have answered the call of the UK government and NHS to come and serve. These ‘foreigners’ have been supporting the NHS by working in challenging roles, in less popular locations and enduring a high degree of personal sacrifice as well as differential treatment. The vast majority have no access to either supporting their own families in need or bringing them to the UK for access to the high quality of healthcare that they so happily provide. The UK Home office’s hostile environment policy and complete ignorance of many calls for allowing visa’s for adult relatives of NHS employees has not won many friends for this and previous governments. Many have laid down their lives in the service of the nation during its most challenging time during COVID-19 pandemic.
Hence the perfectly sensible suggestion that a rich, developed country proud of its NHS should rely less on foreign and grow more of its own, should really not cause such hurt and distress that many have felt and vehemently protested against. Baroness Harding is a friend and very recently has done much to embrace the need for diversity in the NHS and many governmental organisations. She is personally committed to equality, justice and inclusion for all. These are noble ideals and aspirations. There is no doubt that her public persona is one of respect for the 22% of NHS staff who may perceive themselves as being the butt of the ‘foreigner’ description nor the multiple generations of descendants of immigrants who have built this country for what it is from Victorian times. Britain would not have been as great as it has been in its Imperial past without the blood, sweat and toil of its commonwealth nations. It is true that much of the blood, sweat and toil was obtained without consent by a master and imperial overlord but it does not take away from the fact that what Britain is today- is as a result of its serving minions. In other words, the foreigners.
At this point in time, we are not sure of who may be appointed to the CEO role of the NHS. We are not sure who will lead the NHS out of its mountain of waiting lists and the deluge of delayed and missed diseases and prepare to cope with the ‘nth’ surge of COVID-19 or its successors. But what is true is that whatever the plan in the next 10-20 years, Britain will need to call on its ‘foreigners’ to help serve its citizens. The foreigners are not endeared to the current (and many previous administrations). Britain is a parliamentary democracy and no one in the opposition has come out in support of the contribution of the ‘foreigners’ working in the NHS and in many other industries. This is a vital mistake. Now is the time to befriend, not alienate. Post -Brexit Britain is weakened and whatever was left has been harrowed by the pandemic. Britain needs every ounce of energy, commitment and engagement from its native as well as ‘foreign’ intelligentsia and workforce. It is time to give some real concessions to these foreigners. An astute Home Secretary may wish to consider a review of its adult visa regulations and tackle the tough environment that breeds anti-immigrant mentality and differential attainment for ‘foreigners’. It is time to offer a hand of friendship, respect and perhaps even an apology.
Dr Indranil Chakravorty