'They do not want us to be consultants'; New study shows 75% of

Satyajit Sinha is a staff grade orthopaedic surgeon at Monklands Hospital in Airdrie. Before he moved to the UK from India, he had three years of postgraduate hospital training. After passing a tough exam to allow him to practise in this country, he took up a post as a senior house officer (SHO), with the hope of going on to train as a consultant. But after four years his visa ran out, and he could wait no longer for a position as trainee consultant.

He watched as Scottish colleagues with less experience were promoted while he was obliged to take a staff grade job with no prospect of career progression but the reward of a full work permit. Sinha, 36, said: "I had nine months left of my visa with no training job materialising. You do get panicky that you are running out of time. You take a staff grade job with no career progression.

"If you compare me with training registrars, you will see that I have done as much research, with eight published papers and eight others under review. There have been other doctors in training positions who have not had what I have got.

"They do not want us to become consultants. We are talking about good quality doctors and they are doing limited jobs. There is racism in that overseas doctors are overlooked for training opportunities when they are fully qualified for the posts."

Sinha's situation is not unusual. His colleague, Dr Raj Rai, spokesman for the junior doctors' committee of the Overseas Doctors' Association, cites cases of other overseas doctors who have not got as far as Sinha. He claims they are exploited by the NHS. After their four-year visas run out, they are forced to apply for unpopular staff- grade jobs rather than continuing their training to become consultants.

He said: "That is where the real exploitation occurs. Because we want to stay in this country we take the non-training posts."

Rai regrets that overseas doctors' contribution to the NHS has never been properly acknowledged.

"Overseas doctors have been working in the NHS for 40 years and there has been no recognition for their work. They are providing an invaluable service to the NHS but there has never been a public expression of recognition. I have never heard any appreciation from the Health Secretary."

This week health minister Malcolm Chisholm may not pay tribute to the contribution ethnic minority staff have made to the NHS, but he will make it clear that racial discrimination will not be tolerated. The Scottish Executive will announce a new unit to tackle racial discrimination within the NHS and measures to oblige all managers to attend racial awareness training courses.

The government will also publish the results of a study it commissioned into the treatment of ethnic minorities in the NHS - the Sunday Herald revealed it showed widespread racism towards staff and patients.

The damning report by Dr Rafiq Gardee, public health consultant for Glasgow Primary Care Trust, shows racism exists at every level of the NHS in Scotland - extending from refusal to appoint ethnic minority staff to senior posts to a failure to provide satisfactory health care for ethnic patients.

This weekend a new report by Paisley University reveals that three- quarters of ethnic minority staff have experienced racial discrimination by other staff, while well over half have experienced racism from patients. It comes as the head of the transplant unit at Glasgow's Western Infirmary is taking Glasgow University to an employment tribunal, alleging two counts of racial discrimination because of his failure to be appointed a professor two years running.

Rahul Jindal, who left his home in Indianapolis in the US to take up the post as head of the transplant unit, working at Glasgow's Western Infirmary and the Royal Hospital for Sick Children at Yorkhill, claims he was promised a professorship when he was offered the job.

Earlier this year the head of Scotland's heart transplant unit, Surendra Naik, claimed that racism played an important part in the collapse of the national centre. He said racial discrimination was responsible for at least one doctor being refused a permanent position at the transplant unit, which was forced to close last year when the Indian-born surgeon left Scotland for a job in Nottingham.

The new report, by Paul Coleshill and Dr Rohan Chauhan of Paisley University, highlights a large gap between the policies of NHS trusts and boards and the experience of staff. It concludes: "The experience of the Scottish NHS is not one of equal opportunity for ethnic minority staff."

The report finds that racist and abusive behaviour by patients is tolerated. Ethnic minority nurses are not being recruited or retained because there is no effective career progression for them, so it recommends a review of criteria used for nurse upgrading.

One of the recommendations in the report is that part-time ethnic mentors should be appointed as a trusted source of support for ethnic minority staff. Forty-eight percent of respondents felt they had no support with regard to racism. Racism ranged from the attitudes of other doctors and nurses towards ethnic staff to racial comments and physical abuse.

The report states: "Promotion and progression were a major concern. When at meetings, white doctors were seen to interact only with other white doctors. Ethnic minority doctors reported being ridiculed or made fun of when they spoke in public or semi-public meetings. Both doctors and nurses felt racism is deeply rooted and institutionalised within the NHS."

Half of those questioned said they had not complained about racist incidents. In most of cases staff who complained to the nurse or doctor in charge, or took the matter up with management, were told to ignore it.

One of the reported cases involved a patient saying to a nurse, "Get away from me, you are not one of my kind." This was done in the presence of a consultant and other staff, who ignored the incident. There were also reports of patients shouting at staff to "return to their own country".

In another case documented in the report, a consultant openly told an ethnic minority doctor not to apply for a post, as he would not get it because of his race.

"On the whole, the majority of ethnic minority staff were disillusioned with the present system but felt they were unable to do anything, that racism was part and parcel of the NHS," the report states.

Most respondents were afraid of further discrimination and felt that reporting an issue would hinder their careers. Sixty percent said their experience of promotion rates and procedures had been dismal. Staff felt that in some cases they were not even shortlisted for interviews because their names sounded foreign.

Doctors felt it was difficult for them to get posts in larger city hospitals and so had to resort to seeking posts in outlying district hospitals.

Sinha hopes the action by the Scottish Executive will not be too late for him. With shortages of specialists in Scotland leading to the cancellation of clinics, he hopes the system may be reviewed so that he and many of his overseas colleagues can complete their training to become consultants.

He said: "Overseas doctors are overqualified for the jobs they do. They could be used to take on more senior posts. Many need just one more year's training to become consultants."

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