Manifestations and negotiations of racism and 'heterophobia' in overseas-born South Asian GPs' accounts of careers in the UK

Abstract

This paper draws on interviews conducted for a wider oral history research project that focused on the experiences of South Asian doctors who worked as general practitioners in the UK's National Health Service (NHS) between the 1940s and the 1980s. It uses the evidence gathered to reflect on what doctors' experiences can tell us about the nature of racism in the NHS today. The doctors' narratives suggest that the discrimination faced by migrant and ethnic minority doctors has been multifaceted and their ability to avoid or challenge it has been underestimated. The existence and persistence of racism in British medicine is a well-documented phenomenon. Little attention has been paid to the understanding that can be gleaned from instances where migrant and BME doctors talk about not having experienced racism or about having been successful in overcoming it. Nor do we have a detailed understanding of the range of experiences of discrimination and racism that migrant and BME practitioners have. The paper draws on theoretical notions of 'heterophobia', understood here as fear of difference, and psychological function to explore these issues. Discrimination affecting migrant and ethnic minority practitioners appears in these narratives as a complex and multifactorial process that is susceptible to disruption by individuals and groups. We conclude that the NHS should be conceptualised as a racist and 'heterophobic' space where difference in a broader sense interacts with race. Closer analysis of how some doctors are able to function in such an environment can advance our understanding of discriminatory processes. Reframing our view of racism in this way and engaging with the experiences of a previous generation of migrant doctors can assist the NHS, organisations representing migrant and BME doctors, and individuals in devising successful strategies to challenge racism, 'heterophobia' and discrimination.