Read more: Do ethnic majorities now need special protection?
I landed at Heathrow on 26th January 1991 with three pounds in my pocket and a turban on my head. In my head were Oxford spires, Bertie Wooster, Pink Floyd, Sir Humphrey Appleby from Yes, Minister and the Marylebone Cricket Club—as well as a firm conviction that I would feel at home. I was heading for Hounslow in west London to get some cash from a family friend before going to the General Medical Council (GMC) offices near Great Portland Street to register, and finally to Lincoln to start work as a junior doctor. At Heathrow, I asked an elderly lady how to get to Hounslow, admitting that I only had £3. “Don’t worry love, you will get there and still have change left for a drink.” Paradise: where women you have never met call you “love.”
The GMC office was tricky to find. Outside the tube station, I asked directions from a group of youngsters who snarled: “Fuck off.” Disheartened, I turned to a man rushing somewhere. He looked at my creased paper with the GMC address and phone number, rang the number on his brick-sized mobile phone to find out where it was and walked me to the front door.
Lincoln was trickier still. Flat, everyone white, and not a turban or dark skin in sight. Walking back the first evening from a corner shop, I was stopped by three young men. Tattooed and aggressive, they wanted to know if I was aware that their country and my country were at war. They thought I was Iraqi. They were in no mood for lessons in geography, religion or culture; my pleading that I was a Sikh from India was of no interest. As they started to push and shove me, a group of women across the road came over. They were nursing students and one of them had seen me earlier that day trying to find my way round the hospital accommodation. One of them shooed the guys off with language that would do a seasoned sailor proud. I was close to tears. She took me to her flat, made me the most welcoming cup of tea I have ever had, and said: “Don’t mind those dickheads, love.” Love, again
I was bewildered. This was not the England I thought I knew. My ancestors came from a small clan of Kashmiri Brahmins who converted to Sikhism in the 18th century. Indian Kashmir has now almost been cleansed of its non-Muslim population; my clan, a successful minority in Kashmir, has been without a home for three decades. I was lucky; I grew up in Delhi. I was training to be surgeon and living a recklessly indulgent life till Indira Gandhi’s assassination in 1984. In the aftermath, I joined groups seeking justice for the Sikhs. By 1990, it was clear that there would be no justice.
I decided to leave India and found a job as a charity worker in Ethiopia. Three weeks before I was to leave, a work opportunity arose from England, as a psychiatry trainee in the East Midlands. Confronted with a dilemma, I invited friends over and opened a bottle of Indian Scotch. After several drinks a friend suggested: “Why don’t you stop over in England to see how it is? After all, England is on the way to Ethiopia.”
After arriving in Lincoln, I became exquisitely sensitive to racism. My antennae twitched at every perceived slight and humiliation, even when, in retrospect, some incidents had benign and often slightly comic explanations. I remember being asked to attend to an elderly lady who wanted to leave an inpatient ward against medical advice. As I approached the ward, she was standing by the door arguing with a nurse. She looked at me and said: “Look, my taxi is here.” Having examined her, I told her I was going to detain her under the Mental Health Act. She was incredulous: “How can it be right that you can come to my country and stop me from leaving?” I explained that I was simply doing my clinical duty as required by law. She asked which law it was and which party had been in government when it was passed. I said it was the 1983 Mental Health Act and although I was not certain, I thought the Tories had been in power. “Bloody Tories” she exclaimed, still struggling to accept that someone like me could override her will. In her world, people like me were taxi drivers or corner shop owners. Was she driven by racist or malicious intent? I don’t think so. Racism would be an easy charge, but doesn’t explain everything.
In those early years, I could easily find examples of pervasive and pernicious racism within society and in the NHS. A consultant I worked with told me that I must return to my country after completing my training, since there were “too many of your kind” in the UK already. I witnessed subtle prejudices and downright discrimination against ethnic minority candidates in exams and interview panels. In what was then the NHS merit award system, I noticed how white consultants locked themselves in closed committees and handed out financial rewards to each other, ignoring their often equally worthy non-white colleagues. A London medical school had a systematic way of excluding applications from non-white and female candidates, based on name recognition. At a party, a slightly drunk female colleague accused me of “building mosques in the UK” and having “four wives back home.” When I explained that I was a Sikh, not a Muslim, she said: “Of course you are going to deny being a Muslim.”
So how racist is Britain? The answer depends on one’s reference point. Compared with a utopian society of flawless human beings, Britain undoubtedly harbours some people with racist prejudice. Compared with human societies as they exist in the real world, Britain is one of the most tolerant and welcoming nations in the world. Had I moved from New Delhi to Chennai, Kolkata or Hyderabad, I would have faced discrimination based on language, culture and geography. Tribal affiliations are part of being human. And many countries, including those from which most migrants originate, have a shameful record of discrimination and human rights violations. India regularly experiences large-scale violence, often triggered by trivial religious or political disputes. A Muslim man was recently lynched because it was suspected that he had beef in his house. The UK should not be judged by India’s standards. It is also not right to expect the UK to live up to an unrealistic standard, where every individual is non-racist, and where everyone has the right to be offended by a subjective interpretation of someone else’s words; where history has to be washed clean of racist impurities; and where white culture is a homogenous monolith that subjects an equally homogenous minority group to its malevolent intent.
Everything to do with race cannot be always attributed to racism. Some years back there were serious suggestions that ethnic minority patients should only be seen by ethnically matched clinicians—apartheid within the NHS. This followed evidence that ethnic minorities were more likely to be diagnosed with a serious mental disorder, and were more likely to be detained under the Mental Health Act. There is robust evidence that the reasons for higher rates of mental illness and detention lie with the socio-economic disadvantages experienced by some minority groups, including societal marginalisation and discrimination, but these factors are outside the control of the NHS. Under pressure from anti-racist groups, successive governments have accepted the charge that mental health services are “institutionally racist,” and have spent hundreds of millions of pounds on race equality—as if sending psychiatrists on cultural sensitivity training courses would improve the social disadvantage of minority communities. (Ironically, the one part of the NHS with disproportionately large numbers of ethnic minority staff is mental health care.) No one would say GPs were racist because they diagnose higher rates of coronary artery disease in people from the Asian subcontinent or hypertension in those of Afro-Caribbean origin. The remedy for such ethnic differences in health lies in implementing social change that reduces exposure to risk factors for heart disease and high blood pressure, not in blaming doctors. But such is the power of the racism charge that politicians are forced to act before they have had time to think.
In my first year in the UK, a white woman with post-mastectomy depression refused to see me because she felt that someone from my “culture” would not be able to understand her. I wrote to her asking to meet up before she decided whether I could help or not. She did, and we had a successful therapeutic relationship. White patients cannot demand that only a white doctor sees them. If as an ethnic minority patient, I demand that an ethnically matched clinician should see me, I am saying to my white friends: I am equal to you, but you are not equal to me. Our shared humanity and the commonality of human suffering, pain and loss should allow us to understand the influences of culture without demanding that patients from minority ethnic groups be treated in a fundamentally different way.
I led research, commissioned by the Department of Health, to understand the experiences of ethnic minorities seeking help (The Enrich Project.) In our research, we asked black and Asian communities whether they want to be seen by someone from their own background. No one asked for it; everyone said that they don’t care about the ethnic origin of the clinician as long as the clinician was competent and treated them with respect and dignity.
When we meet another human being, each one of us makes the same spontaneous, automatic, instantaneous and involuntary judgements about them: male or female, adult or child, my tribe or not my tribe. These are evolutionary responses designed to assess threat. Is the other person a potential friend, foe or mate? Tribal costumes and decorations are primarily designed to confirm “us versus them” status. Hence the importance in all societies of visible markers of difference. There is a famous saying in anthropology: “in some ways we are like everyone else, in some ways we are like some other people, in some ways we are like no one else.” Between our common humanity and individual uniqueness is the separation of our tribe.
There are disadvantages in considering racism as a sufficient explanation for all ethnic differences everywhere. We found in our Enrich project that for the same poor experience of care, white families would blame “poor services” while black families would blame “racist services.” If the problem is formulated erroneously, wrong remedies are applied, which risk exacerbating rather than alleviating the problem. On 19th September 1990, Rajiv Goswami, a 20-year-old from Delhi University, set himself on fire in a public place in New Delhi in protest against the government’s plan to increase the compulsory quota for lower castes, from school placements to senior government jobs. Within a few days, 150 young people attempted suicide in protest, often in public places. I interviewed 22 of them, six of whom subsequently died. None had a serious mental illness. But each had experienced reverse caste discrimination, either directly or against a family member. They were upper caste but poor. By assuming that caste was the only source of disadvantage, the government intervention was discriminating against people for whom being upper caste had conferred no advantage. Today, in the UK, white working-class boys have the greatest attainment gap in education. No one speaks up for them, since they are not an ethnic or racial minority. Would anyone consider the hugely successful East African Gujaratis in Leicester an oppressed group? Race is not the only, or even the biggest, barrier to success in the UK.
In 25 years of living here, I have seen Britain make huge and positive strides towards equality and against racism. The kind of racism I experienced in my early years is increasingly rare, although there is a worrying recent increase in hate crimes in some parts of our society. No mainstream politician in Britain would make the kind of statements routinely heard from Eastern European leaders. Although it is difficult to be sure, I suspect very few people, certainly among the younger generation, harbour the kind of naked prejudice that was apparently common in the 1970s. This is a cause for celebration, even as one has to guard against complacency.
I now tell new arrivals to the UK that it is easy to integrate into British society. Get a dog and strangers will start talking to you while walking in the park. Go to the pub, even if you don’t drink. Spend Sunday pottering in your local garden centre. Encourage your children to participate in host culture and traditions. You will make many friends in Britain. British people are more than happy to meet you halfway, but you have to make a start too—you have to walk towards them, not walk away and isolate yourself with your own kind. For culture is not an impermeable barrier between people that, if breached, inevitably leads to conflict. Our common humanity transcends our tribal loyalties.
Two years after I arrived, I had to apply to the GMC for full registration, which required a positive reference from each consultant I had ever worked with. I got the references, including from the consultant who had wanted me to leave the UK. He could have easily wrecked my chances of staying in the UK, but didn’t. I asked him why he had given me a positive reference. He said that he had been unable to lie. I can call him a racist, or I can acknowledge that even when he could have hidden behind the anonymity of the GMC process, his basic decency and sense of fairness won out. A quarter of a century in the UK has only confirmed for me that most people I meet are decent, kind, fair and free from racism.
We must not deny, ignore or excuse our tendency to stereotype and our unwitting prejudices against people not like us. I remember many years ago leaving a rock concert in an area that was supposedly home to far-right extremist groups. I decided to take a cab rather than walk home. It was about 2am, I had my long hair down and was wearing a fiendish black leather jacket. I saw a large shaven-headed white young man getting some cash out. I hesitated. We looked at each other. I had no choice but to approach the cash point. As I got behind him, he looked at me and said pleadingly: “You are not going to mug me, are you?” I burst out laughing, in relief and astonishment, that he was scared of me. There we were, each trapped in our own prejudices, and finding the other threatening.
We know the world only through a narrow perspective—our personal past and our current understanding of the world. We cannot see the world afresh every moment. To claim to be colour blind or prejudice free is to lie to oneself. We all have prejudices. In a decent society, the best we can do is to be aware of these and try our best not to let them influence our judgment. By and large, most Britons, from all ethnic and racial groups, try their best.
Now read: White flight?
I landed at Heathrow on 26th January 1991 with three pounds in my pocket and a turban on my head. In my head were Oxford spires, Bertie Wooster, Pink Floyd, Sir Humphrey Appleby from Yes, Minister and the Marylebone Cricket Club—as well as a firm conviction that I would feel at home. I was heading for Hounslow in west London to get some cash from a family friend before going to the General Medical Council (GMC) offices near Great Portland Street to register, and finally to Lincoln to start work as a junior doctor. At Heathrow, I asked an elderly lady how to get to Hounslow, admitting that I only had £3. “Don’t worry love, you will get there and still have change left for a drink.” Paradise: where women you have never met call you “love.”
The GMC office was tricky to find. Outside the tube station, I asked directions from a group of youngsters who snarled: “Fuck off.” Disheartened, I turned to a man rushing somewhere. He looked at my creased paper with the GMC address and phone number, rang the number on his brick-sized mobile phone to find out where it was and walked me to the front door.
Lincoln was trickier still. Flat, everyone white, and not a turban or dark skin in sight. Walking back the first evening from a corner shop, I was stopped by three young men. Tattooed and aggressive, they wanted to know if I was aware that their country and my country were at war. They thought I was Iraqi. They were in no mood for lessons in geography, religion or culture; my pleading that I was a Sikh from India was of no interest. As they started to push and shove me, a group of women across the road came over. They were nursing students and one of them had seen me earlier that day trying to find my way round the hospital accommodation. One of them shooed the guys off with language that would do a seasoned sailor proud. I was close to tears. She took me to her flat, made me the most welcoming cup of tea I have ever had, and said: “Don’t mind those dickheads, love.” Love, again
I was bewildered. This was not the England I thought I knew. My ancestors came from a small clan of Kashmiri Brahmins who converted to Sikhism in the 18th century. Indian Kashmir has now almost been cleansed of its non-Muslim population; my clan, a successful minority in Kashmir, has been without a home for three decades. I was lucky; I grew up in Delhi. I was training to be surgeon and living a recklessly indulgent life till Indira Gandhi’s assassination in 1984. In the aftermath, I joined groups seeking justice for the Sikhs. By 1990, it was clear that there would be no justice.
I decided to leave India and found a job as a charity worker in Ethiopia. Three weeks before I was to leave, a work opportunity arose from England, as a psychiatry trainee in the East Midlands. Confronted with a dilemma, I invited friends over and opened a bottle of Indian Scotch. After several drinks a friend suggested: “Why don’t you stop over in England to see how it is? After all, England is on the way to Ethiopia.”
After arriving in Lincoln, I became exquisitely sensitive to racism. My antennae twitched at every perceived slight and humiliation, even when, in retrospect, some incidents had benign and often slightly comic explanations. I remember being asked to attend to an elderly lady who wanted to leave an inpatient ward against medical advice. As I approached the ward, she was standing by the door arguing with a nurse. She looked at me and said: “Look, my taxi is here.” Having examined her, I told her I was going to detain her under the Mental Health Act. She was incredulous: “How can it be right that you can come to my country and stop me from leaving?” I explained that I was simply doing my clinical duty as required by law. She asked which law it was and which party had been in government when it was passed. I said it was the 1983 Mental Health Act and although I was not certain, I thought the Tories had been in power. “Bloody Tories” she exclaimed, still struggling to accept that someone like me could override her will. In her world, people like me were taxi drivers or corner shop owners. Was she driven by racist or malicious intent? I don’t think so. Racism would be an easy charge, but doesn’t explain everything.
In those early years, I could easily find examples of pervasive and pernicious racism within society and in the NHS. A consultant I worked with told me that I must return to my country after completing my training, since there were “too many of your kind” in the UK already. I witnessed subtle prejudices and downright discrimination against ethnic minority candidates in exams and interview panels. In what was then the NHS merit award system, I noticed how white consultants locked themselves in closed committees and handed out financial rewards to each other, ignoring their often equally worthy non-white colleagues. A London medical school had a systematic way of excluding applications from non-white and female candidates, based on name recognition. At a party, a slightly drunk female colleague accused me of “building mosques in the UK” and having “four wives back home.” When I explained that I was a Sikh, not a Muslim, she said: “Of course you are going to deny being a Muslim.”
"Britain is one of the most tolerant and welcoming nations in the world"Yet my everyday life was not an accumulation of disagreeable experiences. The racist events stand out not because these were common, but because these sharply contrasted with everyday life among the friendly, decent, scrupulously fair and unfailingly polite population that makes up the bulk of Britain. I quickly made friends, learnt to love ales, started attending concerts by my teenage rock heroes. I also worked out the hidden intricacies of English as spoken by the English. In a meeting, if your view was considered “interesting,” it meant you might be right. “Very interesting” implied that you were obviously barmy. When the English called you “Sir,” they were distancing themselves. When they were amusingly rude, you were one of them. I was lucky I worked with people who were accustomed to working with ethnic minorities on an equal basis. I suspect my experiences would not have been the same in a different class and professional setting.
So how racist is Britain? The answer depends on one’s reference point. Compared with a utopian society of flawless human beings, Britain undoubtedly harbours some people with racist prejudice. Compared with human societies as they exist in the real world, Britain is one of the most tolerant and welcoming nations in the world. Had I moved from New Delhi to Chennai, Kolkata or Hyderabad, I would have faced discrimination based on language, culture and geography. Tribal affiliations are part of being human. And many countries, including those from which most migrants originate, have a shameful record of discrimination and human rights violations. India regularly experiences large-scale violence, often triggered by trivial religious or political disputes. A Muslim man was recently lynched because it was suspected that he had beef in his house. The UK should not be judged by India’s standards. It is also not right to expect the UK to live up to an unrealistic standard, where every individual is non-racist, and where everyone has the right to be offended by a subjective interpretation of someone else’s words; where history has to be washed clean of racist impurities; and where white culture is a homogenous monolith that subjects an equally homogenous minority group to its malevolent intent.
Everything to do with race cannot be always attributed to racism. Some years back there were serious suggestions that ethnic minority patients should only be seen by ethnically matched clinicians—apartheid within the NHS. This followed evidence that ethnic minorities were more likely to be diagnosed with a serious mental disorder, and were more likely to be detained under the Mental Health Act. There is robust evidence that the reasons for higher rates of mental illness and detention lie with the socio-economic disadvantages experienced by some minority groups, including societal marginalisation and discrimination, but these factors are outside the control of the NHS. Under pressure from anti-racist groups, successive governments have accepted the charge that mental health services are “institutionally racist,” and have spent hundreds of millions of pounds on race equality—as if sending psychiatrists on cultural sensitivity training courses would improve the social disadvantage of minority communities. (Ironically, the one part of the NHS with disproportionately large numbers of ethnic minority staff is mental health care.) No one would say GPs were racist because they diagnose higher rates of coronary artery disease in people from the Asian subcontinent or hypertension in those of Afro-Caribbean origin. The remedy for such ethnic differences in health lies in implementing social change that reduces exposure to risk factors for heart disease and high blood pressure, not in blaming doctors. But such is the power of the racism charge that politicians are forced to act before they have had time to think.
In my first year in the UK, a white woman with post-mastectomy depression refused to see me because she felt that someone from my “culture” would not be able to understand her. I wrote to her asking to meet up before she decided whether I could help or not. She did, and we had a successful therapeutic relationship. White patients cannot demand that only a white doctor sees them. If as an ethnic minority patient, I demand that an ethnically matched clinician should see me, I am saying to my white friends: I am equal to you, but you are not equal to me. Our shared humanity and the commonality of human suffering, pain and loss should allow us to understand the influences of culture without demanding that patients from minority ethnic groups be treated in a fundamentally different way.
I led research, commissioned by the Department of Health, to understand the experiences of ethnic minorities seeking help (The Enrich Project.) In our research, we asked black and Asian communities whether they want to be seen by someone from their own background. No one asked for it; everyone said that they don’t care about the ethnic origin of the clinician as long as the clinician was competent and treated them with respect and dignity.
When we meet another human being, each one of us makes the same spontaneous, automatic, instantaneous and involuntary judgements about them: male or female, adult or child, my tribe or not my tribe. These are evolutionary responses designed to assess threat. Is the other person a potential friend, foe or mate? Tribal costumes and decorations are primarily designed to confirm “us versus them” status. Hence the importance in all societies of visible markers of difference. There is a famous saying in anthropology: “in some ways we are like everyone else, in some ways we are like some other people, in some ways we are like no one else.” Between our common humanity and individual uniqueness is the separation of our tribe.
"Today, in the UK, white working-class boys have the greatest attainment gap in education"Race and ethnicity are just one way of dividing us, and in my experience, class is a deeper dividing line in British society than ethnicity. Many such divisions can be overcome by commonalities of language, values, traditions, food and social networks. We need shared symbols. Witness how debates about the niqab are so difficult and disconcerting. In a free society, the state has no business telling people how to dress, and yet dress that creates a complete visual barrier between people not only emphasises difference, it can also seem a rejection of shared social norms. While I would never dream of asking a patient to change the way they dress, I know that I would struggle to conduct a mental state examination or engage in psychotherapy with a person in full niqab since I would have no access to the non-verbal cues that are so important in the therapeutic encounter. Governments have a much trickier job balancing individual freedom with social cohesion. I wonder how British society would react if traditional Digambar Jains, some of whom live naked, were to demand the freedom to live true to their faith in this country.
There are disadvantages in considering racism as a sufficient explanation for all ethnic differences everywhere. We found in our Enrich project that for the same poor experience of care, white families would blame “poor services” while black families would blame “racist services.” If the problem is formulated erroneously, wrong remedies are applied, which risk exacerbating rather than alleviating the problem. On 19th September 1990, Rajiv Goswami, a 20-year-old from Delhi University, set himself on fire in a public place in New Delhi in protest against the government’s plan to increase the compulsory quota for lower castes, from school placements to senior government jobs. Within a few days, 150 young people attempted suicide in protest, often in public places. I interviewed 22 of them, six of whom subsequently died. None had a serious mental illness. But each had experienced reverse caste discrimination, either directly or against a family member. They were upper caste but poor. By assuming that caste was the only source of disadvantage, the government intervention was discriminating against people for whom being upper caste had conferred no advantage. Today, in the UK, white working-class boys have the greatest attainment gap in education. No one speaks up for them, since they are not an ethnic or racial minority. Would anyone consider the hugely successful East African Gujaratis in Leicester an oppressed group? Race is not the only, or even the biggest, barrier to success in the UK.
In 25 years of living here, I have seen Britain make huge and positive strides towards equality and against racism. The kind of racism I experienced in my early years is increasingly rare, although there is a worrying recent increase in hate crimes in some parts of our society. No mainstream politician in Britain would make the kind of statements routinely heard from Eastern European leaders. Although it is difficult to be sure, I suspect very few people, certainly among the younger generation, harbour the kind of naked prejudice that was apparently common in the 1970s. This is a cause for celebration, even as one has to guard against complacency.
I now tell new arrivals to the UK that it is easy to integrate into British society. Get a dog and strangers will start talking to you while walking in the park. Go to the pub, even if you don’t drink. Spend Sunday pottering in your local garden centre. Encourage your children to participate in host culture and traditions. You will make many friends in Britain. British people are more than happy to meet you halfway, but you have to make a start too—you have to walk towards them, not walk away and isolate yourself with your own kind. For culture is not an impermeable barrier between people that, if breached, inevitably leads to conflict. Our common humanity transcends our tribal loyalties.
Two years after I arrived, I had to apply to the GMC for full registration, which required a positive reference from each consultant I had ever worked with. I got the references, including from the consultant who had wanted me to leave the UK. He could have easily wrecked my chances of staying in the UK, but didn’t. I asked him why he had given me a positive reference. He said that he had been unable to lie. I can call him a racist, or I can acknowledge that even when he could have hidden behind the anonymity of the GMC process, his basic decency and sense of fairness won out. A quarter of a century in the UK has only confirmed for me that most people I meet are decent, kind, fair and free from racism.
We must not deny, ignore or excuse our tendency to stereotype and our unwitting prejudices against people not like us. I remember many years ago leaving a rock concert in an area that was supposedly home to far-right extremist groups. I decided to take a cab rather than walk home. It was about 2am, I had my long hair down and was wearing a fiendish black leather jacket. I saw a large shaven-headed white young man getting some cash out. I hesitated. We looked at each other. I had no choice but to approach the cash point. As I got behind him, he looked at me and said pleadingly: “You are not going to mug me, are you?” I burst out laughing, in relief and astonishment, that he was scared of me. There we were, each trapped in our own prejudices, and finding the other threatening.
We know the world only through a narrow perspective—our personal past and our current understanding of the world. We cannot see the world afresh every moment. To claim to be colour blind or prejudice free is to lie to oneself. We all have prejudices. In a decent society, the best we can do is to be aware of these and try our best not to let them influence our judgment. By and large, most Britons, from all ethnic and racial groups, try their best.
Now read: White flight?
