Dr Chaand Nagpaul says data must be gathered now to save lives of UK BAME citizens

The government’s failure to record and publish real-time data on the ethnicity of Covid-19 patients is a scandal that is endangering lives, according to the chair of the British Medical Association.

Speaking to the Observer, Dr Chaand Nagpaul said: “This is not an issue that should require further campaigning. It would be a scandal if it requires further lobbying as data recording needs to start now, not tomorrow. When you have stark statistics like this, it is an instruction for government to act.”

Hospitals are not currently required to record the ethnicity of any patients who are admitted, fall critically ill or die. There have been more than 15,000 hospital deaths in the UK with the virus, but an independent study of the first 5,578 patients has shown that Covid-19 is disproportionately affecting ethnic minorities.

On Friday, the intensive care national audit and research centre revealed that 34.5% of Covid-19 patients in critical care were black, Asian or from an ethnic minority, despite accounting for only 13% of the general population.

While BAME workers represent 44% of the NHS workforce, they accounted for 68% of the 57 NHS staff known to have died with the virus. Every one of the 14 doctors reported to have died so far is from an ethnic minority.

Facebook Twitter Pinterest BAME staff account for 44% of the NHS workforce. Photograph: Chris J Ratcliffe/Getty

There are concerns that a higher number of BAME doctors on the frontline who feel less able to speak out is leading to disproportionate infections and deaths.

“We’re well aware that doctors have been under pressure to see patients but have not felt adequately protected, with shortages of PPE,” said Nagpaul.

“The BMA’s evidence and that from the General Medical Council has shown before that BAME doctors are twice as likely not to complain about safety in the workplace as they have far greater fear of facing recriminations or reprisals … bullying and harassment has [also] been recorded at far higher levels.”

On Thursday, the Department of Health and Social Care agreed to launch a formal pandemic review on BAME deaths to be led by NHS England and Public Health England (PHE). The announcement was said to have blindsided the NHS, which referred the Observer’s inquiries to PHE.

The housing, communities and local government secretary, Robert Jenrick, was asked about the effect of coronavirus on people from BAME communities at Saturday’s press briefing.

“There does appear to be a disproportionate impact of the virus on those from BAME communities,” he said. “For that reason, the chief medical officer commissioned work from Public Health England to better understand this issue.”

Facebook Twitter Pinterest BMA chair Dr Chaand Nagpaul is urging the government to act now.

Prof Stephen Powis, the national medical director of NHS England, said: “This is something that I am very concerned about, and I know that the chief medical officer is concerned about too.

“In NHS England, obviously, a number of our staff … come from those ethnic groups, and we are actively also looking ahead of that work, of what we have to do to support, and, perhaps, protect them specifically.”

Nagpaul said the review was welcome, but that the government could immediately instruct all hospitals to record the ethnicity of patients.

“We desperately need to change the methods of collection [of patient information] and what we collect to understand what is going on,” he said. “It is endangering lives … this cannot be brushed under the carpet; it would be morally wrong.”

One senior NHS England source admitted to the Observer that the true figure of BAME NHS staff dying from the virus could be higher, given the limited data currently available. The organisation said it was “on the back foot” trying to confirm staff deaths first reported on social media.

BAME doctors are twice as likely not to complain about safety in the workplace as they fear recriminations or reprisals. Dr Chaand Nagpaul, BMA chief

Jonathan Ashworth, the shadow health secretary, called for transparency. “It is vitally important that government ministers should insist this data is collected and published as a matter of urgency, so we can get the full picture on how the virus impacts all communities,” he said.

On Sunday, Sadiq Khan, the London mayor, is expected to draw attention to the “structural racism in our society” that is causing BAME communities to be hit so hard by the virus. He will pay tribute to ethnic minorities vastly over-represented in frontline roles – such as care assistants, supermarket workers and bus drivers – and who are therefore exposed to a much greater risk of catching coronavirus in the first place.

According to Sir Michael Marmot, the chair of the Commission on Social Determinants of Health, the stark disparity in the ethnic makeup of deaths from Covid-19 is foreshadowed by wider inequality.

“We know from research that being in poverty reduces your life expectancy and is highly correlated to poorer health outcomes,” he told the Observer. In February, a follow-up to Marmot’s landmark 2010 review concluded that public health inequalities had worsened in the past decade.

He added: “If you don’t collect data, you don’t know a problem exists. In the UK, BAME groups are much more likely to be among lower socioeconomic groups, live in poorer conditions and overcrowded housing and more likely to be in lower-paid and insecure jobs. That means poorer health.

“It also means social distancing is much harder, particularly for older people. Some of the most vulnerable people in our community are living in extended, multi-generational homes.”

PHE medical director Yvonne Doyle said: “This is a really important issue, and detailed and careful work needs to be done before we draw any conclusions.”