Looking to the Future

As the pandemic and its response highlighted, the NHS faces huge challenges. Today, as pressures on the NHS are at an all-time high, healthcare professionals face difficult decisions about their future.

Will the NHS remain an attractive place to work for migrants? What does the future hold for NHS workers? What will happen to areas and roles that were heavily reliant on European migrant workers pre-Brexit? How can the structural underrepresentation of minority ethnic workers in senior roles be overcome?

Read the thoughts of a range of people about some of the key difficulties and opportunities facing Britain’s healthcare system. We’ll be gathering more responses to these questions and adding them below – get in touch and share your thoughts.

Will you stay or will you go?

Neehal Shah

“I cannot work in the system much longer. The fact that it’s all target-based means you are working with a conveyor belt of patients. It shouldn’t be that way.”

Arrived from Kenya in 2005

Image: Walter Baxter / A surgery at NHS Borders Dental Centre, Hawick

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Dr Elif Ezgi

“I hope that within the next three years, I will become a consultant in the UK. I have a supportive environment right now. For long term plans, I have no clue. Everything changes. If anything happens back home to my family or they need me, I may go back."

Arrived from Turkey in 2016

Image: Dr Elif Ezgi

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Dr Meenal Viz

"The reason I went into medicine was that I wanted to serve the public. But I realise that my skills and passion can actually be used outside the walls of the hospital. I am open to new opportunities as long as they have a positive impact on the world."

Arrived from Gibraltar via Czech Republic in 2018

Image: Dr Meenal Viz

Who will shape the future technologies of the NHS?

Dr Pearse Keane

“My idea was that I would develop and apply the latest advances in artificial intelligence to identify eyes with the most sight-threatening disease, so we could prioritise those patients and get them in front of a doctor as soon as possible.”

Arrived from Ireland via the USA in 2010

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Lord Ara Darzi

“The huge benefits robotic technology has brought us to date lie in precision surgery and the ability we now have to carry out more complicated surgical procedures in a minimally invasive way – via keyhole surgery. In years to come, I think robots will be smaller and more intuitive; they’ll allow us to deliver targeted therapy. But if we are to continue moving forward, we need disruptive innovators who are ready to challenge dogmatic practice and an environment in which they are free to experiment.”

Arrived from Iraq via Ireland in 1990. Performed the UK's first robot-assisted keyhole surgery operation.

Image credit: The Board of Trustees of the Science Museum

Where will the next generation of workers come from?

Dr Ramesh Mehta OBE

“The NHS is always going to be short of healthcare staff. Although the British government has recently added extra seats in medical schools, that is nowhere near the requirement. India produces almost 80,000 doctors and a large number of nurses every year and plans to further increase these numbers significantly in the near future. It will no doubt provide healthcare workers to the world. But it’s important that doctors who migrate from developing countries like India also return to serve their countries."

President, British Association of Physicians of Indian Origin (BAPIO)
Arrived from India in 1981

United Kingdom Homecare Association

"Non-British nationals make a major contribution to the UK’s social care system. Careworkers perform vital tasks to enable older and disabled people to live independently. Around one in six members of the social care workforce are non-British nationals from Europe and beyond. They help make a real difference to people’s lives.

The UK has a diverse population and people with the right skills and values for social care work have always been in short supply. Despite the uncertainty created by the UK’s exit from the European Union, we will continue to need a workforce which reflects our local communities."

How can the NHS tackle racism?

Yvonne Coghill

"The NHS has a love/hate relationship with its black and ethnic minority staff. Bringing people in from all around the world is what we do and we do it well, but how people are treated whilst they’re in the NHS is another story. In 2015, the Workforce Race Equality Standard came into force. What it does is it looks at the difference between the experiences of white and black and ethnic minority staff in the NHS. It’s stopped people from saying ‘That’s in your imagination’ or ‘You’ve got a chip on your shoulder."

Outgoing director of the NHS England Workforce Race Equality Standard programme and Vice President of the Royal College of Nursing
Arrived from Guyana (formerly British Guiana) in the 1960s

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Dr Meenal Viz

"I feel hopeful. With Black Lives Matter and recent movements, it’s no longer just ethnic minorities fighting alone. To see our white colleagues and doctors stand up for us, I think that’s quite a pivotal thing. You can’t have a group of people who are being oppressed be the ones responsible for making the change. They don’t have the same power. Now we are getting past the point of equality, and getting to the point of equity."

Arrived from Gibraltar via Czech Republic in 2018

Image: Dr Meenal Viz

Shilpa Ross

"The NHS is founded on the principles of fairness, providing access to health care to all. The NHS is also one of the most ethnically diverse workforces in the public sector. However, there are clear disparities in the experiences of those staff from an ethnic minority background compared to those who are white. Our research included in-depth interviews with ethnic minority staff and case studies of NHS organisations trying to tackle these inequalities. We found ethnic minority staff in the NHS perceive significant barriers to their career progression and a range of other issues around feeling valued and included. The lived experiences tell a powerful story about the importance of setting the right culture for all staff in the NHS. There are some promising signs of NHS organisations taking positive steps towards equality and inclusion by making it safer for staff to talk about race and racism and enabling career development and progression. Unfortunately the research shows there are no simple or straightforward solutions and addressing racial inequality within the NHS workforce will take sustained commitment over a long period of time."

Policy Fellow, The King's Fund

Credits

Suggested further reading

Migrant architects of the NHS: South Asian doctors and the reinvention of British general practice (1940s-1980s) by Julian Simpson

Against the Odds: Black and Minority Ethnic Clinicians and Manchester, 1948-2009
by Emma L Jones and Stephanie J Snow

Nurturing the Nation by Debbie Weekes-Bernard, published by Runnymede Trust

Many Rivers to Cross: Caribbean people in the NHS 1948-69 by Ann Kramer, interviews by Abigail Bernard

Copyright

Birth of the NHS lead image credit:
Photos and footage courtesy Dr Raj Khanchandani, Mae Appleton, Nicole Henworth, Gulzar Waljee, Simon Fuchs, Royal College of Nursing Archives, Wellcome Collection, BFI

All material is for educational and non-profit purposes only. All original photographs are the copyright of their respective owners.

The materials archived, stored and presented here are copyrighted by their respective contributors, and may not be saved, re-transmitted, republished, or reformatted by any means, electronic or mechanical.

Acknowledgments

We are extremely grateful to everyone who shared their personal stories, experiences and photographs with us for the exhibition.

Curator: Aditi Anand
Curatorial Assistant: Shereen Lafhaj
Text: Matthew Plowright and Aditi Anand
Project Manager: Robyn Kasozi
Design and development: Eight Arms
Additional design and direction: Roland Williams
Sound editing: Bill Bingham

Animation by Tribambuka, with narration by Michael Rosen

Photographers and artists:
Rankin, EVEWRIGHT, Charlie Phillips, Chris Porsz and The Singh Twins

With thanks to the following for their contributions:

Data courtesy NHS Digital

Rankin images and stories courtesy Rankin and NHS England

Oral histories of Lynette Richards-Lorde, Lena Hunt, Dr Neslyn Watson-Druée and Denzil Nurse courtesy Abigail Bernard, Researcher/Interviewer from Many Rivers to Cross (Isabel Appio, Managing Editor; Ann Kramer Introduction; Publisher Sugar Media)

Oral histories of Yvonne Coghill, Ngozi Edi-Osagie, Rashid Joomun, Pauline Ong, and Neehal Shah copyright NHS at 70, The University of Manchester. NHS at 70 is supported by the National Lottery Heritage Fund and the Arts and Humanities Research Council www.nhs70.org.uk.

Oral history and photograph of Ewa Raglan courtesy Royal College of Physicians Museum

Oral histories of Helen and Margaret courtesy Ethel Corduff, author of the forthcoming book on Irish nurses Ireland’s Loss Britain’s Gain

Lee Appleton, Nicole Henworth, Rohit Rao, and Yasmin Waljee

Volunteers:
Alice Grahame, Alice McKimm, Anaïs Walsdorf, Andrea Potts, Celeste Camilleri, Francesca Newton, Gemma Evans, Morgan Mcleod, Nicoletta Enria

Funders:
Alfred Caplin Charity Settlement, Arts Council England, The Dorfman Foundation, Unbound Philanthropy

Lead Sponsor:
The Rumi Foundation