Credit: Chris Porsz

Many new arrivals have found it difficult to work or progress their careers due to assumptions made about their abilities. In the first few decades of the NHS, newly qualified doctors often found themselves working in isolated parts of the UK, in areas of clinical practice which were considered less attractive and in lower-level positions.

While some found acceptance and settled in quickly, many, in particular nurses, encountered hostility and racism, both systematically and from patients under their care. 

Those of us who came from India and Pakistan could only get jobs at district general hospitals, which were not as good as they are now. It was virtually impossible for us to get a job in a teaching hospital. And once we became registrars, that was the ceiling.

The applications I sent were rejected just because of my name and where I got my degree. Any interview that I went to, bar one, I got the job. It was a question of getting to the interview stage.

Dr Nayyar Naqvi OBE
Arrived from Pakistan in 1968

Courtesy BFI

No one prepared you for how the patients were going to treat you. They’d slap your hand away and say, ‘Don’t touch me, your black is going to rub off on me.'

Arrived from Trinidad in 1969

In the 1960s and 70s, many offensive comments were written about immigrant doctors in the correspondence columns of the British Medical Journal, focussing on their alleged lower standards of education and language skills. The popular press soon picked this up. In this Evening Standard cartoon by Jak, a black surgeon is pushing a large circular saw up to the operating table while the white medical staff look on in doubt.

The image below contains racist content. Click to reveal.

Cartoon by Jak (Raymond Jackson): “You’re sure he speaks English? I only came in for my tonsils!”, Evening Standard, 1969. Credit: British Cartoon Archive, Special Collections & Archives, University of Kent/ Associated Newspapers Ltd.

While some people struggled to overcome barriers in public-facing roles, other new arrivals found work in areas of the NHS which were largely invisible to outside observers. From cleaners to porters to caterers, this crucial day-to-day work has made the NHS tick.

NHS migrants : In numbers

Learn more about the roles carried out by foreign nationals and minority ethnic staff in the NHS.


After doing several cleaning jobs, I was referred for a job in the NHS in the catering department by a friend who worked with me. The income was low starting up, and having a voice or opinion made my relationship with others clash.

Mary Otchere
Arrived from Ghana in 1985

Getting on in the NHS

Despite obstacles and challenges, people from across the world have got on with the day-to-day realities and routines of their jobs within the NHS, forging careers by taking advantage of opportunities wherever they arose – even if this sometimes led them in unexpected directions.

Dr Muhayman Jamil

"I decided I didn’t want to do neurosurgery anymore. I was approaching middle age and it’s a young man’s game. I quit, then out of the blue, a friend in palliative medicine asked if I could step in and help for a couple of weeks. That was 20 years ago and I’m still doing palliative medicine!"

Arrived from Iraq in 1990.

Courtesy Muhayman Jamil

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Dr Hargundas Khanchandani

"Because Dad didn’t pass the MRCP, he couldn’t become a consultant. He could see there was nowhere else to progress so he decided to become a GP. In Luton at the time, there were a few hundred immigrants from India and Pakistan. And all of them were patients of my father. They all joined his practice because he could speak Urdu and Hindi."

Arrived from India in 1954.

Image courtesy Dr Raj Khanchandani

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Mary Otchere

"As years went by it became better and 20 plus years in I’ve grown to love and enjoy my job. My colleagues and I are a big happy family. We all bonded over culture and experiences. An average day in my role is full of laughter!"

Arrived from Ghana in 1985.

Gulzar Waljee

"These days midwives are given a car. We, in 1963, were given a cycle. And you were called in the middle of the night at 1am, 2am in snow, rain and winds."

Arrived from Tanzania in 1959.

Image courtesy Gulzar Waljee

Dr Ewa Raglan

"After finishing medical school, I got a job for six months. During that time, I became pregnant. I was looking after patients day and night and living in the hospital and in the morning, I would be sick for 15 minutes, then at 8 o’clock I would be fine and ready for ward round. I didn't tell anyone. For me it was very important to finish the job for my career progression."

Arrived from Poland in 1974.

Courtesy Royal College of Physicians Museum

Claudia Anghel

"There are so many special moments and you feel connected to every family you support. When you save a baby’s life, you rejoice with that family who will never forget what you’ve done for them. When a baby is stillborn, you sit and you cry with the mother. I remember one woman who had to receive additional gas and air during a challenging birth... she couldn’t see my name badge clearly and asked if she could prod me to see if I really was an angel."

Arrived from Romania in 2013.

Courtesy: Claudia Anghel

Dr Lionel Stoll

Born in Lithuania to Russian Jewish parents, Dr Stoll migrated to England in 1919. He borrowed money from an uncle to start his first practise in Chalk Farm in 1935. A strong supporter of the NHS, he served as a GP for over 50 years.

Lionell Stoll's medical case and equipment. Images courtesy: Hackney Museum and Jewish Museum London

A day in
the life

Listen to people talk about the day-to-day challenges of working within the NHS.

Audio courtesy NHS at 70.
Image courtesy The Board of Trustees of the Science Museum, Austin, M.W.

Neehal Shah

On dentists not being paid properly for their work in the NHS and the struggles of working in a target-based system. Arrived from Kenya in 2005.


Dr Ngozi Edi-Osagie

On making difficult decisions about premature babies and the ethical considerations of her role. Born in the UK in 1964. Moved to Nigeria at age 10. Moved back to the UK in 1989.


Pauline Ong

On the complexities of running a hospital as a non-executive director. Arrived from the Netherlands in 1978


Rashid Joomun

On the challenges of data collection as an NHS Trust Information Manager. Arrived from Mauritius in 1976.


Advances & achievements

People from all over the world have carved out successful careers across the NHS and across the UK, providing much-needed services for their patients and making a lasting impact on the communities in which they work and their fields of expertise.

I worked single handedly for 12 years to set up the cardiac service. I set up a heart fund to buy good equipment and hire staff. I feel very proud that we now have one of the best cardiac units in greater Manchester."

Dr Nayyar Naqvi OBE
Arrived from Pakistan in 1968
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My father was definitely an outsider. The area he was working in – preventing fatal blood clots in the lungs post-surgery – was considered to be unfashionable and hadn’t been studied much. But it has turned out to be an area that has saved millions of lives."

Dr Vijay Kakkar
Arrived from India in the 1960s (as told by Lord Ajay Kakkar)
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"We started one-to-ones between midwives and mothers – and it’s national now. When people go and look at a hospital, they know which midwife is going to be looking after them. We were one of the first to have parents staying in the unit so they can learn how to handle the babies. Those issues are so important when it comes to relationships between parents and child."

Lynette Richards-Lorde
Former General Manager, Wandsworth Health Authority, St George's Hospital
Arrived from Guyana (formerly British Guiana) in 1959
Next Chapter

Making a life in Britain