“I'm tired of being called names. I know I'm black. I was born black. And I like being black. So tell me something I don't know.”
Those words, uttered 50 years ago by a young nurse who regularly faced racist abuse from patients in a London hospital ward, marked a turning point in Allison Williams' life and career.
Williams came to Britain in 1969 from the Anglophile culture of the post-war Caribbean, where children of all nationalities learned English literature, grammar and history by heart, only to be bullied in their “home country”.
She is now among those who, having dedicated their lives National Health ServiceIt is feared that the UK still does not adequately recognize the huge contribution made to UK health care by black, minority ethnic and overseas-born or trained staff – decades after Windrush generation nurses ended the service in its early years.
These professionals included Deloris James, who was born a British citizen in St Kitts and Nevis and moved to Cardiff in 1964 when she was 10 years old. She was “nudged” into a career in the NHS, following her mother, who was a midwife, with 12 other relatives also working in the health service.
“From the stories I hear, it seems like things are worse than when I worked in the NHS,” said James, 71, who worked as a nurse and midwife. “I’m not saying there wasn’t racism, but it seems much more widespread.”
The number of foreign nurses and midwives coming to the UK is fallingThe decline is blamed on rising racism and changes in immigration rules. In an interview with the Guardian, the chair of the Academy of Medical Royal Colleges, Jeanette Dixon, said the NHS was at risk as foreign health professionals increasingly viewed the UK as an “unwelcoming, racist” country.
Between April and September, 6,321 nurses and midwives from overseas joined the register of those licensed to practice in the UK, compared with 12,534 who did so during the same period in 2024. In October, the Royal College of Nursing reported that nurses' reports of racist incidents at work had risen by 55% in three years.
Meanwhile, Overseas-trained doctors are leaving the UK in record numbersAccording to the General Medical Council, 4,880 foreign-trained doctors will leave the UK in 2024, up 26% from the 3,869 doctors who did so the year before.
Williams, a writer who came to Britain in 1969 and worked for 40 years in the NHS as a nurse, midwife, manager and clinical director, said: “More than 50 years have passed and no lessons have been learned. No one has seen fit to congratulate or thank the multicultural people who came – in our generation, to 'rebuild the country' as we were told.
“I came at a time of brain drain when so many English people had gone to Canada, America and Australia. When I was in hospital, there were 30 girls in my class. One was English, four were Irish, and the rest were West Indians and West Africans – there were 14 of us West Indians from Trinidad alone.
“The education and social life were amazing, but there was a lot of racism from the patients. They would hit you, hit you or push you away. I was called the N-word. I was told I was nasty. It was quite alarming.”
A year later, Williams told her mother that “she couldn’t take it anymore” and that she felt like she was “walking on glass.”
But her mother told her: “You have a dream. You've wanted to be a nurse since you were a child. Racism is their problem. You just move on with your career and find a way to deal with it.”
“It really motivated me to take such a strong stand on the department,” Williams, who noted this point in the title of her autobiography. Tell me something I don't knowsaid. “I don't know where it came from… it was the most empowering statement I've ever made—since [racism] It just never bothered me.”
Williams moved into obstetrics, where there was much less racism and where she discovered that “bringing life into this world was such a privilege.”
She said: “Every once in a while a woman would say she didn't want a black midwife. But then the managers were very strict. They would say, 'They're all we have and they're the best – either you have a black midwife or you pack up and go somewhere else.'
Decades have passed and not every black, minority ethnic, foreign-born or trained health professional feels they can count on the support of their colleagues.
Latest NHS news Standard Workforce Race Equity Report found that black or minority ethnic (BME) women (15.6%) were most likely to have been discriminated against by other staff in the past 12 months, and 51% of NHS trusts reported that BME staff were more than 1.25 times more likely than white staff to be subject to formal disciplinary processes. In 80% of NHS trusts, white candidates were significantly more likely to be appointed from a short list than BME candidates.
Alison Hewitt is the second generation of her family to dedicate their working lives to the NHS. Her aunt was a Windrush generation nurse and her mother was a pediatric nurse, but Hewitt broke the mold and began training in radiography 35 years ago, when black radiologists were rare.
She said: “I think a lot of Windrush nurses have kept their mouths shut. Whereas at the moment you're constantly fighting with HR.”
But despite discrimination and inequality, 28.6% of NHS trust staff are black or minority ethnic, and around 20% are non-British citizens.
“Where I work, there are at least 27 countries represented,” Hewitt said. “If black staff, Asian staff and foreign-born staff went home, the NHS would collapse within hours. We have always been called upon to do difficult work.”
However, Hewitt believes that if anything is driving staff turnover in the NHS, it is “economic improvement”, and Williams agrees.
“Where would you go in a world where there is no racism?” – said Williams. “This is a global, international problem. But what you can find [outside the UK] is that the salaries are higher, or there is something else to compensate for it.”
Saada Maida, a 41-year-old gynecologist from Leamington Spa who came to the UK as a refugee from Syria, said NHS staff from all walks of life shared the common challenge of managing patients with different needs in a “systematically underfunded” system, but stressed he was made to feel welcome – and believes “the UK is one of the least racist countries”.
He added: “The common denominator between these people leaving is the feeling that they are not valued in the NHS. If you take on a contract in the Gulf, we know there is systematic inequality there, more than in the UK, but the pay is higher. I think all the doctors or health workers leaving the NHS, I think the incentive, whether they admit it or not, is largely financial.”
Having seen so many of her family dedicate their lives to the NHS, James worries the service she knew will be lost to cuts And privatizationand the pressures faced by his “wonderful” staff.
“I’m very sad,” James added. “We're back to the 50s again, when people were invited to come to Britain to work and rebuild, and when they come they are faced with this war effort.”
