Tag: opinion piece

NHS Scotland’s biggest reform in years must put tackling racism and inequality at its heart

Scotland’s NHS is about to undergo one of the biggest structural changes in its history (writes FOYSOL CHOUDHURY).

The Scottish Government has announced plans to radically reshape the way NHS Scotland is organised, including replacing the existing 14 territorial health boards with two strategic boards as part of a wider programme of public service reform.

The Government says the reforms will reduce bureaucracy, improve services and deliver better outcomes for patients.

Those ambitions should be welcomed.

But there is a question that must not be lost amid the discussion about structures, savings and management: Where does tackling racism and health inequality fit into the future of our NHS?

This is not a question I raise simply because I have recently left the Scottish Parliament. It is an issue I raised repeatedly during my time as an MSP.

Throughout my five years representing Lothian, I used my position at Holyrood to raise concerns about health inequalities, access to treatment, poverty and racism.

I asked ministers about the inequalities faced by communities across Scotland and highlighted the stark differences in health outcomes between areas of deprivation and more affluent communities.

I raised concerns about access to NHS services and the pressures facing services such as NHS 24.

I also raised the need to ensure that staff are properly trained and supported, including questions about safeguarding training for NHS staff who interact with members of the public.

These may appear to be separate issues, but they are connected by one fundamental principle: A health service cannot truly be fair unless it works fairly for everyone. That includes the people who work in it.

In April 2024, I chaired a meeting of campaigners and business representatives on anti-racism in the workplace. What concerned me most was hearing how many people working in businesses and public organisations felt unable to report racial abuse.

I took that directly to the First Minister in Parliament and asked what the Scottish Government was doing to empower people to report racism at work.

This matters enormously to the NHS.

Our NHS depends on people from every community. Thousands of staff from Black and minority ethnic backgrounds make an enormous contribution to Scotland’s health service every single day.

They deserve to feel safe, respected and valued at work. Patients deserve the same.

And we should never accept a situation where someone is less likely to receive the care they need, less likely to be listened to, or less likely to feel comfortable speaking to a healthcare professional because of their ethnicity, religion or background.

During my time in Parliament, I also raised specific concerns about health inequalities affecting minority ethnic communities.

I asked the Scottish Government about access to kidney disease services among BAME communities following research highlighting inequalities in kidney health.

I raised wider issues around poverty-driven health inequalities and questioned ministers about what more could be done to close the gap in health outcomes.

I also spoke about access to medical technology for people living with diabetes, because advances in healthcare mean very little if the people who could benefit from them cannot access them.

These questions were never about creating a hierarchy of disadvantage.

They were about recognising that inequality has many causes, poverty, geography, disability, ethnicity, age and other circumstances, and that our NHS must be equipped to understand and respond to them.

That is why the Government’s proposed NHS reforms must be about much more than moving responsibilities from one organisation to another.

If we are genuinely going to build a better NHS, we need to ask whether the reforms will improve the experience of the patient who currently struggles to access care.

Will they reduce health inequalities?

Will they improve outcomes for communities that have historically experienced poorer health?

Will they give staff the confidence to report racism and discrimination?

Will they ensure that equality and anti-racism are embedded in leadership, recruitment, training and accountability?

And importantly, will communities themselves have a meaningful voice in shaping the new NHS?

These questions are particularly important in Edinburgh and Lothian, where we have diverse communities with very different experiences of health and public services.

Reorganisation cannot become an excuse to lose local knowledge.

Centralisation must not mean that decisions are made further away from the people affected by them.

And efficiency must never be allowed to become a substitute for equality.

I have spent many years working with communities through my work with the Edinburgh and Lothians Regional Equality Council (ELREC) and other organisations, long before entering Parliament.

That experience taught me something very important: people often know where systems are failing them.

We need to listen to them.

The NHS is one of Scotland’s greatest institutions. It belongs to all of us.

That means reform must be judged not simply by how many boards there are, how much administration is removed or how much money is saved.

It should be judged by whether patients receive better care, whether staff feel safer and more valued, and whether the gap between those who experience the best health outcomes and those who experience the worst is finally narrowed.

Scotland has an opportunity here.

The Government can make anti-racism and tackling health inequalities a central part of NHS reform rather than something added afterwards.

I hope it does.

Because when we talk about building the NHS of the future, we should be clear about what that future must look like:

An NHS where everyone is treated with dignity.

An NHS where every patient is heard.

An NHS where every member of staff can work without fear of racism or discrimination.

And an NHS where your background, postcode or circumstances do not determine the quality of healthcare you receive.

That is the NHS Scotland I believe we should be building.

And that is why, as Scotland embarks on its biggest NHS reform in decades, tackling racism and inequality must be at the very heart of the conversation.

Foysol Choudhury MBE is a former member of the Scottish Parliament & Shadow Minister for Culture Europe and International Development.

Foysol Choudhury: Time for Scotland to support Asylum Seekers 

A new plan brought in by the UK Conservative Government is yet another attempt to remove genuine asylum seekers from the UK (writes FOYSOL CHOUDHURY MSP).

The scheme will require asylum seekers from Afghanistan, Eritrea, Syria, Yemen, and Libya, who may have been in the UK for up to 18 months, to answer the 11-page document that consists of 50 questions, ranging from political persecution to trafficking experiences.

More shockingly, this form must be answered within 20 days to avoid refusal and must be completed in English. 

These demands being made of the most vulnerable in society are unreasonable and undermine genuine claims of asylum seekers who are traumatised from experiences of conflict or persecution.

Firstly, the language barrier to filling out highly complex questionnaires will automatically exclude those who do not speak English and may also lead to people paying to use translation tools when they can ill afford to do so.

Secondly, the time frame to complete this is unjustified and will exacerbate inequalities between asylum seekers who do not have the assistance to fill in the form.

Legal experts say that a 20-day timeframe is not enough time to seek and receive any legal advice, which could overwhelm our legal system here in Scotland when the service is already under crippling pressure. Due to the crisis in immigration legal aid, there are simply not enough immigration legal aid representatives to assist all the individuals who must complete their questionnaires within short timeframes or face the grave repercussions of their claim being withdrawn.  

This scheme comes at a time when the UK Government is introducing a controversial bill, the Illegal Migration Bill, which means those arriving into the UK by boats are not eligible for asylum claims and could lead to them being deported to a third country, like Rwanda. 

Recent rhetoric by Suella Braverman, Home Secretary of the United Kingdom, fuels anti-migration ideology and the tagline “stop the boats” to control the supposed “waves of illegal migrants” create a negative and manipulated image of asylum seekers.

This is echoed by the Prime Minister, who joins in this discourse of hostility towards those fleeing conflict. The UK government are using their ‘fear of the other’ rhetoric to stoke fears and racism to deflect attention from its policy failures and see it as a vote winner for the next general election. They are using people seeking safety for political gain, trying to deflect attention from the cost-of-living crisis, the NHS crisis and their unpopularity in the polls. 

Despite the false narrative spread by Westminster of an “invasion” of asylum seekers, the UK accepts fewer asylum seekers than other European countries. Whilst the UK issued 10,492 positive decisions in 2021, seven European countries issued more positive decisions than this. These include Germany (59,850), France (33,875), Italy (21,805), Spain (20,405), Greece (16,575), Austria (12,105) and the Netherlands (12,065).  

Furthermore, Westminster is attempting to drive a false narrative that asylum seekers all choose to come to the Global North, and the UK. Suella Braverman has suggested that 100 million displaced people around the world are attempting to enter the UK. Despite this dominant discourse, the reality is very different. Most asylum seekers move to a neighbouring country and currently, 84% remain in the Global South.

Human rights groups and the United Nations High Commissioner for Refugees (UNHCR) claim that the “stop the boats” policy would make the UK an international outlaw under European and UN conventions on protecting asylum seekers.

Fundamentally, seeking asylum is not illegal. The UK was at the forefront of signing the 1948 Universal Declaration of Human Rights (UDHR) and the 1951 Refugee Convention, which are historic developments to protect and uphold basic human rights. 

Under the Refugee Convention, asylum seekers are under no obligation to apply to the first safe country they reach; enter a country by regular means; or provide documentation. It is important to note that the UNHCR has condemned this bill and has urged the UK Government and all MPs to consider the humanitarian impacts of pursuing this bill.  

What is also concerning, are the claims that right-wing Tory MPs are attempting to amend the bill which would pull the UK out of the European Convention on Human Rights (ECHR). Alongside this, Braverman has been advocating for the government to leave the ECHR already, which is worrying to anyone committed to safeguarding fundamental rights. Leaving the convention would put everyone’s rights at risk. It’s a person’s last resort for holding the state to account when it has abused their rights. 

Although asylum is a reserved matter for the UK Government, this new plan for applications will have a direct impact on Scotland. Scotland’s Dungavel immigration detention centre will likely see an increase in the number of people detained here, as the process for securing a successful asylum application will become much harder due to these restrictive rules.  As this centre is based in Scotland and we will be impacted by the higher number of asylum seekers detained, Holyrood must hold discussions with Westminster to ensure that the UK’s commitment to the UNDHR and the Refugee Convention is upheld. 

We must ensure support is provided to asylum seekers to guarantee they face a fair process. The Scottish Refugee Council are working alongside lawyers and experts to propose changes to the current plan.

These suggested amendments to the questionnaire include simplifying the document; providing translations in relevant languages; creating a user-friendly guide for completion of the questionnaire and providing an extension for all unrepresented individuals. 

In response to this plan and the Illegal Migration Bill, we need to encourage the Scottish Government to support asylum seekers with the application form and recognise the importance of entering into a discussion with Westminster, so that commitments in international law can be upheld.  

To raise my concerns about the new bill, last Thursday I asked Shona Robison, the Cabinet Secretary for Social Justice, Housing and Local Government, what impact the UK Government’s proposed Illegal Migration Bill could have on Scotland’s legal aid services.

The Cabinet Secretary was unable to assess the overall impact this will have but agreed that it is likely to cause a magnitude of issues. I will continue to press these issues in the Scottish Parliament to ensure legal professions are best supported, which will ensure effective assistance is provided to asylum seekers. 

Foysol Choudhury MSP: Immoral Trading Must Stop

Zara. H&M. Lidl. Tesco. All high-street retailers who have supposedly been engaging in unethical practices when purchasing from garment factories in Bangladesh. Whilst consumers in the UK often buy items at these popular chains, unfortunately a story of inequality, exploitation and unfair practices lurks behind many purchases (writes FOYSOL CHOUDHURY). 

Research undertaken at the University of Aberdeen surveyed 1,000 factories in Bangladesh and their findings were shocking.

The cost of materials and production has soared globally. Yet, the research showed that the price we pay to producers in Bangladesh has apparently stayed the same as before the pandemic, two years ago, meaning that garment factories are facing a real term cut. As a result, many factories selling to large, global retailers such as H&M and Zara were supposedly paid below the cost of production for their garments.  

Unethical practice was also evident, with the research concluding that between March 2020 and December 2021, 90% of high street brands were found to be engaging in unethical practices such as cancelling orders and delayed or failed payments.  

Many retailers involved have denied claims. However, if the factories are not being paid enough for their production, unfortunately the workers at these factories may not be being paid enough either.   

Rightly, we fight for the rights of our workers at home. However, it would sadly seem that we neglect the rights of workers globally who are responsible for producing the clothes and items we use regularly. 

Twelve of the brands listed in the report were apparently members of the Ethical Trading Initiative, aiming to promote workers’ rights. This, whilst undertaking business practices which could quash fair pay for workers in Bangladesh.  

We cannot preach about paying workers fair wages globally whilst perpetuating a system of financial exploitation which, unfortunately, ensures that businesses often don’t have the funds to pay their workers a fair wage.

We cannot continue to give with one hand and take with the other when it comes to the visage of fair play versus our unethical trading practices. 

We cannot continue to operate on an ‘out of sight out of mind’ basis. Instead, we need to recognise that these practices are, in part, being propped up by the UK’s global unethical business practice. We need to shift our priorities and act to ensure that all workers involved in our production chains, around the world, have access to workers’ rights.  

I urge governments to ensure that our importers pay the correct costs and make the process ethical. We must not profit at the cost of others around the globe facing exploitation and unfair wages; this immoral trading must stop. 

The University of Aberdeen ‘‘Impact of Global Clothing Retailers’ Unfair Practices on Bangladeshi Suppliers During Covid-19”:

 https://www.abdn.ac.uk/news/documents/Impact_of_Global_Clothing_Retailers_Unfair_Practices_on_Bangladeshi_Suppliers_During_COVID-19.pdf