The myth of a post-racial society is long gone. Its remnants disappeared somewhere in the ashes of Grenfell, the return flights of Windrush and the tears of mothers afraid their Muslim teenagers will be taken by border police.
But we are never short of myths. The myth that healthcare is a space devoid of politics is alive and well. The spirit of the NHS, the first universal healthcare system in the world where “everyone — rich or poor, man, woman or child — can use it or any part of it”, is one worth holding on to.
But times have changed. An increasing number of discriminatory policies, favouring healthcare for some while marginalising others, is not only a public health concern – human rights are at stake.
Frontline Staff As Border Agents
Healthcare staff are usually expected to juggle multiple roles in their clinical work, such as evaluators, educators, healers and administrators. But these roles were never static.
In the age of austerity and surveillance capitalism, the State have made additional roles mandatory. Healthcare staff are now tasked to fulfil their role of border agents, State informants, and an arm of the national security apparatus extended within healthcare.
Image credit: Photo by Zackary Drucker for The Gender Spectrum Collection.
These novel roles are the culminated braiding of counter-terrorism and hostile environment policies.
The logic of the hostile environment – to make things as difficult as possible for illegal immigrants – and the logic of counter-terrorism (ie Prevent) – to identify and report individuals susceptible to radicalisation – co-exist in an interwoven logic which sees Muslims and Muslim-like people as potential invaders and threats.
Discrimination Against Muslims
Some still wonder how such policies discriminate towards Muslims if they are not specified as a group. The answer is simple: Muslims embody the illegal immigrant and the terror threat in the British public’s imagination; so much so, it arguably played a significant role in the success of the Brexit referendum.
So, when I speak of institutional racism, I mean racism entrenched within policies, making otherwise well-intended staff act upon racial prejudice or unwittingly play a role in the devastation of families caught – rightfully or wrongfully – in a hostile net.
Image credit: Unsplash
What are the implications of designating the NHS a ‘pre-criminal space’? Through Freedom of Information requests, Drs Charlotte Heath-Kelly and Erzsébet Strausz found Prevent’s counter-radicalisation protocols embedded within several NHS Mental Health Trusts as part of the comprehensive risk assessment for all patients.
Following interactions with patients, a pop-up message now appears on the computer asking staff members if they checked for their patient’s ‘emotional resilience’.
There are explicit, racialised consequences to such non-evidence-based practice. In my post-doctoral research, I found that Muslim NHS staff critical of the Prevent policy were more likely to experience emotional reactions during Prevent training and self-censor themselves as a result – for fear of being referred to deradicalization by their colleagues.
Suspects Of Knife Crime
While the British Black population have long charged the NHS with institutional racism for biased treatment, the logic of Prevent now comes full circle back towards them: healthcare staff are now requested to identify and report those they suspect may engage in knife violence, a phenomenon typically racialised to Black bodies in the British public’s imagination.
The enforced hostile environment rendering NHS staff liable to verify the legal status of patients who may be undocumented has also seen the extent to which healthcare provision, border control and surveillance data sharing have become inseparable.
With parents fearful of the hostile environment policy, the number of undocumented children in the UK – estimated at 120,000 – who may not receive medical care may certainly breach the United Nations Convention on the Rights of the Child.
Image credit: Pexels
The weaving of health and politics has produced Kafka-esque tragedies: a comment of a suicidal adolescent, made in confidence to a psychiatric nurse, is now being used by the Home Office as a cause to justify the deportation of the entire family.
Don’t forget that the hostile environment policy affects the Windrush generation’s access to healthcare as well.
The UN And Ethno-Nationalism
The UN stipulates that all persons are accountable to just, fair and equitable laws, without discrimination. It is easy to think of the inevitable racist referrals which might occur from Prevent or the Hostile Environment as bad apples of otherwise necessary, non-discriminatory policies.
But even the UN sees the bluff. The real challenge we have before us, the more momentous task, is to turn the table and consider how ethno-nationalism the pivot for how such policies are produced in the first place.
It is ethno-nationalist logic, sustained and reified in political discourse, which sees “some people’s” skin color, migration history, violence and cultural heritage as more or less worthy than others.
Human rights concerns begin when ethno-nationalism is disregarded, for discrimination is the spirit of ethno-nationalism and the attitudes of ‘Fortress Britain’. And although hatred for the ‘other’ may exist among all peoples, make no mistake: a non-White individual’s hatred might have them arrested or made stateless, while a White individual’s hatred might see them elected.
Thus, as much as we all work towards the eradication of xenophobic and racist policies institutionalized in healthcare, we must remember: these policies are only visible manifestations of ethno-nationalist logics embedded within society. Unless we resist politics which privilege Whiteness and marginalize individuals perceived to be invaders, backwards or a threat to national security, we can expect these rotten-tree policies to spoil many more good apples to come.
Dr Tarek Younis is cultural psychologist with a PhD/PsyD in Clinical Psychology. He is an Honorary Research Associate at University College London.