Consultant Cardiothoracic Surgeon, Royal Infirmary of Edinburgh, Edinburgh 

Cite as: Zamvar V. Editorial: Inequality and Diversity. The Physician 2014 vol3(1)

When I was growing up in India, I often heard about how “Unity in Diversity” was one of the pillars of the Indian nation. Diverse ethnic populations thrived in the melting pots of Bombay, Delhi and other metros. However, there was always an undercurrent of inequality behind the facades of these slogans, and beyond the major cities.

Inequality thrives at various levels even in the UK. Social scientists and politicians debate a lot about our unequal society, and have at times diametrically opposite ideas for dealing with it. However, there is another kind of inequality that affects mainly the minority groups in the UK. As you skim through this issue of the Physician, you will come across many articles that explore why South Asians lag behind in many of the health indicators in areas as diverse as mental health, and breast cancer.

Mammographic technical quality appears much lower for Asian women who cannot understand English (page 23); Significant disparities exist in post-mastectomy breast reconstruction between Asian and Caucasian women in Manchester (page 39); Breast screening uptake rates remain low in ethnic minority women (page 38).

Inequality is suffered not only by the recipients of healthcare, but by the providers as well. A recent GMC report concluded that Black and Ethnic Minority doctors from the UK are twice as likely to face sanctions from the GMC compared to White UK medical graduates.

This issue of the Physician also highlights some of the various quality improvement projects in the NHS. Dr Abhaya Gupta describes how a geriatrician-led system for the care of elderly patients with hip fracture improves outcomes. Many may consider this a no-brainer (quality improves if you shift responsibility for care of elderly patients with multiple co- morbidities from orthopaedic surgeons to any other group of physicians) (apologies to my many orthopod friends).

Prof. Bhugra explores how cultural influences play an important role in the patient-physician relationship. It behoves physicians to be aware of the cultural beliefs of the patients they serve.

Prof. Sandhu explores the various factors that motivate doctors. Very poignant is his quotation of Muhammad Iqbal’s epic poem “Khudi ko kar buland itna ke har taqder se pehle khuda bande se khud pooche, bata teri raza kya hai”. “Rise to such heights that God himself asks you, what do you wish your fate to be”

With this meeting in Manchester (Towards excellence in patient care), and with this issue of the Physician, if young BAPIO members can feel motivated to dream on and look beyond the immediate horizons, BAPIO would have partly served its mission.

“Sitaron se aage jahan aur bhi hai, aur bhi hai”.