Beware treading the racist path

I am disturbed by the new Records 21 target: 'Ethnic origin is recorded for 100 per cent of new registrations'.

Obviously a patient's ethnicity is relevant in certain clinical situations - for example CHD risk, renal disease, susceptibility to TB and the choice of anti-hypertensive treatment. So why am I concerned about the target?

It is because of the emphasis on gathering racial information at the moment of registration.

The whole point of a non-racist attitude is to avoid using someone's ethnicity as the prime way of labelling them: we should be as 'colour-blind' as possible, seeing the person, not the racial group. So why does the DoH ask us to emphasise ethnic grouping immediately a patient comes to a new surgery?

It is offensive. What erroneous impression does this give of the practice's attitudes? The DoH might imagine this is just another bureaucratic enquiry, but with a target of 100 per cent, practices are effectively obliged to ask about ethnicity at the point of registration rather than wait for the completion of a health questionnaire or a subsequent new patient check.

Early evidence suggests this question most frequently offends non-Caucasians - so asking about race early on is in itself racially divisive. (And why is the DoH targeting just ethnicity? Why not smoking habits or a family history of CHD?)

The DoH must recognise that an early enquiry about ethnic origin looks and feels racist. Not only is it offensive to the patient, it is also offensive to practices which are truly colour-blind, because it forces them to do the exact opposite of what they want.

The solution is to adjust the target to 90 per cent, with a six-month breathing space before new patient ethnicity data is counted. The gap would allow this important information to be collected during a routine clinical encounter - a much more neutral and appropriate time to ask such a delicate and personal question. It also allows the clinician to explain why ethnic information is so important.

And the 90 per cent target would hopefully remove the need for any embarrassing target-chasing phone calls ('Sorry to trouble you: it's the surgery here. Which ethnic group are you from?') to those who haven't actually attended since registering. It's a small change, but an essential one.

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