Should the NHS consider a racism fee?

https://www.itv.com/news/2019-10-31/...tv-news-finds/

Let's say a patient learns that his surgeon is brown, and requests the planned procedure be performed by a white surgeon instead. It may be ethically dubious to accommodate racism, but, in practice, such requests will often be accommodated, because the healthcare system has an obligation to provide care, and the relationship between a patient and their physician may be irreparably damaged by overt racism.

If racists must be accommodated, why not price in the negative externalities by charging a fee that can cover the cost of administration and rescheduling? If a patient asks to see a white doctor, their visit will be terminated, and they'll be rescheduled, but they'll also receive an invoice with a clear explanation for why they, unlike everyone else being served by the NHS, are on the hook for a few hundred quid. Repeat ad infinitum. If racists must plague society, society may as well make money off of them.

PS. The vast overwhelming majority of patients are decent or at least sufficiently well-socialized that they do not express overt racism. You're probably more likely to encounter sexism than racism, in healthcare. That said, my friends working in England have definitely noticed an increase in casual racism, primarily from patients, directed towards all categories of staff at their hospitals. Obviously my suggestion isn't serious, but this problem is very serious.

No. Don't try and use government health services to engage in punitive social engineering. If you want to impose a "reject your doctor" fee, you need to apply it to all requests, not just those who want a doctor with a different skin color. I will grant there is a measurable cost to accommodating requests to effectively "customize" your healthcare professional to your comfort-preferences but I see no reason why only the racists should be expected to pay for doing so. "Because Aimless doesn't like and is offended by their socio-cultural politics" is not any sort of good reason. Keep the invoice notification that the reason they're being charged is for requiring a customized reschedule and you'll maintain the desired pocketbook disincentive for the behavior. You just get denied the opportunity to generically sneer in judgement at anyone you don't like for free on top of it. You already have venues for that.

Govt health services are already used to engage in social engineering in the UK, typically with legitimate medical and health-economic justifications. Social opprobrium is an excellent way to discourage overtly racist behavior, and if you're okay with asking for a white doctor, it should be okay to clarify, on your invoice, that the rescheduling was because you asked for a white doctor. As a rule, the NHS doesn't charge fees for missed appointments that need to be rescheduled, so it's fair to motivate the charge—it would, after all, be a departure from the practice of not charging for appointments that need to be rescheduled. It should also be possible to arrive at a cost estimate for the impact of racism on healthcare workers. That cost is an unnecessary one currently borne by the NHS, but it isn't paid for. It's becoming a major work-environment issue, so it's entirely legitimate to explore different strategies for mitigating it. In some hospitals you'll see signs notifying patients that threats and other forms of aggression may see them removed from the premises and, if appropriate, reported to the police. It's not a big step from that to being able to impose a fee for racist rescheduling requests.

Don't get me wrong—I don't believe any healthcare system would implement this idea, nor do I wish to see it implemented myself. I do however think that this type of racism has a real cost—beyond the cost of rescheduling, there is the cost of the victim's reduced happiness and productivity—and wonder what would happen if individuals were required to bear the cost of their racism themselves, rather than being able to unload the full cost onto their victims—and onto the NHS.

If someone refuses treatment they should be sent packing.

Such vile behaviour shouldn't be tolerated with a "rescheduling" or anything else.

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Originally Posted by RandBlade

If someone refuses treatment they should be sent packing.

Such vile behaviour shouldn't be tolerated with a "rescheduling" or anything else.

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Yeah this is the right decision. They could always go shop for private care from the race or gender of their preference if they really want to.

Not my point. This is not a state v private issue and if someone came to my business and asked for a white member of staff to serve them I'd tell them they were no longer welcome a customer and to leave.

The NHS has a duty of care to all, regardless of race, creed, religion, criminality and in this case outlook, no matter how distasteful.

Such a system as outlined by Minx would likely not be implemented, not mainly because it is overtly racist, but mainly because it adds logistical complexity and administrative burden which an overstretched NHS can ill afford.

A request coming from an Alf Garnett type to be treated by a white doctor would I suspect be wearily accommodated if possible - a white doctor being available that is. The importance being, from the duty of care point of view, that the patient gets their treatment.

The NHS has a duty of care yes but patients have a right to refuse care.

If care is refused that should be the patients choice and the end of the matter. Unless that results in risk to others due to spread of contagious disease.

If someone refuses treatment against medical advice and insists on a homeopathic treatment instead then I don't believe the NHS has an obligation to indulge them on that. If someone refuses treatment against medical advice because their hardworking doctor's race, gender, religion or anything else I fail to see why we should indulge that more than any other fruitcakes.

Maybe I'm missing something but it seems simple to me.
Be offered treatment - treatment accepted job done.
Refuse treatment - be sent home.
Abuse staff - be sent to the Police instead.

What am I missing? I'd rather stand with the doctors than any scum that abuse them.

So, the people saying people saying the person refusing to treatment by a non-white surgeon should be told to take who they're given or GTFO and STFU: you're coming from the right place and I respect that, but consider that that non-white surgeon also has the right not to be subject to racism while they're trying to do their job?

Because if they're given a choice between having a black or asian surgeon, and not having surgery they're probably going to go with having the surgery. And then be a dick about it.

Yeah exactly. If they abuse the staff they should be treated as criminals. Zero tolerance for abuse. If a surgeon doesn't want to treat a racist and another surgeon will I would back the NHS staff 100% with that, but if a racist wants to cherrypick who will treat them I am not OK with that.

The welfare of the staff comes before the racism of the scum.

At least in London, I've found that most NHS staff I've encountered are nonwhite. The system overall is 20% nonwhite and most of the nonwhite staff are on the medical side, so folks should get used to the idea that their doctor could be any race.

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Originally Posted by RandBlade

If someone refuses treatment against medical advice and insists on a homeopathic treatment instead then I don't believe the NHS has an obligation to indulge them on that. If someone refuses treatment against medical advice because their hardworking doctor's race, gender, religion or anything else I fail to see why we should indulge that more than any other fruitcakes.

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Homeopathy is not the same thing. The NHS does not offer homeopathic treatment.

Quote:

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Originally Posted by RandBlade

Yeah exactly. If they abuse the staff they should be treated as criminals. Zero tolerance for abuse. If a surgeon doesn't want to treat a racist and another surgeon will I would back the NHS staff 100% with that, but if a racist wants to cherrypick who will treat them I am not OK with that.

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The NHS treats criminals. Like I said, the duty of care extends to all.

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And we are talking about the symptom here and not the cause. As the article in the OP states, recorded statistics of racist incidents has increased recently due to an environment where it has become more acceptable. The article mentions Brexit, a toughened stance on immigration, and the appalling rhetoric used by politicians as reasons for this.

That culture shift toward racism and the increase in hate crimes is a recent trend, and it needs to be reversed. Politicians have a responsibility.

Homeopathy is exactly the same thing. If it works it is entirely due to the placebo effect, which is medically recognised, but there is zero medical reason for it just as there is zero medical reason to cater to racism.

I am not suggesting that racists should be denied treatment. Yes treat criminals, yes treat racists, treat everybody. But if treatment is refused then so be it. We don't force treatment on people and if they don't want to be treated then send them packing don't reschedule with different staff.

I see no medical justification to pander to abuse and racism any more than there is a medical justification to pander to those who wish for homeopathic treatment.

Quote:

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Originally Posted by RandBlade

... there is zero medical reason to cater to racism.

I see no medical justification to pander to abuse and racism

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These do not make any sense. :confused: Medical reason has nothing to do with racism. Treatment is agnostic. Medical 'justification' is agnostic.

I think we're talking at cross-purposes. I make no references to those who refuse treatment. We were purely talking about whether a racist should be treated. If you refuse treatment because said treatment is not homeopathic, or said treatment is administered by a darkie, or said treatment is not provided by a pink sparkly unicorn then so what, you can refuse treatment for whatever idiotic reason you like. I really dont care.

The treatment itself is completely agnostic. As it should be.

Absolutely treatment should be completely agnostic but if treatment is refused then why should it be rescheduled?

I thought we were talking about a case where eg a bigot says "I don't want treatmentment by that doctor, I want a white doctor". To me the answer is no there's no medical reason to reschedule treatment you treat the doctors with the respect they deserve or you are declining treatment and good luck to you. Why should we pander to bigots who refuse treatment for non-medical reasons?