Health

After this crisis, remember the NHS is not drained by migrants, but sustained by them | Nesrine Malik


Amged el-Hawrani thought he just had the flu. He thought maybe he was just a bit run down or hadn’t been sleeping enough. By the time he was admitted to hospital with breathing difficulties and put on a ventilator, it was already too late. Three weeks later, he died of Covid-19. He was 55 years old.

The NHS ear, nose and throat (ENT) consultant never knew he had the virus. He was sedated long before the test came back positive, after twice coming back negative. The diagnosis until the final test result was a stubborn bilateral pneumonia. A physician to the end, his last words before being sedated were “why are they taking so long, they need to intubate me”.

As an ENT surgery consultant he was especially vulnerable to catching Covid-19, and was likely exposed to patients whose complaints were coronavirus-related: loss of taste and smell, breathing issues and persistent coughs. “He wasn’t even aware he needed protective gear,” his brother Amal told me, “he was just doing his job.”

El-Hawrani was one of six boys whose Sudanese parents settled in the UK in 1975. Their late father, a consultant radiologist, moved to the UK to gain access to the latest equipment and research in his speciality, and passed on his passion for medicine to his eldest sons. “He had no hobbies, he was always studying, always reading, he loved it,” Amal recalls.

The love for the vocation extended outside of the family, as the El-Hawrani home became a hub for other Sudanese doctors in training. Those who needed advice and guidance on their professional journey, or just needed a place to stay as they did so, found refuge in the El-Hawrani home, rent free. The commitment to family and medicine was passed down. “Most of my dad’s time was dedicated towards his family,” said El-Hawrani’s son, Ashraf, “the rest was dedicated towards his profession.”

Today, the close-knit family, and the wider medical community of friends around it, cannot even seek some small comfort in mourning together. Alongside the shock of El-Hawrani’s death now lies the dread of the disease infecting his mother, who is in her late 70s. Her sons have isolated themselves from her and each other, and turned away mourners.

El-Hawrani was the second frontline doctor to die of the virus. The first was also of Sudanese origin; Dr Adil El Tayar, an organ transplant specialist who volunteered in an A&E department in the Midlands to help fight the virus. Two of the four children he left behind are also NHS doctors.

Following their deaths, the contributions of El-Hawrani and El Tayar and their families to our healthcare system have been held up as exemplars. Yes, they were gifted and selfless, but they were not exceptions. They were part of a community of NHS doctors all over the UK, who are foreign born, or born to immigrants.

In the 1970s and 80s, El-Hawrani and his siblings grew up in a country matter-of-factly hostile to people of colour. His younger brother Amal recalls being told by other children that he couldn’t play with them because he was brown. Thirty years later, the UK is more diverse, but the antipathy towards immigrants has crept upwards, voiced by politicians instead of schoolchildren. The narrative they set for the country in general, and the NHS in particular, is that they are being drained by immigrants who put nothing in and take everything out. This was always a lie, but it has never been a more discreditable one than now.

Alongside El-Hawrani and El Tayar in the honour roll now sit Dr Alfa Saadu, who was also volunteering, this time in Hertfordshire, one of the counties worst hit by the virus; general practitioner Dr Habib Zaidi; and Areema Nasreen, an acute medical unit nurse. The numbers do, and have always told the truth: 44% of medical staff are BAME. For nurses and midwives, it is one in every five, and in some areas such as London, it is four in 10.

Not that the government has made it easy for non-EU migrant doctors to work in the UK. They have to navigate a complex maze of Home Office requirements to renew expensive work visas which are often tied to jobs which are themselves dependent on budgetary constraints. A single fallen domino in this chain ejects a sorely needed doctor from the country.

In its newfound affection for the NHS and such doctors, the government has now shown hitherto unattainable bureaucratic agility, and decided that all nurses, doctors, paramedics and healthcare professionals will have their visas automatically renewed for a year free of charge.

Many of these migrant doctors will be paying a hefty annual NHS surcharge for the privilege of using an NHS they staff, in addition to paying tax and national insurance contributions. This surcharge is set to rise from £400 to £624 a year this October. The health secretary, Matt Hancock, who in November declared that the NHS surcharge was going to be extended because “it’s the National Health Service not the International Health Service”, on Thursday saluted those NHS staffers who perished as “people who came to this country to make a difference”.

These are likely to be temporary face- and life-saving platitudes and measures. When it’s back to business as usual, when the NHS is used as a political pawn, and blame for its underfunding is placed at the feet of migrants, remember Amged El-Hawrani and all the others who fell on its frontline to save lives. Remember their names, their faces, their stories and the families they left behind. And remember that the NHS is not drained by migrants, but sustained by them.



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