Discrimination and the development of general practice

Chapter 4 shows how a discriminatory professional environment limited doctors’ professional options and how their responses to this context contributed to defining the nature of British general practice. The entry of medical migrants into general practice was unplanned both by central government and doctors themselves. Understanding how doctors ended up working as GPs and being overrepresented in industrial parts of Britain involves developing an appreciation of the environment that the NHS provided at the time. Doctors’ decisions to stay in Britain were made in a professional context which was characterised by racism and what Albert Memmi has termed ‘heterophobia’ (i.e. the fear of difference). Being marked as non-white, and more generally as different directed South Asian doctors towards less prestigious roles in medicine, such as being a GP. A second layer of discrimination occurred within general practice, resulting in migrant doctors being disadvantaged when it came to obtaining GP positions in the more desirable areas.