Denial of Islamophobia is harming Muslim doctors in the NHS

The past year has felt like a nightmare of increasing intolerance and violence in the world. At the end of 2023, I wrote a piece in The BMJ with Paul Wallace, my dear friend, mentor, and colleague, calling for inclusive compassion as Jewish and Muslim doctors.1 Sadly, Paul died in February 2024,2 and I feel upset and ashamed that the world is in a worse place now than when we wrote our piece. Hopefully, he is in a far better place.

Muslim healthcare professionals feel frustrated by the constant denial of Islamophobia they experience in the NHS and wider society. This is a form of testimonial injustice, defined as an “unfair deficit of credibility from a hearer owing to prejudice on the hearer’s part.”3 This is adding to the well documented minority tax4 that affects minority groups who face the double burden of first experiencing prejudice and then having to take action to confront it. Muslim healthcare professionals, among other groups, have been dealing with the trauma of losing friends, colleagues, and family in the conflict in the middle east and censorship and exclusion for speaking out.5 In the midst of all of this, the race riots in the UK in the summer of 2024 amplified tensions.6 In a flurry of virtue signalling, leaders and institutions in the NHS denounced racism, xenophobia, and anti-immigration hatred.7 On both occasions, the elephant in the room was Islamophobia.

The violence in Gaza has caused a humanitarian crisis on a shocking scale. It has also increased polarisation, division, and intolerance within the medical profession. Since 2023, the number of complaints referred to the General Medical Council relating to antisemitism and Islamophobia has increased.8 Antisemitism is on the rise.9 Many of my Jewish friends and colleagues have told me how frightened they feel and describe horrific threats they continue to receive to their lives and places of worship. We are all responsible for rejecting racism and religious discrimination regardless of our backgrounds; there can be no hierarchy or tribalism.

I take issue with the constant denial of Islamophobia operating on an institutional level in the NHS, as evidenced by the silence of most of our senior leadership. Muslim healthcare professionals feel “silenced and alone” when speaking about the war in Gaza, reporting self-censorship and a culture of “selective activism and support” that excludes them.5 When there are public calls to burn mosques10 and Muslim cemeteries are desecrated,11 the target of hatred is clear and this needs to be named and denounced by NHS leaders.

In my own circle, many are thinking of leaving the NHS and/or emigrating. The events of the past year have hammered the final nail in the coffin. Several surveys have previously shown that Muslims are most likely to experience religious discrimination in the NHS.12 Doctors who are female, from an ethnic minority, and Muslim face the triple penalty of increased discrimination and exclusion.13 This is experienced at all levels in the NHS14 by Muslim healthcare professionals and is harmful personally and professionally.

I have heard some people make comments like “Islamophobia is complex”, “I don't know what it means”, or “I don't agree with the definition” to justify their silence and inaction. The definition of Islamophobia15 has been agreed upon by experts through extensive consultation as being “rooted in racism and is a type of racism that targets expressions of Muslimness or perceived Muslimness.”15 It is not a perfect term, and the UK government has launched a working group16 on Islamophobia/anti-Muslim hatred to provide a working definition, as hate crimes against Muslims soared in 2024 and were the highest on record.17 Although rooted in racism, Islamophobia intersects with religion, nationality, and gender based discrimination and oppression in a wider system of structural exclusion, and has multiple adverse impacts on health.18

The first step towards tackling Islamophobia is acknowledgement and a reversal of the testimonial injustice that I and my colleagues experience daily. A 12 point plan of multi-level interventions to challenge racism and Islamophobia14 has been proposed based on principles of authentic allyship, advocacy, action, and accountability. Specific interventions include visible role models, tailored coaching, leadership development, and mentoring, including reverse mentoring. Education needs to go further than training in cultural competency, unconscious bias, and how to be an active bystander. There needs to be more focus on cultural humility and safety that helps create work environments that foster ongoing learning, reflection, and constructive dialogue. On an organisational level, inclusive diversity days, a zero tolerance policy on Islamophobia, workforce faith equality standards, intersectional equality impact assessments, faith networks, and psychospiritual support can be helpful.

Change begins with each of us. We must actively nurture a more inclusive, compassionate and equitable world.