Response by BIMA to the GMC statement regarding a complaint involving a GP and patient wearing a face veil

We, the British Islamic Medical Association (BIMA), would like to thank the General Medical Council (GMC) for their balanced and reasonable response to the recent highly publicised complaint involving Dr Keith Wolverson and an unnamed member of the British public who wears a niqab (face veil) [1]. 

We hope that this incident is handled in a way that protects the dignity of both the patient and the doctor in question, and await further details as they are made available. Due to the public nature of the discussion and some troubling responses from the general public and fellow professionals alike – we would like to make the following observations: 


1. The facts of this incident are unclear therefore there should be no rush to judgement
This is an ongoing investigation where there are clearly two sides of the story and facts are yet to be established [2]. We oppose presuppositions being made towards Dr Wolverson of racism or Islamophobia just as we reject the narrative that the patient or her husband are seeking to blow an innocent request out of all reasonable proportion.
 
2. This should never have been a debate about the niqab

We must be clear here that the issue is not about whether the niqab belongs in British society, or whether it is part of genuine Islamic tradition, or whether it is morally right or wrong. These issues are completely outside the realm or the expertise of the profession.

3. We worry about the implications of taking complaints public

It is not advised that GMC complaints be taken to the press whilst still under investigation. Yet despite this advice, Dr Wolverson has engaged with The Sun and then subsequently with the Daily Mail. His choice to publicise the issue and the platforms he chose – tabloids with a long history of anti-minority, xenophobic and Islamophobic articles – has caused a swell of negative opinion directed at all Muslim women who wear the niqab. 

In the current environment, it is extremely unlikely that a member of an ethnic minority, a female, a Muslim, and one that wears the niqab – would be portrayed fairly by the tabloid press. The level of Islamophobia whipped up by this single news story has been as easily predictable as it has been disheartening. 

No matter the outcome, we feel that trial by media and the vagaries of public opinion is never the right answer to a complaint – for the clinician or the patient. We appreciate that clinicians are operating in increasingly pressured environments where mistakes, errors in judgement and compassion fatigue are more likely to occur.
 
Furthermore, we recognise the significant burden that complaints cause clinicians, especially if they are unsubstantiated or vexatious in nature, and the desire to respond robustly to them. It is imperative that professional regulators continue their reforms of fitness to practice processes to protect staff from such harms. 

4. We are concerned by the assertions of extremism from professional colleagues

There have been a significant number public comments made by healthcare professionals that have crossed the line from supporting a professional colleague into demonising the entire Muslim community and recycling Islamophobic tropes. Sadly they are so numerous that we cannot list them here, but cover most of the stereotypes outlined in the APPG on British Muslims report [3]. 
 
The fact that healthcare professionals harbour these views, especially in the absence of any evidence, is alarming. It clearly reflects that the insidious trend of intolerance and Islamophobia in our society has not spared our colleagues in the health sector. This needs to be a priority area where we explore the impact Islamophobia is having on patients, staff and the health system.

Dr Wolverson’s own comments in this regard are unhelpful, where he alleges that the husband orchestrated the complaint against him, and that this is “not the way towards social cohesion. We tolerate too much extremism, I’m afraid, and don’t challenge it” [4].

5. There is no evidence the niqab prevents communication

Many have argued that it is not possible to consult effectively with a patient wearing a niqab. We reject this assertion and urge those who ascribe to it to reflect how they may practice with greater inclusivity and respect diversity. Busy clinicians communicate safely every day to patients with strong accents on the telephone, during surgery wearing face masks, and behind curtains during examinations.

This position is supported by published evidence: a 2011 University of York study into the effects of face coverings and acoustics demonstrated negligible transmission in sound from communicating with niqab wearers. In fact, only surgical masks were shown to have significant effects on sound transmission. The authors suggest that reports of niqab unintelligibility may stem from heavy accents or an element of prejudice, rather than on grounds of speech perception [5]. In the same year another study in the Netherlands examined the facial expressions of niqab wearers and found that expressions of happiness, sadness, anger and fear could be recognised amongst niqab wearers [6].

There are caveats such as when communicating with those who lipread, are hard of hearing, or in critical emergencies, but these are the exceptions that prove the rule. Many women who observe the niqab may remove it in these circumstances, and there are many cases where clinicians have positive relationships with such patients. It is through partnership with our patients that any such barriers can be bridged. 



[1] The Doctors’ Association UK http://www.facebook.com/TheDoctorsAssociationUK/posts/341973273185889 
[2] Wooller S, Pattinson, R. Family GP could be struck off for asking Muslim mum to remove veil during appointment because he couldn’t hear her. The Sun 18 May 2019 https://www.thesun.co.uk/news/9100445/gp-faces-axe-muslim-woman-remove-niqab/
[3] Report on the inquiry into a working definition of Islamophobia / anti-Muslim hatred. The All Party Parliamentary Group on British Muslims 2018.
[4] Jones, D. GP facing the sack for asking a Muslim woman to lift her veil so he could hear what was wrong with her little girl says he’s ‘bowled over’ by public’s support after 59,000 sign petition. Daily Mail 25 May 2019 https://www.dailymail.co.uk/news/article-7069015/GP-asked-mother-surgery-lift-veil-no-longer-career.html  
[5] Llamas C, Harrison P, Donnelley D and Watt D. Effects of Different Types of face Covering on Speech Acoustics and Intelligibility. University of York 2011.
[6] Kret M, Gelder B. Islamic Headdress influences how emotion is recognized from the eyes. Frontiers in Psychology. 2012 Vol 3. Article 110.

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