“I want to be white,” he said.

I didn’t know how to respond.

I was quiet.

He was serious, waiting for my reply.

He was only 8 years old, in the hospital with an asthma flare-up.

I had asked him, “What do you want to be when you grow up?”

I wished I hadn’t.

I’ve thought a lot about his answer in the years that followed.

Sometimes, I wonder what he’s doing these days.

I wonder whether he still wants to be white instead of Black.

The health care experience of a Black or Brown person is profoundly different from a white person’s.

There is a deep, intense history to this, with wide repercussions being felt today.

But it’s not just history, is it?

There is a huge, active wave of racism working through the NHS today—on every level.

It’s rooted in the financial and educational disenfranchisement of ethnic minorities, stemming from legacies of racial discrimination and white superiority, slavery, and colonialism.

It’s this that underpins poor health outcomes for African and ethnic minorities.

Cradle to grave, health outcomes are worse for Black and Brown patients than for white patients.

Death in pregnancy and childbirth is:

• Five times more in Black women
• Two times more in Asian women

Stillbirth and death in the first month of life is:

• Highest in Black babies
• 1.5 times more in Asian babies

From mental health to asthma:

• All outcomes are worse in Black and Asian patients

Black and South Asian dementia patients die younger.

If you are a patient from an ethnic minority, then health inequality grips your hand and follows you wherever you go.

None of this was covered in my GP training.

I found it rarely discussed at mainstream educational events in more than a footnote or aside.

I’ve not heard it mentioned in staff training at GP practices, in clinical or practice meetings.

It’s usually people who already care about these issues who seek out training and raise awareness.

Where is the sense of urgency?

Patients are dead because of their skin color.

This is an emergency.

Solutions aren’t simple.

It is not easy to tackle embedded racism and associated socioeconomic factors.

We need more than the glacial pace that things are moving at now.

The experience of physicians is not equal either.

Physicians face racial discrimination at work, from patients and colleagues, all the time.

• Fifty percent of junior physicians and 40 percent of consultants are from ethnic minority backgrounds.
• Why does this shrink to 11 percent at the executive level?

After all, this is where the real power to effect and finance real change sits.

There is not enough authentic representation here, or in government, to make real health, social, and economic reforms.

We need to stop young Black patients from wishing they were white.

“I want to be white,” he said.

I didn’t know how to respond.

I was quiet.

He was serious, waiting for my reply.

I cowardly changed the subject.

I was in shock.

But given how things are, I shouldn’t have been.

What would you have said?

Seema Pattni is a physician coach.