South Asian History Month: My career in 'firsts'

The College is celebrating South Asian History Month in July. In the first of a series of blogs, our former Vice President Pearl Hettiaratchy reflects on a colourful and challenging career, charting her journey from adjusting to a new life in the UK and confronting discrimination, to working in the upper echelons of the GMC and the College.

This blog is about my journey through psychiatry from 1968 as a young doctor (wife and mother) from Sri Lanka to being appointed the first South Asian/Ethnic minority office-holder of the College – Vice President in 1995. 

Mine was an unusual journey as I took up psychiatry in June 1968, with little knowledge as to what it was about. It was to secure accommodation so that our young daughter who we left behind in Sri Lanka could join us.

Starting out

My journey started at St. James Hospital Portsmouth in June 1968 on a clinical attachment to test my spoken and written English by the then Wessex Regional Health Authority. These were difficult early days in a new country, adjusting to a whole new way of life, with limited or no resources – no security, no home, family or friends. However, we had each other, our degrees and our faith.

My husband, Sidney, was also doing a similar attachment at the local general hospital in paediatrics, his chosen specialty. Securing permanent employment was near impossible in paediatrics, but I was offered the post of locum Registrar within three weeks of our arrival. Sadly, my father-in-law died suddenly of coronary thrombosis in September, with Sidney having to fly back to Sri Lanka. He was the only son and we were a very close family. So, our savings had to pay for the air fare of £390. These were most difficult days, when I had to live alone in accommodation on the top floor of the psychiatric hospital – a very strange experience when I had never lived alone at any time in my life.

I continued my training, completing both DPM and Membership exams within four years and was appointed consultant in 1975 in old age psychiatry. My husband also completed all his exams and he too was appointed consultant in child and adolescent psychiatry in Basingstoke.

Juggling jobs and duties

The training period was most challenging as you had to combine working, training and on-call duties with family life. We had three children by then and they were aged seven, six, and three months. I approached my consultant post with passion and great enthusiasm, introducing novel and innovative approaches in the treatment of the elderly, access to services and a widespread programme of teaching and training of all staff. This saw the development of psychotherapeutic services to patients and carers, the UK’s first Travelling Day Hospital for the Elderly and The Wessex Region’s Day Release Course in Old Age Psychiatry. I continued to lead my work for the Trust and played an active role in management and service developments.

In 1984, I was headhunted and appointed consultant in Winchester where I lived from 1975. This was an opportunity for me to set up a community-based service with no institution to dismantle. I so looked forward to this new challenge having had a very happy 16 years in Portsmouth where I left as Chairman of the Division of Psychiatry.

My early months and years in Winchester were most traumatic with racism, overt and covert displayed – it was a baptism of fire! I was the first female consultant appointed in Winchester in any specialty. I was also a saree-wearing consultant!I dealt with all these difficult issues sensitively, firmly, professionally and had the support of my husband, our children, trusted colleagues from Portsmouth, friends and my deep faith.

Advocating across the board 

Throughout my career I have combined my clinical work with contributions to other health-related organisations. These included the Royal College of Psychiatrists, General Medical Council, Mental Health Act Commission – later CQC, Lord Chancellor’s Dept, DOH, work with the Chief Medical Officer, BMA, and various voluntary bodies.

Interestingly, I had to serve on the Region’s Distinction Awards Committee, the Trust and College’s awards committees too. I was also the Lead in Clinical Governance. At the Royal College of Psychiatrists, I have served on many committees –Psychiatric Practice and Training in a British Multi-Ethnic Society, Executive Committee Section of Old Age Psychiatry, Nursing Committee, Unethical Psychiatric Practice, and worked with the Dean and DOH on mental health services to ethnic minorities.

At the General Medical Council, I served on the Professional Conduct Committee, Review Body for Overseas Qualified Doctors, Steering Group on Performance, Race Equality Group and Working Group on Professional Conduct Committee. I was also appointed one of five screeners in 1997 to deal with complaints covering conduct and performance. My term of office with the GMC ended in 2013, when I resigned as an Associate as all the hearings were moved to Manchester.

I firmly believed that the wider contribution I made kept me alive to local, regional and national issues, as well as keeping me updated, and in turn enhanced the care I gave to each patient. I was also able to bring back to the Trust experience and expertise gained.

Dedication and passion

I retired from my consultant post at age 60 in 2002 but continued with all the other health-related activities. It felt as though I had stepped off the treadmill! It was the 24-hour responsibility I carried for my patients combined with heavy on-call duties that had to end at 60! My clinical work always took priority, and this meant working most weekends and evenings even if I wasn’t on call.

In all my work, I have strived to achieve systems that are fair, just and discrimination free. I have always aimed to provide patient-centred, quality-assured care to each patient and their families. On some occasions, I have taken unpopular stances in the best interest of my patients. One of these led to the Ombudsman reviewing the decision managers made on the care of my patients, overruling my clinical decision and discharging patients whilst I was on holiday. A select committee hearing followed with severe censure of all managers involved, positively influencing long-term care of the elderly, vindicating the stance I took.

Throughout my career at different times I have faced discrimination and racism both overt and covert. I have dealt with it sensitively and effectively. I am a better person for having faced it and have always risen above it.

My many firsts 

There were many firsts in my long career when one would say glass ceilings were shattered.

1984 – First woman appointed consultant to Winchester Health Authority in any specialty and I was the first South Asian woman too, a saree-wearing woman.

1994 – First Sri Lankan to be elected by the Profession to the General Medical Council in the long history of Medical Regulation. This was celebrated by my family in Sri Lanka too. It is good to recall the words of the late Sir Robert Kilpatrick (President 1989-1995) “Dr Hettiaratchy, you are the first ‘sareed’ lady to grace these chambers”. I continued to grace the chambers for two terms ending in 2003 and elected a second time in 1999.

1995 – First South Asian/Sri Lankan to hold high office at the Royal College of Psychiatrists. I served as Vice President to Dame Fiona Caldicott and later Prof. R. Kendall.

1997 – First Overseas Qualified Doctor/Asian/ethnic minority to be appointed by the GMC as a Medical Screener for Complaints against Doctors. These were difficult times as there was concern from the profession on issues of discrimination and racism and how the GMC dealt with them. My appointment I was told by the President, the late Sir Donald Irvine, had to be agreed by the whole council individually and officers as the appointee had to have the confidence of all of the GMC. It was highly sensitive work I did for over a decade screening 20 or so complaints each week.

2002 – First Sri Lankan to be appointed OBE by Her Majesty for services to the elderly in her Golden Jubilee Honours.

2003 – First South Asian woman to be elected as an Honorary Fellow of the College. The citation refers to my work with the elderly, race equality and discrimination and healthcare as a whole.

2009 – First Sri Lankan woman to be appointed Deputy Lieutenant of Hampshire.

My career of choice

Since I became an officer of the Royal College of Psychiatrist, many have followed since then – and today, with some 40% of members from BAME communities, I would hope that at all levels within the College BAME members are equitably represented. I hope this blog inspires anyone reading to understand the rewarding nature of the work of a psychiatrist, but also outlines the trials and tribulations that have to be faced in pursuing that career. 

In the career information packs I contributed to in 1990 to 1996, I said: “At the core of psychiatry is the ability to empathise, understand and give something of yourself to the patient within the therapeutic relationship”. This still applies today, for every patient I see.