Racism has been and is central to an understanding of the health of black people in Britain. Black people have played and are playing a central role in the National Health Service (NHS). Their role is, however, shaped by racism. Their experiences as consumers of the NHS are also shaped by racism--in terms of their treatment for both physical and mental health problems. In addition, their specific health problems such as sickle cell anemia have not received the attention they deserve. The NHS has become part of the internal control system of the British racist immigration system. The cuts in the NHS, and in other areas of the welfare state, since 1979 have created the conditions for increasing racial conflict on the one hand and for interracial class-based resistance on the other.