The accusation comes as Sir William Macpherson's report on the police handling of Stephen Lawrence's death accuses the Metropolitan Police of similar failings.

Dr Jane Richards, who chaired the BMA's working party on racial equality, said Sir William's definition of the term would "broadly apply to the health service".

It would not be an exact fit, she said, because while racism exists in the NHS, it also exists in society as a whole.

So while there are health care professionals who are racist towards their patients - unwittingly or otherwise - patients are often racist to NHS staff, she said.

"The NHS has been looking at this issue for some time. Back in November there was a plan of action drawn up to tackle racial harassment."

Plan of action

The BMA took part in the initiative, which was set up by the NHS Equal Opportunities Unit.

Then Health Minister Alan Milburn called for "zero tolerance" of racism in every part of the service.

Dr Richards said: "Racism affects all parts of the NHS - doctors, managers, nurses. But some of it comes from patients towards staff.

"In that way it broadly fits with that [Sir William's] definition of institutionalised racism.

"But it isn't just a case of the NHS being bad, unfortunately it's a two-way business.

"The NHS has faced the problem, is aware of it and is being very up front about it. And that's very important."

Long-term problem

But the problem has plagued the health service for decades.

Dr Richards said she had seen patients make judgements based on ethnic background.

"During the years I've worked in the NHS I've heard patients say Oh, I don't want that midwife to look after me'. It's that sort of thing that hurts," she said.

However, racism can manifest itself through doctors' attitudes too, she said.

"I'm afraid that sometime the handling of a patient's treatment is not so good - people are sometimes treated less kindly.

"We also have the very big problem of how far we go to meet the needs of people from ethnic minorities who have difficulties explaining their problems.

"How much do we take into consideration their ethnic backgrounds? How much do we consider their difficulties with the language?

"We aren't perfect. This is honest, and honesty on this issue is important."

She said it was Sir William's concept of "unwitting" racism that applied most precisely to the situation in the NHS.

Studies show racist career structure

Dr Sam Everington, a GP in North London, has carried out studies to gauge the extent of racism within the medical profession.

His research suggests that racism permeates every step of the medical career ladder.

One of his studies indicated that medical school applicants with European sounding names had a better chance of getting an interview than those with Asian sounding names.

Another found that top consultants were at least three times as likely to get a merit award if they were white.

A merit award is worth up to �58,525 on top of a �61,605 salary.

A third revealed that black doctors were six times more likely to be disciplined by the General Medical Council.

Dr Richards said her experience supported Dr Everington's work.

She had heard of cases where doctors had been advised to use shortened, "more European-sounding" versions of their name to secure advancement.

However, progress is being made to tackle the problem, she said, as was illustrated by people from ethnic minorities taking up senior positions.

"Racism is still around, but it is fading. We need to able to say that, yes, this sort of thing does happen but also that we are prepared to tackle it.