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Don’t say it if you don’t mean it! Guest blogger Jacqui Francis writes on NHS race (in)equality

See also:

Tackling race inequality in the NHS - how Public World can help you.

Data, dialogue and development: Presentation to the Chief Nursing Officer's Black and Minority Ethnic Advisory Group, Brendan Martin, March 2015

Race in the workplace: a barometer of organisational health, Veena Vasista, January 2015

Discrimination by Appointment: How black and minority ethnic applicants are disadvantaged in NHS recruitment, June 2013

For as long as I can remember recruitment campaigns have been searching for ‘The Holy Grail’ – that day when they have a shortlist of diverse interviewees who reflect the communities and workforce they serve.

My experience of working with the NHS for over 10 years as an external panel member in the selection of non-executives directors to NHS Trusts and recruitment to expert bodies is that this grail is as elusive as ever.

However, every organisation I’ve worked with wants diversity.  I know they want it because they say they do. They say it everywhere – in policies, at presentations, seminars, training courses, on websites, application forms and every advertisement for a post.

Usually at the bottom of the page, somewhere in the small print, you will see the ever-expanding statement, trying to keep up with changes in equalities legislation.

It can read like a list from the thesaurus. We would welcome, are committed to, are working towards, respect (respect and value), recognise. I could list more but you get the point. Organisations say it all the time.

However, according to Roger Kline, author of the The “snowy white peaks” of the NHS, we are not increasing the numbers of people from ethnic minority backgrounds in NHS senior executive or non-executive roles.

The NHS has 1.3 million people working for it. A Health Service Journal survey in 2008 found that 16% were from an ethnic minority background. Kline’s report quotes Trust Development Authority (TDA) and Health and Social Care Information Centre (HSCIC) figures showing that in 2013 5.8% of non-executive directors and 5.9% of senior and very senior managers were from an ethnic minority background. This is despite many initiatives – NHS Leaderships programmes, Bevan, Seacole, Jenner .... and research.

I shouldn’t doubt the commitment. Staff are briefed, watch webinars, and receive emails and reminders of the values and expected behaviours of the organisations. They are also sent on training courses. They usually have at least one of the following words or phrases in the titles: under-representation, diversity, inclusion, equality, fairness and recently ‘unconscious bias' training/awareness raising - although after all this time, I would have thought the title should be ‘conscious bias’! They are told about the economic value, the social value, corporate social responsibility, governance, best practice and why diversity ultimately makes sense for patients, the organisation and stakeholders.

However, what keeps coming back to me are two points: 

1. While undertaking training in Solution-Focused Counselling the trainer reminded us that we spent two thirds of our time discussing the problem and not enough time on the solution. 
2. The second point is– ‘the problem is not the problem’.  We no longer work on the ‘problem’.  We’ve become stuck in the ecosystem that has grown up researching the problem, developing better data collection, organising and re-organising the metrics, re-writing policies, writing new policies and improving reporting systems.

We’ve become stuck in a systems, processes, numbers vicious circle.  We continue to be told that we need more women – what should we aim for?  Should it be 25%, 30% or 40%?  At a recent ESRC seminar at Aston University on Equality Diversity & Inclusion, Binna Kandola helpfully told us the figure was 50%.  (Just think about that for a moment and you’ll get it).  We keep going round and round the same issues and yet little changes.

It’s time to take action, so don’t say it if you don’t mean it.  If you say you are committed, why not try the Neil Armstrong approach - one small step.

You know that criterion usually found at the end of job descriptions; they all have it, they say things like ...  'demonstrate understanding of diversity, must have a commitment to'... etc.  Try putting that criterion first – then stand back and listen to the reasons why you can’t! You might be surprised how the discussion goes.

However, why should putting it first be a problem? Just take a look at your organisation's diversity statement.  You are, after all committed to increasing the under-representation of diverse groups, and you welcome applications from under-represented communities.  What better way to demonstrate that than by making sure it’s the first criteria applicants read in the person specification for the role for which they have applied?

After all, you wouldn’t say it if you didn’t really mean it – would you?

  • Jacqui Francis is a TDA panel member and an independent consultant 
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