NHS must conquer nervousness over leadership diversity

This week HSJ celebrates the contribution of healthcare leaders with a black and minority ethnic background. We have identified 50 pioneers who have all improved the ability of the NHS to respond to the needs of one of the most diverse populations in the world. Many, of course, are also leading figures in their own sector or discipline. Throughout the magazine and online we explore the nature of the contribution and examine how it might be enhanced.

‘Any group of leaders will tend to recruit in their own image, meaning those who do not fit that image will struggle for support’

But despite the significant record of BME leaders within the NHS, nervousness is the abiding emotion when exploring why, in former chief executive Sir Nigel Crisp’s redolent phrase, the service’s upper echelons are dominated by “snowy peaks”.

Any group of leaders will tend to recruit in their own image, meaning those who do not fit that image will struggle for a peer group and support. But the “snowy peaks” problem has its own unique mix of characteristics.

Reluctant establishment

The first − and perhaps most significant − is its lack of profile. While most NHS leadership groups would be very happy discussing the appropriateness of services for the BME community, the conversation rarely moves to the ethnic mix of that group.

The white establishment in health − let us recognise it for what it is − shares the reluctance of most British institutions to be too active in this area; largely out of a cultural aversion to overt tactics like quotas.

‘The credibility of the NHS as a national institution demands a leadership mix that better reflects the population’

BME leaders tend to pride themselves on having reached their position by merit and many rising stars avoid activism fearing that they will be pigeonholed as race warriors.

It is also the case that BME communities can be very demanding of people who do manage to achieve leadership positions. Those BME leaders who are not deemed to be energetic campaigners for their community are often criticised for having forgotten their roots. In doing so, the critics − acting out of the best intentions − force the brightest and best to pass another test that their white counterparts do not have to.

The 2011 census indicates that over 15 per cent of the English population is from a non-white background. The credibility of the NHS as a national institution demands a leadership mix that better reflects that. We hope HSJ’s BME Pioneers will highlight the issues faced by future leaders and provide encouragement and inspiration to help them achieve their full potential.