The snowy white peaks that range across the NHS has been the subject of recent articles in the HSJ. Those urging the NHS to have a more diverse group of leaders do so on the assumption that having more black managers in senior posts would make a difference. I am not convinced.

‘Look no further than the president of the US, often referred to as the most powerful man in the world yet unable to make even modest changes in his country’s health care service’

In the US they have achieved this goal. Both in corporate America and in the public sector, black people are represented in key senior posts. Many major cites in the states have a black mayor, a black chief of police and prominent black politicians. However, whether it is housing, education or health, inequality persists. Life expectancy is lower and unemployment higher among the black and ethnic minority communities.

Positive message

To those who claim appointing a small number of black people to leadership posts would send out a positive message to ethnic minority staff within NHS trusts and the communities they serve, I say not if their experience of the service is colour blind, not if they still find it harder to get promotion than their colleagues, not if the service continues to fail to recognise cultural and religious differences, and not if people continue to feel that managers, doctors or nurses are judgmental about their lifestyle.

It’s not just about race. A few high profile black leaders will not change the culture within NHS trusts.

If you remain unconvinced then you need look no further than the president of the US, often referred to as the most powerful man in the world yet unable to make even modest changes in his country’s health care service to benefit the disproportionate numbers of black people on low incomes who endure poorer health and shorter life expectancy. His efforts are undermined by the prevailing culture, just as those of a black chief executive of an NHS trust would be.

By all means let’s make every effort to have a fair recruitment process and take steps to ensure boards reflect the diversity of the communities they serve but the goal is not to have more black people in senior posts, it is to have an NHS that is capable of providing a service to the whole community and has the confidence of all sections of the community.

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