The future of race in the NHS

A member of the Executive Committee of the NHS BME Network marks Black History Month by looking at the need for diversity in the workplace:

My first thought is the Master’s tools will never dismantle the Master’s house. For there are no new ideas in the NHS race debate, there are only new ways of making them be felt.

The spaces where we talk about these issues are at risk of becoming a sinkhole for the radical and high-energy so necessary for any meaningful shift. Black History Month and its varied resonance with BME colleagues is a timely reminder that not all colleagues feel the same. And they’re all in unique and different places.

To refuse to participate in the shaping of one’s future is to give it up. Yet what hashtag, conference, workshop, diversity training, evidence-gathering process have we not engaged with to bring about change? What is that internalised barrier that keeps the NHS from addressing the problem once and for all?

Probably the most misunderstood aspect of creating lasting change is the belief that, once we know what we should do, we will automatically follow it through. If this were true, everyone would always have healthy habits and be following West Ham United Football Club for great sport! We know, however, that this is not the case. Every single change, no matter how small, is hard.

Human beings are entrenched in their desire to do what is familiar, and really dig in their heels against change when they have a competing commitment. Black History Month is a useful opportunity to remind people diversity does not mean competition.

From local to international recruitment within the NHS, the idea of merit is what drives most hiring decisions. At least, that is what we like to believe. But is it always the case? Sometimes, covert racism and inequality play a nasty role. It is a counterproductive injustice as it often leads to low job satisfaction depending on the racial composition of the workplace. Workplaces with a higher number of white leaders in senior positions, compared to ethnic or racial minorities lead to disgruntled minority employees and vice versa. It means workplace diversity is an essential factor for job satisfaction.

Black and ethnic minorities recruited into jobs in the public sector can only do well if the positive societal values are there. Taking the recent example of Naga Munchetty, a BBC presenter of the Breakfast program who came under fire for airing her views on the US President Donald Trump.

The values of the BBC came under severe scrutiny when they failed to stand by their presenter for speaking up against a clear racist statement by the US president. On the contrary, they proceeded by creating a hostile work environment for her with their handling of the situation. Could you say the NHS answers similar questions of asserting public morality and accountability into its institutions?

It is sturdy enough dealing with racism and injustice from ignorant individuals in society. Facing the same from an employer who is meant to protect and respect your rights as an individual can only go on for so long.

Black History Month is a useful reminder that ethnic minorities, especially those from overseas, have had to play second class employees for decades in the NHS. It is wrong. We know that racial composition if balanced has benefits like culture exchanges, increased job satisfaction, high productivity, retention of best talents, a better attitude of employees and more.

What does this mean for NHS employers? It means adopting actionable values for recruiting people. They should be intentional about getting a balanced and diverse workplace. Any organisation that is publicly funded must set and publish targets to ensure they are representative of the taxpayers they deliver for. Low job satisfaction is like dry rot. Once it starts, it finds its way throughout the organisation, and sooner or later, everyone feels the impact. It affects productivity and output. We can all agree no employer wants this. Least of all the NHS.

The necessary ingredient to make the past work for the future is our energy in the present. Continuity does not happen automatically, nor is it a passive process. The white majority chooses it.

What you hear in my voice is hope not moral authority nor despair. A hope and belief that the bend and recognition towards People issues of the NHS, will herald a change. Black History Month is a great catalyst to emphasise that agenda. I hope you celebrate it well wherever you are.

Adebusuyi Adeyemi

Adebusuyi (Ade) Adeyemi currently works for NHS England and NHS Improvement and sits on the Executive Committee of the NHS BME Network.

He is also the Director of the Chatham House African Public Health Leaders Fellowship. Chatham House is The Royal International Affairs Think Tank and Ade supports policy development work with developing countries across sub-Saharan Africa and South East Asia.

He is also founder and Managing Director of, an international health jobs platform that helps bring hundreds of health professionals from overseas, into the UK.

Ade is a member of the Davos World Economic Forum’s prestigious Global Shapers community of leaders and senior associate member of the Royal Society of Medicine. He has also served on the National Executive Committee of the Fabian Society (Britain’s oldest political think-tank) and was nominated as a 2014 ‘Rising Star’ of the NHS by leading publication Health Service Journal (HSJ).
Writing for the Fabian Society, Ade won its 2017 annual prize for young writers for his discussion paper on ideas to improve BAME representation in the Labour party [Outsiders, Adeyemi & Bailey, Dec 2016]. Ade writes in a personal capacity.

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