Black and Minority Ethnic People: Workplace Issues

Baroness Hussein-Ece Excerpts

Tuesday 3rd May 2016 Lords Chamber

[Baroness Hussein-Ece (LD)]

My Lords, I, too, thank the Minister for introducing this very timely debate. I also commend the Government for instigating the review which is to be led by the noble Baroness, Lady McGregor-Smith, who spoke very eloquently about her own background and experience.

I come to the debate feeling somewhat as if we have been here before. I did not put this in my report, but I have just remembered while sitting here that back in the late 1980s and early 1990s, in another life, I was a race equality officer. I could not have imagined, all these years later, that we would still be debating some of the issues that were very apparent at the time. The noble Lord, Lord Parekh, may remember Section 11 of the Race Relations Act—I think he might have referred to it. This demonstrates how we need to return to the principle of what we mean by race equality and that we must prioritise it, as it has somewhat slipped over the years. We thought we were probably doing quite well but we took our eye off the ball, so we have slipped right back. As other noble Lords have mentioned, great progress has been made on gender equality and in other areas, but we have very much taken our eye off the ball on this issue.

I, too, am a supporter of targets. I know many people are not and that there are many in my party and other parties who generally think targets are discriminatory in some way. However, they focus the mind and measure progress. Eventually, as in other areas, they can be set aside once progress has been made and equality has been achieved.

I want first to address BAME staff, management and board representation in the NHS. It is the largest employer in the country and the largest employer of people from black and minority-ethnic communities. It employs 1.4 million people, a very large number of whom are from BAME backgrounds. On 24 February, I asked the noble Lord, Lord Prior, why we have not been doing very well with BAME staff, management and board representation in the NHS. I commend him, because he was very honest and frank. He said:

“My Lords, it is outrageous that we have so few people from BME backgrounds in senior management and on NHS boards. We need to take action to improve the experiences of BME staff and their representation”.

He went on to give the House a few figures: some 22% of all staff in the NHS are from a BME or minority ethnic background, 28% of doctors and 40% of hospital doctors. Yet only 3% of medical directors are from BME backgrounds and 7% are in senior management roles. We have two chief executives and six chairmen from BME backgrounds out of 250 trusts. He said:

“So the performance across the NHS is … absolutely terrible and we have to take some serious action to change it”. —[Official Report, 24/2/16; 263-4.]

I was shocked by that: I knew it was bad, but I had not realised how bad, and how we have slipped back. Although the Minister should be commended for his approach and frankness on the issue, a 2015 survey of national bodies such as NHS Executive Search, Monitor and the NHS Trust Development Authority, whose boards are all subject to ministerial appointment, showed that none of their boards—at the time; I do not know if it has changed since—had any BME representation. The Minister was asked, as those appointments are in the gift of the Government, could they not take more action and lead by example? The Minister may not have the answer today, and I will be quite happy if she comes back to me on it, but is that still the case and what is being done to address that appalling deficit?

The NHS Equality and Diversity Council announced in 2014 that it had agreed to take action to ensure that employees from black and minority ethnic backgrounds have equal access to career opportunities and receive fair treatment in the workplace, so there has been an enormous amount of work in the interim. The extensive evidence of the benefits of diversity for innovation in leadership teams, which has been mentioned across the House today, is overwhelming. The case has been made. For the first time, the NHS has been required to demonstrate progress against a number of indicators of workforce equality, including a specific indicator to address the low levels of BME board representation. Despite this, as I mentioned, little progress has been made.

In The Snowy White Peaks of the NHS Executive Search Agencies, Roger Kline, a research fellow at Middlesex University, states that one of the known, visible aspects of conscious bias is the processes and practices used to recruit, develop and retain talent. In recruitment in particular, he points out, the lack of ethnic minority specialists operating in the executive search field, in the agencies who work with the NHS, has resulted in the “same sort of people” recruiting in their own image,

“with recruitment heavily influenced by candidate confidence as much as competence and by networks”.

The noble Lord, Lord Adebowale, mentioned that networks are far more important in securing senior management and board positions than knowledge and experience. If you are from a BME background and do not have extensive networks, you will not necessarily be successful when you apply to those boards. I say that with the caveat that there are of course some notable exceptions in the recruitment field—companies and organisations that are making great strides and trying very hard to address this issue.

In other words, there is continual fishing in the same, increasingly small pool. All the recruitment consultants seem to be fishing from a very narrow pool of candidates. I do not know whether the figures are available, but when we see an increase in women’s representation, I wonder how many of the same women are sitting on different boards. That is an issue as well. There is a lot of duplication—these are not unique numbers. You see board members on websites, and they seem to have an awful lot of other roles as well. That is another issue—that people go to the same people again.

Roger Kline mentions how change would,

“require trust and national level succession planning for executives—and the use of NHS Executive Search to provide candidate shortlists before trusts are allowed to consider”,

somebody outside over headhunters, who may not always look for diversity. So for the NHS as a whole, it seems much less likely that BME staff will be appointed from shortlisting than white staff will be. The absence or exclusion appears largely to be caused by discrimination in career support and the appointment process. The evidence is overwhelming that it takes much longer for BME staff to get promoted. I have heard of many instances of competent and long-serving BME staff leaving altogether after losing confidence and feeling completely demoralised over having any chance of career progression. What a waste of talent that is—all that experience going to waste.

Roger Kline also highlights in The Snowy White Peaks of the NHS Executive how:

“Large parts of the NHS still pay lip service to challenging discrimination in leadership and unlocking talent of women, BME and disabled people”.

Racism and discrimination against staff is a big factor—we have to talk about it. I hear what the noble Baroness, Lady Bottomley, said: that there is a fear of talking about it. But we have to talk about it, because we have to tackle it. It is a reality. According to the figures I have seen in one study, there has been a 65% increase in reported racist verbal and physical attacks against staff by patients in the five years up to 2013. According to recent figures, disappointingly, some hospital management actually collude and acquiesce. For example, in a case where a family said that they did not want their child treated by a black doctor, they gave in; these things are taking place. They may be going on beneath the radar, but they are happening—they are the reality.

The proportion of staff receiving well-structured appraisal support is also related to patient satisfaction, patient mortality, staff absenteeism and turnover, and a better performance on the annual health check. Working in well-structured teams helps to address staff absenteeism and turnover, as well as the annual health check performance, which is very important. Crucially, it is a factor in overall satisfaction in a hospital trust. Training and development is also a very important predictor. The more that employees receive training, learning and development that is relevant for the job and career progression, the better the outcomes. By giving staff clear direction and good support, treating them fairly and supportively, leaders create positive cultures of engagement, whereby dedicated NHS staff in turn can give their best in caring for patients.

Addressing the problems that many BME staff face will require a number of initiatives, but we need a multi-faceted approach and a complete rethink of senior leadership recruitment in terms of period of office and talent management. Much research points to what is required—dramatically widening the pool of talent and reminding these organisations that they are not a law unto themselves but public servants appointed to carry out a specific role for the benefit of patients, and funded by the taxpayer, as we were reminded earlier. I hope that the review to be carried out by the noble Baroness, Lady McGregor-Smith, will look closely at this area, as the NHS is such a large employer and a lot of lessons can be learned. However, as we have heard, the problem is not unique to the NHS.

I have a couple of other, wider points to make. As we know, BME communities have played a huge role in the NHS since its inception and throughout its history, socially and historically. We must ensure that they are not kept unfairly from proper career progression but are supported to play a full leadership role, as with all areas of public and private employment—as we have heard.

I also welcome what the Prime Minister said recently about the need to investigate why black people are more likely to be in prison than in top universities; he has appointed David Lammy MP to look into that. Nick Clegg, the former Deputy Prime Minister, talked about this issue a lot in the context of social mobility. It has not really bottomed out; it is a real scandal that it still exists in this country.

We need to take a long hard look at the realities of modern Britain. Why is it that 14% of the overall population are BME yet they make up one-quarter of the prison population? We must do better for all sections of our society and raise aspirations, not least through mentoring. All the aspects that have been discussed today are extremely positive and I welcome all of them. However, the whole issue of race equality now needs to be right at the top of the agenda, and I welcome the review.