Is Steve Barclay right about EDI Roles?

I’m in the awkward position of potentially agreeing with the Secretary of State for Health.? How could that be?? I make no secret of my political predilections and these are very far from those of the member for North-East Cambridgeshire.? However, his recent letter to ICB Chief expressing concern that “many local NHS organisations are actively recruiting into dedicated DE&I (diversity, equity and inclusion) roles.”.

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Barclay (or whichever culture warrior factotum who wrote this on his behalf) continued “these issues are everyone’s responsibly and should be addressed through normal management processes rather than using external providers or dedicated roles within organisations”.? So far so culture war.? The cynics amongst us might well suspect that Barclay is on manoeuvres ahead of a potential Conservative leadership contest or merely trying to give political cover for his boss on a bad day for the Tory Party.

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Yet Barclay’s argument that these funds should be spent on frontline care, is compelling.? And isn’t he right – shouldn’t DE&I be everyone’s responsibility?? If, like me, you’ve been a DE&I leader in a big organisation, you know how exhausting, challenging and thankless it can be.? It’s well documented that taking on these leadership roles often comes at a price for those who step forward – in terms of career progression and in terms of their own mental health.

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So isn’t Barclay right?

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Having specific EDI roles in an organisation, can be bad, can’t it?? Notwithstanding the personal sacrifice EDI professionals have to make, it can create other problems.

In other organisations, I’ve seen it create a silo mentality.? If, EDI is seen as the responsibility of a specific group of people, it can create a sense of separation between those individuals and the rest of the organisation. This becomes particularly problematic when trying to bring the rest of the organisation along and can make it difficult to implement EDI initiatives and can lead to resentment and resistance.? Leadership sponsorship can be lacking too and this is almost bound to lead to failure, as a lack of leadership sponsorship does for any transformation initiative.

While employing full-time EDI representatives is certainly a commitment, it’s rare for them to then be given the authority and resources they need to be effective. Without resources and authority, again, like any other transformation; attempts to drive change will fail.? Simply, lack of resources and authority also send a clear message that EDI is not a priority for the organisation.? What better way to be tokenistic and undermine the credibility of EDI initiatives!

I’ve also experienced how EDI can also be divisive - as people take different sides on issues such as unconscious bias or even arguing against the existence of discrimination or privilege.

Barclay is right in that to do EDI right, is expensive – as it should be.? Right now, the NHS is under severe financial pressure – but this is financial pressure of the government’s making.?

However, having been at the coal face, I’m firmly of the view that dedicated EDI representatives can provide valuable expertise and guidance, help to raise awareness of EDI issues, and advocate for the needs of minoritised groups.? It’s not as if we don’t need to be focused on improving EDI given the NHS’s track record, particularly on race.? The government’s own advisor – General Gordon Messenger; in his review of NHS leadership, concluded that EDI roles were essential to “mainstreaming” best practice equality and diversity outcomes.?

In fact Messenger ultimately envisages that in time, a reduction in EDI roles can be achieved – as Barclay is advocating for.? What Barclay ignores is that progress on EDI is still extremely poor.? As we’ve seen time and time again, racism in particular continues to be a problem for the NHS, for staff and patients.? Much of this, as can be seen, for example from NHS RHO’s work on black maternity, is institutional.?

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Whilst I agree with Barclay that EDI needs to be everyone’s responsibility, we need first to have invested the time, authority and resources in establishing a more equitable future and this requires leaders who have agency, specialist knowledge and a passion for driving the change we need.