The Ward Round: What does it mean to speak up now?

What does it mean to speak up about racism and discrimination now as a leader in the NHS – and has public criticism affected the NHS’ efforts to tackle it following the Black Lives Matter protests?

The situation appears to have evolved since summer 2020 but Anton Emmanuel, who leads NHS England’s workforce race equality standard, has claimed officials are hesitant in publishing a new long-term race strategy amid a “media storm around ‘wokery’”.

His striking comments at an open conference, which urged NHSE officials to show “courage” in the wake of recent headlines, will have likely caught not just them off-guard, but other senior managers.

They also come at a time when the NHS’ efforts to improve diversity and inclusion are being increasingly scrutinised by the public, more than 12 months on from George Floyd’s murder in the United States.

While coverage from some sections of the media has been negative, some in government have also taken a dim view.

Former Conservative minister Sir John Hayes told the Daily Telegraph he would be writing to the health and social care secretary Sajid Javid after he branded a blog post as “woke nonsense”.

The chair of The Common Sense group, which comprises more than 50 Tory MPs, said he would ask Mr Javid to “investigate what is going on” and ensure “not a penny of public money is wasted on this nonsense”.

To be clear, the post, titled ‘Dear white people in the UK’, was shared as a resource by the NHS Leadership Academy on its website after being first published by Aishnine Benjamin on her personal blog.

It was neither policy, nor guidance, but written in the wake of the Black Lives Matter protests last year, and then picked up more than a year later by the Daily Mail.

Quite what Sir John expects to happen over a blog post like that is unclear.

Meanwhile, the Daily Telegraph also reported Mr Javid to have told a meeting of MPs that he would be “watchful for any waste or wokery” from the NHS. Hmm.

This all posits the question: how speaking up as a senior leader has evolved over the last year?

The Ward Round has spoken with various leaders about this over the past few weeks. Although views vary somewhat, there is a consensus that continuing to speak up is the right thing to do. Even amid criticism for doing so.

More ‘nuanced’ discussion

Health Education England chief executive Navina Evans believes the tone of the conversation has “shifted a bit more” and become “quite nuanced”.

She said: “I think there has been a struggle and some people have been uncomfortable [talking about it] … there is a bit of backlash.

“There is a little bit of, ‘isn’t it done now,’ kind of thing, ‘haven’t we moved on,’ ‘what about this,’ and ‘what about that,’ and all of this stuff.

“But it feels, to me, like that’s the kind of conversations that we have to have if we are really going to make progress.”

Dr Evans, who I also spoke to last year for a wide-ranging piece on the topic, said the recent media coverage had been a “real shame”.

She added: “Sadly, it’s not surprising but, on the other hand, people are responding to it because it is having an impact. You could look at it that way.

“It means that it’s making people think and feel uncomfortable.”

On people who might be afraid to speak up, she urged leaders to lead by example, adding: “We have a voice, and we have the power, and we have status… so we should step up to the plate.”

Partha Kar, who is an NHSE lead on the medical workforce race equality standard, a national advisor on diabetes, and a consultant in Portsmouth, told the Ward Round he thinks some people who spoke up at the height of last year’s protests have “quietened down” following pushback from critics.

Professor Kar said: “I think it is sometimes about the way you say it. If you come out and say, ‘all white people are racist,’ you will get some people coming out of the cupboards who sort of fire back at you.

“But if you [present] good data and say this is where we are at, [and say], ‘do we challenge that, do we change that,’ I don’t think you will have an army of trolls running after you.

“I think it also depends on the way you put it, but certainly, some voices have been quieter [than in the past] I would say.”

While he encouraged people to speak up, he suggested presenting data to demonstrate a point or facilitate a wider discussion

Where does this all leave us?

It looks clear that the NHS and its leaders will continue to be confronted in this space, which will invariably come with its difficult periods.

But ensuring it is actually tackling a problem that has hurt staff for so long is paramount.