John Hutton – 2004 Speech on Leadership in the NHS


Below is the text of the speech made by John Hutton on 15th October 2004.

Good morning and welcome to this important national conference on how the NHS can become an organisation that practices as well as preaches the benefits of being an equality employer. I want to congratulate the Leadership Centre in taking this particular initiative. And I want to thank all of you for the contribution you are making to help the NHS realise the potential of all its staff – whoever they are and wherever they are from. Because this will not only help to open up new career opportunities and challenges for our employees. It can help to improve patient care and the patient experience as well. This must be our top priority at all times.

I don’t want to make a long formal speech this morning. I’d prefer instead to listen to what you have to say about how things are going and what more we need to do. But there are a few things I would like to say.

Our society is still scarred by social and economic disadvantage as well as by health inequalities.  Where a baby boy born in Manchester today will live 7 years less than a baby born in Dorset.  Where those from minority ethnic backgrounds experience more health problems than other sections of society. Where unemployment rates for disabled people are double those of non –disabled people – affecting their health and long term well-being.  The NHS exists to help tackle and overcome some of these fundamental disadvantages. If we are to succeed in overcoming these health inequalities, we have to be serious about tackling race inequality as well because we know there is a connection between the two. We have to do this both in the provision of health care services as well as the way in which we employ people from black and minority ethnic communities.

In this context it is critically important that the NHS builds equality and diversity into the way it delivers services, supports communities and draws on the talents of the whole population.  I think we are making some progress. Initiatives such as Improving Working Lives and Positively Diverse were designed to bring about real improvements inside the NHS with clear standards, good practice guidance and practical support.

But there is more we need to do. This work needs sustained focus – on the needs of patients from all communities as our consultation on choice is bringing out and on the way that staff are developed and supported. Alongside this we need strong leadership, clear standards and transparent routine monitoring so that we can chart our progress and benchmark ourselves against the best. And I want the NHS to be the best employer when it comes to equality and diversity issues. I want us to set the standard. I want you to be in the lead. But we have more to do if we want the NHS to be the employer we know it can be.

Earlier this month I launched Equalities and Diversity in the NHS. This makes the casefor diversity, recognises the progress made, provides many examples of innovative practice, and sets out key challenges and priorities. Every NHS organisation can use it to review its progress in championing greater equality and diversity and to see how it can accelerate this agenda.

Why is this so important? Let me remind you of the facts.

The 2001 Census showed that people from black and minority ethnic communities make up 7.9% of the population in England. They make up 8.4% of the total NHS workforce. So far so good. But people from black and minority ethnic communities make up less than 1% of our chief executives and only 3% of our executive directors. Out of over 400 Directors of Nursing only 16 are black. And yet 9.3% of nurses are from black and minority ethnic communities.

There are some promising signs. We are drawing in talent from a range of backgrounds – 18% of last year’s intake on to the Graduate Management Training Scheme for example came from black and minority ethnic backgrounds as did 12% of NHS non executives. But the bottom line is that too many of our talented people lack opportunities for career progression, feel that their special skills and experiences are undervalued and, critically, experience racism and discrimination. This is unacceptable. This is what we must change.

Equalities and Diversity in the NHS provides a framework for doing this. At its heart are challenges around leadership and cultural change – the focus of today’s conference.

We hear a lot about leadership. But leadership can’t just be something we only talk about. It is something we need to do. Good leadership means better services. Better services means meeting the needs of local communities as well as meeting important national standards. We believe that investing now in our leaders of the future will help the NHS meets it challenges on equality and diversity.

The NHS needs robust and visible leadership and accountability at all levels in respect of equality and diversity. This means creating a working environment that respects and values all staff and fostering an organisational culture to reflect these values in all aspects of work. It calls for changes in attitude and changes in behaviour. It needs real leadership from the most senior levels in organisations.

The NHS also needs more diversified leadership. There is no quick fix to this. It requires sustained and systematic effort to enable people from diverse backgrounds to take on senior leadership roles, particularly at Board level. This is what the NHS must become committed to.

A more diverse leadership will be more alert to the talent, skills, experience and enthusiasm of all staff. Experience in other sectors suggests it will encourage new ways of engaging with diverse communities. It should  inspire staff to recognise the importance of affording patients respect and dignity because of their religion and culture when they are at their most vulnerable. A more diverse and representative leadership should encourage people at the start of their careers to consider the NHS as an employer of choice, because it recognises and brings on all talent.

To support their progress into senior leadership roles, it is vital that BME staff have access to high-quality and credible development opportunities. I am therefore pleased today to mark the launch of the first national leadership development programme for black and minority ethnic staff.

Developed by the NHS Leadership Centre, the programme will provide leadership and personal development opportunities for BME staff wishing to move into senior positions. It builds on the findings of Getting on Against the Odds – research published by the Centre in 2002 into the barriers experienced by nursing staff from black and minority ethnic communities in progressing into management and leadership roles.

It is specifically designed for people in middle or senior management positions who want to take on more responsibility as a senior leaders in the NHS.  It is for people who understand leadership issues, and who have the motivation and commitment to engage in a challenging development programme. It looks at the role of senior leaders in delivering service improvement within the context of experiences of black and minority ethnic staff in the NHS.

The Programme will offer a range of development opportunities for BME and non-BME staff, at different stages in their career. 80 people will be given the opportunity to participate in the programme between January and March next year, rising to 240 people in the following 12 months. We are allocating £1.5 millions to this programme in 2004-2005, with plans to continue funding for a further two years.

The programme has been developed in collaboration with BME staff across the NHS. At a conference earlier this year, BME staff told the Leadership Centre why this sort of programme is so important to them. You said that when managers were nominating people for training programmes, your names were not put forward. You said that when jobs were advertised, you were not encouraged to apply. You said that when interesting job opportunities arose, they were not offered to you. You said you wanted a high-quality programme that would give you the skills to take on the most senior roles. That would help you manage difficulties you experienced at work as BME staff. That would give you a clear and practical help in progressing in your career.

You also wanted the chance to learn and develop with non-BME staff. As you felt you did not have access to mainstream programmes, you wanted non-BME staff to come and learn with you. Therefore the Breaking Through programme will offer the option of mixed modules, as well as modules only for BME staff. This has many benefits. This programme will be seen as a mainstream programme by employers and colleagues. It gives non-BME staff the chance to see their organisation and their services from a different perspective. To take new ways of working back into the workplace. To engage with experiences of racism and discrimination and be part of a culture to change those experiences in the future.

This programme is based on the feedback and input the Leadership Centre has received from BME staff over the last 9 months. As well as influencing the design, BME staff have been involved in selecting the organisations who will provide the programme, and will continue to be involved in developing and shaping the programme over time.

To support this national programme, the Leadership Centre will also work closely with Strategic Health Authorities and NHS trusts wishing to run their own local development programmes.

But this programme on its own is not enough. The Leadership Centre will also ensure that all its other programmes address equality and diversity and encourage applications from minority groups. Through NHS Leaders – the first systematic career development and succession planning scheme in the NHS launched earlier this year – we will be able to track talent from diverse backgrounds and help people to reach the most senior positions in the service.

All NHS organisations should be seeking out and spotting talent amongst their black and minority ethnic staff. All should be developing a culture where staff are supported and developed whatever their background. The Leadership Centre will be working with NHS organisations to ensure that BME staff are put forward for mainstream programmes, that they are offered development opportunities. That their potential and talent is noticed.

Over the next few years time I hope to see many of you in the audience in the most senior roles, leading our NHS organisations into the future.

It is fitting that this conference is taking place in Black History month – a time to celebrate the part that black and minority ethnic communities have played in making Britain what it is today. The contributions of staff from black and minority ethnic communities to the NHS is immense. They have played a crucial role in the care and treatment of patients over the years. Without this contribution the NHS would not have achieved what it has and would not be the organisation it is today.

But your contribution is not just historical. It is on-going. People from Black and minority communities contribute every day to the well-being of our society and to the success of the NHS in particular. I would like to express my respect and admiration to all the staff from black and minority ethnic communities who have put so much into the NHS since its inception in 1948. Often in the face of racism and abuse.

But we should now look to the future. I hope we can do this with in the knowledge that what must count in the NHS is not who you are or where you are from. But what you can do. What you can offer. How you can help us make the NHS the service we all want it to be. Successful. Growing. Better able to meet the needs of today’s society and all those who live in this country. This is our ambition for the NHS. Help us realise it.