The NHS and ‘the war on waste and woke’

If staffing is the major issue in the NHS, isn’t cutting diversity and inclusion a mistake?

Tired nurse wears face mask blue uniform gloves sits on hospital floor. Essential worker feels burnout stress of corona virus frontline


The NHS is under huge strain as we all know and many of us have experienced personally. A report out last week highlighted the most urgent problem – staffing. It found that the number of vacant posts in the NHS in England has reached a record high of 132,139 – almost 10% of NHS England’s planned workforce.

So it was interesting to read reports of Health Secretary Steve Barclay’s priorities. According to the Daily Mail, the focus of his plan published last week – described as a plan to address ‘waste and wokery’ – was on cutting managers/moving managers to the frontline – the old red tape argument which seems to wear a bit thin after years of cutting red tape – and on getting rid of diversity and inclusion staff.

It would be interesting to find out how many NHS managers have up-to-date clinical skills. Probably not communications managers, for instance. Managers have a bad rep. But someone has to manage things, connect the dots, check that safety measures are being followed, strategise for the immediate if not the longer term…Cutting internal management back too much means more stress for those remaining [a recent US report by Deloitte and Life Works charted high rates of burnout among managers as a result of Covid], expensive outsourcing, less oversight, more safety issues…How much cutting of management is enough?

I’m not saying that there are not issues with too much form filling sometimes. My mum was a social worker and, back in the day, complained bitterly that a lot of her time was taken up with form filling, meaning she had less time talking to people who needed social services. But some red tape is necessary and protects people’s safety and their rights – both employees and patients. Managers play a crucial role in overseeing this. Similarly, there are concerns that talk of cutting the civil service by 90,000 posts will affect frontline services, at a time when frontline services are under such severe strain.

Then there is diversity and inclusion. Isn’t diversity and inclusion about broadening recruitment campaigns and retaining staff? If staffing is a top priority for the NHS – if that is what is driving stress and burnout, low staff morale, decisions to leave – as we know it is [a report last week from Randstad being a case in point  – then surely getting more candidates to apply and providing an inclusive environment in which they can thrive [and therefore retaining them] must be a good thing, you would think. Countless studies show that diversity and inclusion is good for business and for recruitment and retention.  We’ve certainly seen an upsurge of employers interested in diversity and inclusion in the last months as they seek to widen their search for candidates. And yes, there are debates about the effectiveness of some diversity and inclusion training and other aspects of diversity and inclusion. Sometimes it feels like it is just tickbox stuff. There are also debates about embedding diversity and inclusion into the core business of organisations so you don’t need one person responsible for all of this as a sort of add-on, but that is an argument for more focus on diversity and inclusion, not less.

Today come reports that the Government is thinking of making it easier for NHS trusts to employ more nurses and dentists from countries such as India, Sri Lanka, Kenya, the Philippines and Malaysia, in part to make up for numbers lost to Brexit changes and hostility. While it may provide short-term relief, critics warn that it won’t fix longer term recruitment issues which they say require more investment in training in the UK and in the things that might help attract more people into the profession in the first place, including pay and flexible working that reflects the needs of many of today’s workers.

It’s not only that the direction of travel with regard to the waste and woke approach is wrong, but it is completely inadequate in terms of the seriousness of the problems facing the NHS – a cheap political distraction which will make no real difference at a time when people are simply terrified of getting ill.

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