Following on from the powerful blog “After the speeches…” that outlined actions needed to reduce discrimination, we are delighted to publish the final blog of a ten part blog series by Roger Kline with suggestions on how to tackle structural racism in the NHS.

“BME representation on the Trust Board has been discussed and considered as an issue, with wider diversity having been sort. However, it has been decided that all situations should be appointed to on merit.”

NHS Trust report on the WRES July 2015 (their original spelling)

This Board joined a long tradition in recruitment, now well documented in research, demonstrating how perceptions of potential ability are flawed and how the most ‘meritorious’ individuals may not be the best choice when recruiting to teams.

In “How to Spot an Incompetent Leader” Tomas Chamorro-Premuzic suggests that the one main advantage men have over women when it comes to being picked for leadership roles is “our human tendency to equate hubris and arrogance to talent”. He spells out how confusing confidence and competence is a common failing in selection panels and suggests “overconfidence is the natural result of privilege.”

More widely, we know that candidate characteristics such as gender, ethnicity class and disability all influence recruitment decisions allowing affinity bias or criteria as ‘will he fit in’ to influence our perceptions of candidate ‘merit’. ‘Merit’ in other words, is not an objective standard untainted by bias as a wealth of research found:

• When a man had more experience, people tended to choose to hire the man because he had more experience but when the man had more education, people again chose the man because he had more education. Both education and experience counted less when women had them.

 

• Both male and female science professors showed an unconscious bias against female students, rating them less competent than male students.

 

• In assessments, the performance of women and black and minority ethnic staff — when objectively equal to that of their white male counterparts—is judged as lower both when individuals evaluate others and when they evaluate themselves

 

• The achievements of black managers were more likely to be attributed to help from others (rather than ability or effort) than the achievements of white managers were

 

Definitions of ‘merit’ can become self‐fulfilling: those who gain access to the networks and development opportunities required to acquire merit are generally those who define it.

At each stage of recruitment we make assumptions. When determining which competencies are required for a management or leadership role, for example, NHS policy underpinned by research proposes that compassion and inclusion be core requirements, yet I have personally seen sustained resistance in the NHS to their inclusion from those wedded to more traditional appointment criteria.

Even where there is agreement on what competencies, skills or experience a recruitment panel are seeking, judging whether candidates meet them is not quite the objective task it seems.

The accepted application of ‘merit’ assumes that given a level playing field, individuals of equal talent and motivation will advance at equal rates. When some groups of applicants are disproportionately impacted this is usually explained by lack of experience, training, or opportunities, or by motivational deficiencies, preferences for work and family rather than consideration of whether the definition of merit used is flawed.

Moreover, the individualistic focus of ‘merit’ places responsibility for poor outcomes on the shoulders of the unsuccessful, labelling the unsuccessful as “incompetent or undeserving” whilst successful candidates owe it to their personal achievement.

However, determining the ‘merit’ that recruitment panels should be seeking becomes even complex when we take on board the research that diverse teams are likely to be more effective than homogeneous ones. We find that, counter-intuitively, the best teams engaged in non-routine cognitive work do not consist of the group with the best individual ‘merit’ but are diverse ones consisting of both good performers with other varying cognitive (and often demographic) performers.

Counter-posing the ‘best’ candidate and the one who adds diversity is a false dichotomy. The best teams need both good performance and diversity – the latter is crucial to ensure a good mix of knowledge bases, analytical tools, mental models, different perspectives, experiences and information. No one person is likely to possess each of these – the best team is the one that does. The ‘most meritorious’ individuals might individually score better on intelligence tests, for example, but when it comes to solving problems as a group, diversity matters more than individual brainpower. The simple maths on this is convincing and is set out by Scott E Page (1).

The over-emphasis on ‘individual merit’ is compounded by the stereotypes of ‘merit’ linked to protected characteristics. We have known for a century that individual women and BME candidates are more likely to suffer from ‘horns’ and ‘halos’ with one weakness generalised into an overall negative ratings.

So what can be done?

Correll and Mackenzie suggest these shortcomings of ‘merit’ as a criteria may be countered, in part, by examining and broadening the definitions of success used (in success profiles for example), and then by asking what each person adds to the team being recruited to.

Correll and Mackenzie suggest interview panels might ask different questions:

• “How does this person’s approach help us get to better discussions and decisions?”
• “What skills and experiences am I missing on my team that this person has?”
• “What has this person learned from his/her experiences? Can she take risks and persevere through difficulties?”

As they point out, “We often perceive being quickly promoted as an indicator of someone’s talent. But using this criteria might lead you to overlook the value of grit and perseverance.”

Addressing the traditional view of ‘merit’ needs to be part of a wider strategy of understanding bias and how to mitigate it with all aspects of recruitment and development. Challenging organisations that counter-pose diversity to merit is one element of such a strategy. The good news is that the Board whose WRES report introduced this blog have now appointed two Executive directors and one non-voting Executive director from a BME background and have one BME non-Executive director. So progress is possible.

Reference

(1) Scott E Page (2017) The Diversity Bonus: How Great Teams Pay Off In The Knowledge Economy

Roger Kline

Roger Kline is Research Fellow at Middlesex University Business School. He authored “The Snowy White Peaks of the NHS” (2014), designed the Workforce Race Equality Standard (WRES) and was then appointed as the joint national director of the WRES team 2015-17. Recent publications include) the recent report Fair to Refer (2019) to the General Medical Council on the disproportionate referrals of some groups of doctors (co-authored with Dr Doyin Atewologun) and The Price of Fear (2018), the first detailed estimate of the cost of bullying in the NHS, co-authored with Prof Duncan Lewis.

Declaration of interests

I have read and understood the BMJ Group policy on declaration of interests and declare the following interests: none.