What is anti-racism, and why is it important in the context of health and care? Jo Vigor sat down with Joy Warmington MBE, Chief Executive of the equalities and human rights charity brap, to find out. Joy explores the importance of forging genuine change beyond target setting and delves into her own journey of leading authentically and having the courage to do things differently.
JV: Jo Vigor (host)
JW: Joy Warmington
JV: Hello and welcome to the King's Fund podcast where we explore the big issues and ideas in health and care. I am Jo Vigor, assistant director of leadership and organisational development here at the Fund. Today I'm thrilled to be joined by our wonderful guest Joy Warmington. As the CEO of the equalities and human rights charity BRAP, Joy is a strong advocate for the belief that innovation and learning is essential to forging real change. Her skills and passion have led her expertise being sought out by many from those in the Prime Minister's office, across the media and in our very own work here at the King's Fund and if her plate wasn't full enough she also serves as a non-executive director at Oxford University Hospitals and as a faculty member of the NHS Leadership Academy. Joy, welcome. There's a lot to discuss and I'm really looking forward to this conversation.
JW: Thanks Jo, thank you ever so much for the introduction, I'm looking forward to the discussion.
JV: I just thought we could start the conversation by really having a chat through your leadership journey. It would be lovely if you could start by sharing an overview of what your own leadership journey has been like so far.
JW: One of the things I was thinking critically about was how I forge an identity as a leader as someone who is a black woman, and I think that's actually been quite challenging. I think I started off really trying my best to think about how to lead as a woman and when I was in leadership positions at the time there were no women around to emulate or to get a sense of how to do that. So I think I fell into a very odd imposter type version of myself where it took me a long time I think to get comfortable with who I was as a leader and to recognise I could lead … more authentically lead from the position of all of who I am not just some sort of version of what I felt leadership was going to be like really.
JV: What were some of the turning points or triggers that enabled you to move into a position where you felt more authentic as a leader in the work that you're doing?
JW: I've worked for quite large organisations, so one of my first more formal leadership positions was in a college, was in a further education college. That was quite an isolating position, I was a sort of middle program manager type role, I was the only black woman in that role. It was very challenging to believe that I deserved to be there. So one of the challenges I think was how am I here? I think at the time there were only maybe 13 or 14 lecturers of colour. It was very challenging. I was always seeing myself in a mirror if you know what I mean, always looking at myself thinking how do other people see me? Have I got the right to be here? Is this … watching what I did and how I did it was … it was very uncomfortable. So it was almost like sitting on a pin when you sat down on a chair all the time, something always reminded you of who you are and where you are, and I think from there a lot of the … I suppose the thoughts that I've had about my coming to terms with who I am as a leader is to do with the environment in which you lead. In BRAP I have had a real privilege to not only feel I can be very authentic as a leader but actually I've had an opportunity to test out who I am a little bit and to come to terms with who I am as a leader as well. So it is to me a lot to do with the environment and having a place where your leadership can be nurtured and developed.
JV: Do you feel now, given the work that you have done and are doing, that your voice and agency is recognised by yourself and others? Do you feel much more confident about that in your leadership role?
JW: I think I do. I mean the thing that has improved my belief in my own voice and agency is the fact that it's really important in my view to stand up for something. Even when I was at my most meek and mildness, because I have been meek and mild, I remember sitting in places and going right, "This is wrong but don't speak, don't speak, don't speak," and I'd always be the one who couldn't hold myself, I'd have to say, "But what about," or, "Have we considered." So I've always been a bit like that even when I was very timid and very shy. So I think in order to champion an agenda, which in fairness we tend to think we are already people who are fair, people who are responsible, that we live in a society that is very good, although there are lots of things going wrong I think most people would think this is a great place to live in, this is a place where people get on, etc, etc, and having sometimes to say, "Well actually no, not all the time, let's have a look at some ongoing trends, some ongoing challenges, there are some things that we haven't attended to, some things that we haven't considered in ways that are the most helpful for people," it does require you to have a very strong sense of purpose and courage really because I think there is a certain degree of courage when you're speaking out against conformity.
JV: And Joy, when you're working with people what's the advice you give to people who are looking for the courage to talk about issues around equity and anti-racism particularly in the context of white privilege and white spaces? What would you advise these people?
JW: I often start from self actually. I invite people to do a bit of self-talk. So what is it that you know about yourself, where are you in the mess of issues of equality and race and do you understand yourself and what's happening well enough, because I think it can be quite 'easy' [easy in inverted commas] to point the finger at others without doing the work on yourself really and we all hold positions, we all hold discrimination, we all make judgments, we all evaluate and that's not to say that we shouldn't speak out about that but we also have to find ways of doing it which are complementary I think to our own belief systems. So I often say to people when we're working with them for a while find things that you can address more comfortably in the first instance. I also say think about risk. For some people there's quite a lot of risk in speaking out. I mean I'm quite lucky I work for an organisation, I work with individuals, I work with a team where we do this all the time. If you work in some organisations speaking out doesn't always get you the reward that you deserve and there's an honesty about that and people have their own livelihoods, they have their own positions, they have things they have to do with their lives and I'm not saying that means that there's a reason for you to remain silent, but for lots of people you work with they have to weigh up the risks. For some people that we work with you can be more courageous and I think that's where I would be inviting people to step into the courage, to step into the fact they have a role, they have a position, they have responsibilities and they have accountability for creating more inclusive and less discriminatory environments and that's where I would say, "This is what you really ought to be speaking out about," and how can you find ways to do that in ways that can be heard and ways that can actually take people along this journey with you?
JV: So there's a message really that I'm hearing there Joy about, especially to mangers and leaders and senior leaders about, part of your role is to create that environment of inclusivity, so how do you go around doing that, and part of that is actually about working, looking at yourself and thinking about where you're going to get your courage from and your energy because this work involves a lot of emotional labour and I was going to ask you, what keeps you going because the work you do with BRAP really is there's a lot of challenge and it's demanding and heavy, so what keeps you going and your energy and resilience up?
JW: Well I work with this absolutely fantastic team of people, you've met some of them Jo. We also have supervision, we have regular supervision, we have regular support sessions because, as you say, this work is not easy. I like to approach situations with hope and sometimes if you get too full of despair and distress it can be quite difficult, be quite difficult to approach every commission with a bit of, "Something is going to change here, somebody is going to take some of this on." So there's almost a need to rinse yourself out a little bit to make sure that you can come back into this work with a degree of optimism and I think for me the day that I possibly don't do that is the day that I need to quit it.
JV: Joy, as part of that resilience, or part of looking up and out, who are your role models in this work?
JW: One of my constant role models in my life has actually been my big sister actually who -
JV: That's lovely. That's so lovely.
JW: - is very famous to me, and actually very famous within her own setting and her own industry, but I remember when I was a child she had this afro, the Angela Davis afro and she was very much into politics at the time, so I remember picking up quite a lot from her in terms of her, who she read, who she connected with but also her work ethic, her belief systems, her … she never looked at anything and thought this is not good for me, this is something I can't do. So she was really very motivating and has always been a motivating person in my life and she writes me letters that say thing like on the envelope 'to the sensational Joy Warmington'. So you get a letter that says -
JW: - to the sensational Joy Warmington (laughter). So it's lovely having a sister that constantly rewards and praises you, but I think my motivators have been people like James Baldwin, Angela Davis, the people who have written (inaudible 00:11:46) very purposefully on this issue with such great wisdom and insight who often they were of a time that is a time for today. Sometimes when I look at what people wrote back then I'm like well how the heck, and I think that's partly why I believe something has to change because if people were writing with such wisdom and insight at that point in time it's insight, it's wisdom that is necessary for today as well. So there's a real belief in the history of all of this and the importance and not to forget those people that went before.
JV: Absolutely and it's still true today what they've said as well and written about. So thank you for that. In terms of the work you're doing with BRAP I think it would be helpful for listeners to understand what your definition Joy is of anti-racism's that you use at BRAP.
JW: Lots of people use the term anti-racism without very much understanding of what it really means and the clue to addressing and defining anti-racism is in its name. If we understand what is racism and what keeps racism at play, then anti-racism is really deconstructing racism. It's taking racism off the table. It's not just being against racism. Lots of effort, lot of interventions that are against racism but we're not necessarily as good at thinking how do we get to this place? What can we really do to address the re-creation of racism the way that we make it day after day after day? That includes some very specific things from our perspective. I think the first thing is actually recognising that race is a social construct and people say that, "We know that race is a social construct," but we act like different races really exist within our society, we attribute different values and different belief systems to people based on a belief in race and because we have a fault scientific belief in race it doesn't help us in trying to then think more critically about how some of our belief systems and prejudices have contributed to the racialisation of different groups. So how do what I believe about different groups of people, how is that brought into life through my belief systems? So that's the first thing and that's really hard because we remake race all the time, we're always labelling, we're always categorising, but with that belief in different groups and different racial groups comes some stereotypes that we go … we work through ongoingly, these people can speak English, these people have got this, these people have got that and all of those stereotypes actually hold our society in attention in terms of the kind of ways in which people are progressed across our society. So who we think could be leaders, who we think can be managers, who we think could be cleaners etc, etc, etc. So that sort of is the first thing. We then talk about the systemic and people always get a little bit, "What does that mean?" but I suppose what it really means is the way in which we don't challenge the things that we believe in our society. Those things are just there and because we don't challenge those beliefs, because they become enthreaded in our education, in our institutions, in our media, in creating industries, etc, it doesn't help us to deconstruct racism because we've got to also think systemically about the way in which our whole society upholds those beliefs. We talk also about being able to work on self. So what of racism have I taken on board? So how have I ingested these beliefs and we don't think that's just something that is there, is true for people who are white presenting, we also … you can't live in this society as a person of colour or someone from the global majority without also ingesting racism because it's part of the fabric of our society. So understanding your life, your world through a system of racialisation is something that we all get. So we talk a lot about how we deconstruct ourselves from those beliefs as well.
JV: We will return to the podcast in a moment. What are the connections between health, racism and inequalities? How has this affected black people across generations? Find out on our online open wounds exhibition created and developed by Tottenham Rights which highlights the lived experience of black communities in relation to structural racism within health and social care in the UK. So if we think about the NHS itself, it's renowned for its ethnic diversity but ethnic minorities only make up around 13% of board members and 10% of very senior managers, what do you think from the practice that you've been doing is upholding the power structures as they are now within the health system and what is preventing progress, but what do you think is really going on from the work that you're doing?
JW: Juicy question, juicy question Jo. Lots of things are going on. I mean first of all we believe that representation is going to fix everything. Representation in my view should be an outcome of a fairer and just society. It's not an artificial input. So what we have tended to do is we focus on representation as an artificial input without changing the structures and cultures within our organisation. So we do that, how do we get x amount at the top, how do we get more leaders here and then we spend a bit of time and effort either in advertising campaigns, in sponsorship trying to do that. If it does change I suppose we have to ask ourselves that question what's our expectations from that change because does it mean if you have a few people who have been from previously marginalised or racialised backgrounds that the whole culture of the organisation will change? Well I sit on a board and as a board member there's a lot of things that you have to be responsible for including the culture of the organisation but that isn't something you can change as one or two individuals sitting on a board, you actually need all of the board, all of the various opportunities and levers that the organisation has in order to make that change. I'm not saying it doesn't make a difference having representation but it isn't always the difference that makes the difference. I didn't say that by the way I'm sure it's Angela Davis who said that diversity can also be an instrument of the state, it's the difference that doesn't make a difference. The other thing that we need to think about is throughput. So often we're not rewarding people fairly, we're not recognising that we have a lot of biases in our systems and processes which means that we haven't got the throughput of skills that we should have. People from black and minority ethnic backgrounds often are far more qualified than their white counterparts and part of the reason is you get pushed back and then you go and get another degree and then you get more pushed back and then you go and get another degree, often because you can't make that vertical rise through the ranks you're having to shift and you do a bit of a zigzag and that can count against you, people believe that you're not serious about your trajectory as a leader if you don’t go up and onwards. So there's some stickiness within the organisation, within our systems and processes, we don't often recognise the importance of networks and who you know and there are jobs that are never advertised, there are people who are known to people who get those jobs. So essentially there's a dynamo underneath everything that's trying to make change but the system is held in a lot of tension in doing virtually the same things it's always done.
JV: And Joy I can absolutely see how what you've just said there affects the people in the workforce and colleagues in the health and care system in terms of jobs and progression and recognition of talent and effecting change. I just wanted to ask a little bit about how will the focus on anti-racism, how will that have a positive disruptive impact on health inequalities?
JW: When you're focusing on anti-racism you're really talking about oppression, I think that becomes a bit of a loaded word, but you're talking about ways in which organisations, systems are experienced by individuals which means that they find it more difficult to get out of a system what they truly deserve and the intersect between things like class and race and gender and class and race are extremely prevalent if you're going to start to think about how you would use anti-racism because anti-racism is not just talking about people who might look like me, it's talking about how we work together to think about levering greater equity within a system that is stacked against a certain group of people and if it's stacked against one group of people we're not just liberating it for one group of people we're actually liberating a system. So if we make things a bit fairer for one group of people it's not saying, "Oh that means we're not going to be making it fairer for women," or, "We're not going to be making it fairer for LGBT folk." It's actually making things more progressive, opening things up, making things more inclusive for lots of other groups of people. So that's what I would say around that. I think also we've not recognised … we've not put the emphasis when we're looking at health inequality on what we do. I'm not suggesting that populations … that individuals don't have a role to play in their health and social care, but if we start to look at where the best hospitals are, where the best practices are, where you're more likely to get GP appointments or dental appointments, we have to think about issues of wealth and class. Where you live matters. It matters in terms of what you have access to, it matters in terms of the opportunities that you have access to and unfortunately the patterning between race and class means that for some areas in some cities things haven't shifted for groups of people because people have been born into those communities and still basically having access to the same things. So unless we do something differently, by we I mean our end, then it's really difficult for populations to do much differently and I'm not saying there couldn't and shouldn't be, but I also think there are some opportunities for us because the more we can get racism off the table the more access and opportunities we're going to have in terms of offering health and social care.
JV: You mentioned action plans previously but there's a lot of initiatives that go on in the health and care system especially from central government and the NHS and NHS England and they've released their own equity, diversity, inclusion improvement plan, what would your advice be if you were just to say the one or two things that you really need to focus on to create genuine change? For me I almost feel like saying well let's get rid of the action plan and really dig deep into what's going on in the way that we work and our system, but what for you Joy would be a couple of things that you would want to see to effect genuine change?
JW: So I would say let's get rid of the action plan, but I would say that. Sometimes … I mean I notice in my board positions when you make an action plan and when you focus in on a problem, it can nudge the problem in the right direction. However, it's not systemically fixed. In terms of issues of equality it can't be right, if we just look at race, that lots of people who are white presenting say that they're scared to talk about race, that they don't feel confident about this issue. We're in 2023 for pity's sake, how can we get to that point where people don't feel as if they can have those conversations and have them well, they don't trust themselves, they don't feel as if they can work on this agenda, they don't think they can lead on this agenda? I would say that what we really need to support organisations to do is not only to dig deep but to do a few things really well. Often action plans just focus, there's a splattering, it's almost like a splatter gun approach, we'll do a little bit of everything. I do understand there's a real need to attend to some of the challenges and issues that individuals and groups have. Disability is another area I think that's been really suffering at the moment. However, I don't think we get anywhere by just doing this for a year and then let's just do something else for a year and let's … there's a need to do a couple of things really deeply, really well, until we feel as if we have a more sustainable outcome. So there's more that needs to be delivered in the system than just the target and I think everybody knows that but people feel as if their hands are tied and that the only way we can actually make progress is by setting a target and I just think if we could think about this a little bit differently and judge progress a little bit differently, so what are the ways in which we might want to help the system to develop more courage and confidence and competence on some of these agendas? How might we measure that? How can you be having more productive conversations with people? How can we be not just looking at where people are at in a system but how they feel about where they're at in the system? So really looking at combining some of these performance indicators to give us a real indication of what's going on.
JV: If you had some leaders from the health and care system in the room with us today, what would be the question you'd ask them to go away with to ask themselves?
JW: I'd ask them to be more ambitious, to believe that something can change, because if they don't do it what's going to happen to their colleagues? What's going to happen to staff working in their organisation? We have to think that there's a bit of light at the end of this tunnel.
JV: It's brings me on to a question about BRAP, you've worked with us at the King's Fund to develop and jointly deliver something called a White Allies Programme and I know we're going to be doing some more work next year, when you're thinking about the development of courses like that, what should we all be focusing on?
JW: One of the wonderful things about that programme and the opportunity that has been presented to develop it, has been to use the evidence to focus on self. If we can't get this in our leadership, if we can't live this within our leadership, if we don't recognise the way that a socialisation process has also racialised our thinking, then how are we expected to lead people out of this maze really? So that's been the opportunity of the programme. It's been refreshing. I don't think everybody has loved it because everybody has come … people have come and said, "Tell me what to do," and we've said, "Well actually you need to do you," and people have gone, "But we want to talk to black folk because they're going to tell us what to do" or, "We're going to do some more consultation," or we're going to … if you flip that, we wouldn't say, "Yes, we've got this huge issue let's talk to lots of white groups about whiteness." It's … so there's something about the ways in which we've been conditioned into our thinking about race that we then … we need to shake it up a little bit and we need to get out those ways if we're going to take our society forward. I think that's a real difficult thing for leaders to position themselves into, but really powerful to think that you can lead this agenda in a completely different way. You don't have to do it the way that we've done it for the last 60 years, you don't have to do it like America has done it, you don't have to do it like Europe is doing, you can change this, you can move in a different direction.
JV: Joy you are a joy to work with as well, and I think that's where we're going to need to bring this to a close, but finally to finish, what's a question you'd ask our listeners to think about after listening to this podcast? What's a take home for them?
JW: Where can you be disruptive?
JV: Great. Great question. Yes, great question.
JW: We're all very ground down by the status quo. I mean there's so many things happening, there's a cost of living crisis, there's ongoing war and tensions all over the world and recently obviously, it just feels like we're getting nowhere fast as a human race. So I think we need to think where can we be disruptive? Where can we ask for something different? Where can we have different expectations for ourselves and for others around us?
JV: That's a lovely way to end this conversation Joy and it's been an absolute pleasure to speak with you today. I think there's so much that listeners can learn and take away from the discussion. So it's been absolutely brilliant, thank you.
JW: Thank you Jo.
JV: Well that's all we've got time for today, thanks for joining me Joy. It's been a fantastic conversation. The show notes for this episode and all our previous episodes can be found at www.kingsfund.org.uk/kfpodcast and you can get in touch with us via Twitter or X as it is now known. Our account is @thekingsfund. The producer for this episode was Natalie Cleverly and it has been edited by Bespoken Media. Don't forget to subscribe, share, rate and review this episode wherever you get your podcasts and of course thank you for listening we hope you can join us next time.
- Danielle Jefferies
- Leadership and workforce
The latest figures on the gender pay gap in the UK show that it is reducing. However, there is still work to be done to close the NHS gender pay gap and the gap across the wider health a...
- 20 November 2023
- 3-minute read
- Loreen Chikwira
- Leadership and workforce
What do lived experience and intersectionality mean when it comes to designing health and care services? Loreen Chikwira explains.
- 8 August 2023
- 4-minute read
- Kelly Ameneshoa
- Leadership and workforce
Who is supporting locally employed, specialty and specialist doctors? The NHS cannot afford to lose them
Kelly Ameneshoa highlights the need for locally employed, specialty and specialist doctors within the NHS.
- 26 July 2023
- 5-minute read
- Siva Anandaciva et al
- Leadership and workforce
How can we ensure that health and care staff from all backgrounds feel respected, valued and listened to at work? Siva Anandaciva sits down with Karen Bonner, Chief Nurse, Buckinghamshir...
- 28 June 2023
- 30 minutes