What you permit, you promote: a view from a Chair

Peter Molyneux is Chair of Sussex Partnership, and co-Chair of NHS LGBTQ+ Leaders Network. He first became a Chair in the NHS in 2005. Peter went on his first Pride march 40 years ago, speaking out from a very young age for equality and campaigning for changes in the law. He spends time on the front line with staff and patients, listening.

For Pride In NHS, Peter was in conversation with Dina Medland, an independent journalist, ex-Financial Times. www.dinamedland.me 

Peter Molyneux understands the importance of identity for mental health and overall well-being. “Identity is not a credential. It is something we each live, and each individual needs to be seen. Not being able to self-identify is very damaging for one’s health. To be an inclusive leader you must be able to change what you are doing to enable different perspectives to be heard” to feel they can participate and contribute to solutions, he says.  

As Chair of NHS mental health trusts for a decade, he speaks with conviction not only of the critical need for inclusion and representation at board level but of its very real impact on the future success of any organisation in meeting its goals. Being seriously affected by mental illness is a cause of inequality. When you look at the reasons people are absent from work with anxiety and depression – job imbalance, job uncertainty and job lack of recognition all play an equal part” he tells me. ‘Inclusive’ is one of the most important adjectives that is used about leadership, and the others fall out of it. 

It is clear he has no illusions about it being easy for leadership to get it right on inclusion. “Organisations often behave in ways that do not have a good impact on people. Inequality and discrimination in society is imprinted by an organisation without realisation or recognition. At board level, it is important to have diversity of expertise and experience. However, the challenge is not only for the broader work force to see itself reflected in the leadership, but also that decisions are made fairly, that we respect each others’ opinions and that there is fair treatment across the organisation” he says. 

But that is not as easy to do as it may sound. He gives an example of the complexities. “We invite staff – such as BAME staff – to call out any discrimination. But by doing that we are asking them to relive their experience which can be damaging for them” and that can make them feel injured rather than supported, he suggests.  

A board needs to begin with clarity of purpose on where the inequalities lie. It gets that, he says, by asking the right questions on equal access to certain roles, gathering the data and being willing to examine that data through a different lens. The board must then be willing to change existing procedures for progression as needed to ensure that people development takes place and that talent is recognised. “Look at your services and performance targets and ask – are some people benefitting more than others? You can look at the average and think you are making progress, but you need to drill down into the data.” Understanding the extent to which there is fair recognition and reward is as critical as creating the space for the conversations to take place, he points out. 

“We need to have the curiosity not to settle for the obvious answer (to any issue on inequality and discrimination).  Above all, it’s about listening with curiosity.'” His passion for his role comes from his recognition of a stark reality in 2021: “A lot of LBGTQ+ staff do not feel that they have a sense of belonging to their organisations and don’t feel their voices are being heard – this has been particularly true for trans staff this last year’ ” he says. 

On practical steps, staff networks only work, he suggests, if there is clarity and co-production of purpose in why they are set up. On the road to inclusion, some things are relatively straightforward, such as wanting to create a diverse board. But “it’s much harder to create that inclusive culture throughout the organisation.”    

“I might think I care about the staff and about them expressing diverse opinions. But it’s important to ask constantly – are those their perceptions?” he says. It takes time to be constantly listening, and then there are challenges in not having the infrastructure and resource to be able to do that, he notes.  

“You have to remind yourself that this is core business, and an emergency does not trump it. What the emergency does is show that we need to be constantly listening, with humility and purpose, to maintain this focus all the time, in our boards and across the organisation, in our culture. It has to be who we are, it’s a way of being - not a project.”  

For those in the boardroom, he counsels: “You need to change what you can offer to help people to open up. If they see you are not calling something out, they will notice. You need to recognise that what you permit you promote. “The numbers of individuals suffering discrimination should not dictate leadership reaction. Hiding behind ‘averages’ is unwise and you need to be more granular in your analysis of data. It is complex being in a leadership role and doing it well.” 

We are out of time when I ask what he would do differently. “When you are a Chair you are trying to create a space in which everyone else can thrive and contribute. I never wanted to be a Chair who dominated. But sometimes you can forget that (in leadership) you also need to remain authentic, and that means checking back regularly on how much of yourself you are bringing to the conversation.  

“At the end of the day we (NHS boards) are all people organisations that need to remain caring and compassionate with a focus on equality and inclusion. Every board must ensure that its people feel the organisation cares about them.” 

“Hindsight is a wonderful thing” he says wryly, as we end the conversation.  

“But post-Covid a focus on mental health and well-being needs to run through all organisations. Mental and emotional well-being is driven by decisions we all make, and that’s a huge responsibility. The prize is the well-being of the whole community. We need to skill up communities to deliver prevention and promotion activities and address the social conditions that are the cause of so much emotional suffering. A large employer like an NHS Trust can make a big difference to that” says Peter Molyneux.