Abstract
Changing organisational inclusiveness requires advocacy at the top. But advocacy can be costly. We examine how the costs of advocacy affect the likelihood a board member speaks about diversity issues in board discussions. We exploit the public availability of 5,298 board meeting minutes of 146 UK National Health Service hospital trusts between 2014 and 2021 to identify when individual trust directors speak about diversity issues. Female and ethnic minority directors are more likely to discuss diversity issues. However, directors are less likely to discuss issues related to their own minority background. The focus of individual discussions shifts when society places more importance on diversity and individuals become more powerful. Advocacy appears to be less costly when there is greater societal pressure for diversity, directors are not tokens, and female leaders initiate more diversity discussions. Our results highlight that relying on lived experience is not sufficient to ensure organisations become more inclusive.