04 / 3 / 2015 1.19pm
Dr Penny Newman is a GP, consultant in public health and director of integration at Colchester Hospital. She is author of Releasing Potential: Women Doctors in Clinical Leadership and runs the network Inspiring Women Leaders in Medicine. Penny is a member of the Faculty of Medical Leadership and Management (FMLM) where she works as a coach and to support their work on diversity and the advancement of women in medical leadership in collaboration with others.
Every year I take inspiration from UN Women and their mission to improve the lot of women worldwide. Gender inequalities remain deeply entrenched in every society and impact on access to decent work, basic education and health care, equal wage and representation including in political and economic decision-making. Women in all parts of the world suffer violence and discrimination. Gender equality is not only a basic human right, but has enormous socio-economic ramifications, which UN Women seeks to address. These issues affect us all, and some far more than most.
So this year I am particularly honored to look at gender equality in the NHS, and ways to achieve greater representation of women in leadership, with the support of UN Women. This fits well with NHS England’s Five Year Forward View and commitment to create a modern workforce, become a better employer and provide non-discriminatory opportunities.
But mostly this blog is a present for my mother. She turns 80 on International Women’s Day this year and she was my first and most influential introduction to gender equality as a super bright, single mother and part-time secretary in the 1960s. Her expectations in life reflected societal views which excluded University and equality in the home; this has impacted on her sense of life time achievement and financial security - and on mine.
Things have come a long way over a generation. Women were only first admitted to medical school in 1870 and my parent’s ambition for me a century later has given me huge opportunities that my mother did not have. This year we have at least six female Royal College presidents and three of four CMOs across the UK. Women have been the majority of entrants to medical schools for over two decades and will soon be the majority of qualified doctors so there is no shortage in the pipeline. One could think that the problem had been solved.
However, what lies beneath this remarkable achievement isn’t quite as rosy: There remains unequal advancement vertically into leadership and horizontally into more female - or family - friendly roles. Women doctors make up:
- 33 per cent of consultants, and are underrepresented in surgery (11 per cent consultants) and emergency medicine (30 per cent consultants) and more likely to choose paediatrics (49 per cent consultants) and psychiatry (40 per cent consultants).
- 41 per cent of GP partners, and are over represented as salaried (70 per cent) and locum GPs who have access to fewer opportunities for development.
- 24 per cent medical directors on trust boards and 26% of lead GPs on Clinical Commissioning Groups (CCG) governing bodies: Despite their being established to ensure GP input into the commissioning of health care, about 30 CCGs (15 per cent) have no female medical representation.
In other professional groups in the NHS, although women are the majority of graduates, i.e. 60 to 70 per cent of management trainees over the past three years, women make up only 36 per cent of chief executives and 26 per cent of finance directors.
At a time when the NHS has unprecedented need for better board and financial performance, problems with recruiting senior and medical leaders, especially GPs, and need for new leadership styles, why are we ignoring the data and evidence from other sectors? Why is the NHS, whose workforce is 77 per cent female, not doing all it can to make the best use of its talent? The private sector is leading the way here, and the civil service. They recognise the business case is clear and have plans in place to help more women achieve board level roles. Global and national legislative requirements may soon make this a must do.
What can be done?
Action focused on organisations – and not just individual women – is required to crack through the unconscious bias and invisible barriers that inadvertently disadvantage women.
This requires commitment from the top, an NHS business case and organisations held to account while they put their house in order – a Lord Davies report for health. UN Women have created an accountability framework (UN-SWAP) consisting of a sliding scale of 15 indicators which measure how organisations can foster greater equality of opportunities and outcomes. The framework can be modified to the NHS, while other frameworks, such as Athena SWAN Awards, should also be considered. New Workforce Equality Standards on gender will assist.
What difference will this make?
As UN Women work to offer a baby born today equal political opportunity before she is 50, and equal economic opportunity before she is 80 as is currently predicted, the NHS can offer equal opportunities to its employees now and in doing so help solve some of the challenges to the benefit of patients. It is within our gift.
This is my gift to my mother, to work towards a more equitable future for our daughters as she has done for me. Happy birthday Mum!
Blog taken from 'The use of UN-SWAP accountability framework to improve gender equality and productivity in the NHS''Newman P, 2015, unpublished.