Morecambe Bay chief: Women still need a leg up to board level

I’ve worked in the NHS for 34 years, joining as a student nurse and working through the “ranks” – the last 13 were spent in leading organisations as a chief executive. However, the NHS has changed significantly over the years, as has society in general.

Are there more opportunities for women leaders today as a consequence? The short answer is yes …and no.

Looking back

There were many times in my early career where I recognised a great role model and approached that person for assistance and mentorship. Mentors and coaches play an invaluable role in the development of women leaders.

Being supported and encouraged to take a risk is important. There were role models who encouraged me to step out of my comfort zone. This is important, particularly as women are responsible for others’ wellbeing, including families and children. It is easy for women to put everyone else first and therefore not prioritise their own career.

At the mid-point of my career, I secured my first board level post. I was among the youngest in my peer group at the time, and although I knew it would be a steep learning curve, I believed I could do the job.

‘It is easy for women to put everyone else first and therefore not prioritise their own career’

The organisation was a large district general hospital – a successful first wave trust and the stakes were high. The board comprised older, white and male colleagues where the culture was, well, macho. However, I was supported wholeheartedly by the chief executive, was provided with development and coaching, and over time, I mastered the art of operating at this level and felt progressively comfortable with it.

In these kinds of environments, integrating leadership into one’s core identity can be challenging for women – establishing credibility in a culture that is deeply conflicted about whether, when and how they should exercise authority.

Increasingly I hear chief executives saying they want experienced board operators. This offers an obvious challenge for aspiring women leaders: how do they get that first break?

There is a wealth of talent in the people operating just below board level. For a board level post, I appointed a first time [board] director and she is flourishing.

Talk across the service

There was a time in the NHS when leadership development was a common topic of discussion, especially supporting emerging women leaders.

There was also a time when we discussed work-life balance and how to make career moves attractive for women. I led the Improving Working Lives campaign in its day.

We discussed and planned how we might make the NHS job market more attractive, including options such as job sharing at chief executive level. I asked a colleague last week whether she was aware of any chief executive job share arrangements at the moment. The answer was no.

When I became the chief executive for the first time, the trust was hundreds of miles away from where my partner and I lived. So, on being appointed, I set up a pattern which would last years: travelling on a Monday morning and renting close to the hospital during the week.

‘I set up a pattern which would last years: travelling on a Monday and renting near work during the week’

Looking back, it was a compromise. I am pleased that my partner and I managed our way through this, but the situation wasn’t easy and there were times when it tested both of us. I don’t have children and cannot imagine the strain of either being without the children for days (and nights) on end, or the prospect of uprooting the entire family.

These were big decisions and I would argue that women have to make even tougher decisions in 2015. 

Then there is the personal resilience part. Women through the centuries have fought for equality and have certainly gained some ground over that time. However, I hear far too frequently women doubting their right to sit round the table as equal partners with men. I also hear the all too easy critique we give ourselves as women.

I don’t hear that from my male peers anywhere near as often.

This erodes confidence and plays havoc with self-esteem. To be a woman chief executive (to be a chief executive full stop) requires resilience and supporting emerging leaders to develop and sustain is a major challenge.

Way forward

We must do more to support women leaders and understand how we have reached a point where lack of women leaders seems so readily accepted.

There were sniggers and jibes about the reference to the latest “boy band” at the NHS Confederation Conference this year. The fact that all of the top appointments across the arm’s length bodies were men is worth working together to change.

‘There is a wealth of talent in the people operating just below board level’

Gender imbalance as any other inequality is a serious issue.

I know many men who are advocates for women in leadership positions. It is important that men are engaged in the work to promote more female leaders; they have a vital role to play.

I hope that the HSJ Women Leaders Network generates debate, discussion and most importantly action about what we are doing to change things today.

There is strong evidence that diverse leadership in any organisation adds value. In my mind, the case is made for the NHS - now more than ever we have to do more to support women in leadership roles.

Jackie Daniel is chief executive of University Hospitals of Morecambe Bay Foundation Trust