It is unacceptable and unsustainable that of the 23 most senior health service positions, all are white and only four are held by women - and one of those is an interim

The sight of six chief executives from the main NHS arm’s length bodies on stage at last week’s NHS Confederation conference was an unsettling, even embarrassing one.

Everyone was a white male, creating an impression even the fustiest private sector business would work hard to avoid, let alone an institution that should be striving to reflect the population it serves.

‘It creates an impression even the fustiest private sector business would work hard to avoid’

In fact the situation is even worse.

The organisational leadership of the NHS now consists of the Department of Health together with seven arm’s length bodies – the Care Quality Commission, Health Education England, Monitor, the National Institute for Care and Health Excellence, NHS England, Public Health England and the NHS Trust Development Authority.

Unacceptable and unsustainable

Of the 14 arm’s length body chair and chief executive posts, the 12 substantive positions are all filled by white men. Of the two interim chairs, one – Monitor’s Baroness Hanham - is a (white) woman.

The face the DH presents to the world is only a little better.

All of its six ministers are white and only one is a women.

‘We urge the health secretary to appoint them’

A small mercy is provided by the gender of two of the three senior DH officials – permanent secretary Una O’Brien and chief medical officer Dame Sally Davies. Long serving DH finance director Richard Douglas was replaced another white man, David Williams.

In total, of the 23 most senior positions only four are held by women (and one of those is an interim). All are white. This is unacceptable and unsustainable.

With vacancies at CQC, Monitor and potentially NHS England should Malcolm Grant not wish to serve a second term as chair, the DH has an ideal opportunity to address this situation.

This not a question of favouritism or quotas – most HSJ readers can think of women and leaders from a black and minority ethnic community background with the expertise and nous to fill these roles effectively and with distinction.

We urge the health secretary to appoint them and make 2015 the high water mark for white male dominance of NHS leadership.

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