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There are two important words in the question: representative and talent. We do need to make sure that the leadership of our health service is representative of the people we serve - and who pay us via their taxes - so that our services meet the needs of all our users. However, we also need to ensure that we encourage genuine talent - and this requires an open and honest dialogue between staff and their bosses about whether they have the skills and attitudes needed to develop their leadership aspirations.

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