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Why tackle gender inequality in NHS leadership?

Women make up the vast majority of NHS staff, both in clinical and non-clinical functions, and make up the majority of medical students and people entering the health professions. But they are still a minority in the senior ranks of the profession and in senior management. This under-representation of women has the potential to affect the priorities the NHS has in terms of service provision. It also demonstrates quite starkly how even in female-dominated organisations, women have been held back, either deliberately or structurally, from getting to the top.

Our Women in Leadership event, featuring Rachael Maskell MP, a former physiotherapist, Kirstie Stott, Programme Lead for the NHS Graduate Management Training Scheme, Jos Bell, Chair of the Socialist Health Association, and Rika Talukder, a junior doctor, discussed ideas about how to improve the situation. 

It was apparent that the difficulties women face in advancing in the medical and associated professions start at university. While the hard professional skills are vital to learn, so-called “soft skills” such as leadership are also important for long term success. Women make up the majority of medical students and often achieve better academic results. It is incumbent on universities and professional trainers to ensure that women are mentored and encouraged to take on leadership roles and learn the importance of management alongside professional training. 

In addition, it is the responsibility of educators to ensure that women do not have their horizons narrowed by preconceptions about what specialisms are better suited for men and women. We can tackle this problem in two ways. Firstly, there needs to be a focus on identifying and using positive role models in specialisms where women are under-represented. Secondly, and more importantly, there needs to be a cultural shift; a surgeon, for example, needs to have strong leadership skills, but she does not have to exhibit “traditionally male” traits in order to demonstrate that leadership.

The “soft skills” concept was a key theme of the evening. A major problem that was highlighted was the problem that medical professionals often face of being pushed into playing narrower roles and having narrow functions. While unproblematic in itself, it means that people can find it difficult to think of themselves as being able to take on leadership roles. Where women in particular are not encouraged to put themselves forward, often by male superiors, this issue creates a vicious circle for women. A concept of seniority reliant on longevity rather than achievement also makes it difficult to identify when someone is genuinely suited to take on responsibility.

Internal recruitment processes within the NHS came in for criticism. The recruitment process can often be excessively rigid, formal and process-driven. This can benefit those who see themselves as “natural” leaders and those who are of a similar social group to the assessors. The panel thought a better way of internally recruiting was to have a looser mechanism whereby top performers (identified by a holistic process rather than according to narrowly drawn criteria) could gradually be given more responsibility and prepared to enter management if they so choose. It was also felt to be important to ensure that people who want to maintain a strong clinical practice are enabled to do so alongside having management responsibilities. There are a wide range of types of “leadership” roles within the NHS, some which require more commitment than others and which would all benefit from greater gender parity. 

Finally, external recruitment processes also suffer from problems. Where senior managers are brought in from industries or professions where gender equality is even worse, there can be a tendency to hire men rather than women. We need to make sure, using quotas or otherwise, that NHS recruiters are required to make the people they recruit externally look more like the NHS workforce rather than a FTSE 100 board of directors. The panel also highlighted that often this issue would not need to exist if sufficient steps are taken to encourage and promote women internally.

The NHS, and the medical and allied professions in particular, suffer quite considerably from the gendered effects of stereotyping, over-work and poorly defined career paths. To tackle them, and to make NHS management more representative, we are going to need to increase the levels of flexibility, support and mentoring available in the NHS, and concentrate on developing leadership skills from day one of training. Whether we can do this in the light of the NHS funding squeeze is doubtful. But when we waste talent and get our priorities wrong, and when we waste money on recruitment and on training women who drop out of the profession, we can’t afford not to put the changes in place to boost women and improve our health service for everyone.

Blockchain, transparency and regulation

In this article I will argue that the regulator should not be concerned with the underlying technology of the blockchain, but rather concern itself with (1) its own use case of blockchain and (2) the regulation of firms that use the blockchain. The article was published on 20 June 2016.

Time to act to save the Human Rights Act

My proudest moment as a Labour voter and activist is when I think of Labour's implementation of the Human Rights Act

Blue Labour: What is to be done?

The Young Fabian Book Club met this week to discuss Adrian Geary and Adrian Pabst’s “Blue Labour”. The Book is a collection of essays from prominent thinkers in the Blue Labour movement and seeks to set out what the movement stands for.

UK needs to lead not leave on climate

The UK should be leading on environmental action - and not leaving it. The EU accounts for 10% of global emissions, but has a bigger role to play in setting standards for the rest of the world through legislation and regulation. With ‘Brexit’ threatening current UK and EU energy and climate policy, how can positive framing create a win-win for those keen on a low-carbon, European future? 

The new junior doctors' contract: does everybody win?

After months and years of arguments, claims, counter-claims, protests, rhetoric, and anger, the BMA leadership and the Government have finally come to a compromise deal on the proposed new junior doctors’ contract. It’s not over yet. The precise wording of the contract has to be worked out, and the junior doctors have to vote to approve it in a referendum from 17th June to 1st July (having a referendum any time other than late June is inconceivable.) 

Let's not afraid to be glib. The Future of the Left depends on it.

The Labour Party is losing its ability to speak outside of the narrow community of members, activists, and loyal supporters. This is not a Blairite, Brownite or New Labour obsession. Tell that to the brilliant communicators of the new left-wing movements in Europe, Pablo Iglesias of Podemos or former Greek minister Varoufakis. 

Work in the Age of Automation

Three weeks ago Nick Srnicek (author of Inventing the Future: Postcapitalism and a World Without Work) and Cllr Joe Goldberg (Cabinet Member for Haringey Council) spoke to the Young Fabian Technology Network about the effects of technological change on the future of employment.

Their perspectives provided an insightful summary of the different positions in the debate on how to respond to the increasing automation of work - Joe Goldberg argued a focus on education, training and investment (particularly in STEM fields) will provide people with the skills to adapt to these changes and retrain, whilst Nick Srnicek suggested trends such as automation and robotics will eventually replace most of the human labour required by our economy and we should attempt to build a society where income is detached from work.

Although these two viewpoints aren’t necessarily contradictory in the short term (state investment in science and technology are necessary for either), Srnicek argued capitalism in its current form has “run out of steam” and no longer produces growth - one reason why technological change will not create jobs to replace those destroyed as happened in the last industrial revolution. This, alongside recent data showing many of the fastest growing employment sectors don’t require a degree, suggest an increasingly low wage, low skill economy. Joe focused on generational changes such as having more geographical mobility than our parents, which, combined with few millennials having mortgages, means the next generation will have the freedom to change city and jobs far more frequently than their parents.

A large portion of the discussion centered around the idea of a Universal Basic Income. Goldberg proposed a version of basic income that replaces the current benefits system and protects people from the potentially devastating effects of economic and cultural changes that the next industrial revolution will bring, but rejected the idea of a “post-work” society; with the huge global shifts occurring across the world London’s attractiveness as a global hub is as much threatened as the economy would be if people were to stop working with innovative ideas and businesses. Both speakers agreed that other issues such as tax and housing reform would need to happen before a basic income would be possible.

Despite differences in their predictions for the future, there was an acknowledgement on both sides that capitalism has changed and the Labour Party must change with it, with Goldberg noting that the left’s traditional solutions are industrial solutions, unsuited to a post-industrial world.

Tackling Tax

An unjust tax system that favours the few only serves to hurt us all. Revelations of widespread tax avoidance unearthed in the Panama Papers has thrust the UK’s fiscal system to the forefront of public consciousness in an unprecedented fashion. The Labour Party must take this rarest of opportunities to hammer the Tories not just for their championing of tax havens, but for their pig-headed approach to taxation as a whole.

The Conservatives have failed on tax reform

Over the last 48 hours, the world has been rocked to its core, following the biggest leak in history. The Panama Papers have shed light on the way in which the political and economic elite have been purposefully evading tax and shielding their wealth from the public eye.

Housing our neighbours

If we are to appear as a government in waiting we must overcome the tenderness of discussing immigration policies, and we must do this fast. This starts by going straight to the core of this debate by asking ourselves, how do we actually intend to house new arrivals, particularly the most vulnerable? 

Budget 2016 - Sweet or sour for the NHS?

You could be forgiven for thinking that Wednesday’s budget didn’t say much about health – other than that headline-grabbing sugar levy. And following the frontloaded increase in NHS funding set out in November’s Spending Review, you might think that the health service really isn’t doing too badly under this government. 

But, as ever in health policy, things aren’t quite that simple. 

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