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The NHS sets target. Hits it.

As a headline this falls into the same category of “Man bites dog” or “Freddie Starr ate my hamster”. 

The current challenges facing the NHS - funding, an ageing population, Byzantine organisational structure, etc. - mean that it has consistently underperformed against expected standards. It has made little difference whether the targets set have been self-generated or imposed from outside, the NHS tends to undershoot clinical benchmarks and overshoot budgets. Hence I was relieved to read the recent HSJ leader - Let’s aim for 50:50 on boards by 2020. Finally, I thought, the NHS is going to set itself a target it can actually hit.

I wrote recently about the concept of corporates having external gender targets imposed on them by Europe for the appointment of NEDs. This elicited a wide range of comments - the most popular being a variant of “Board diversity good. Targets bad”. To me, setting tough targets, with legislation behind them if necessary, is the best way to alter behaviours. For all of its undoubted clumsiness, by setting really tough targets businesses will definitely have to change their behaviours to avoid legal recourse, financial penalties and, worse, brand damage.

Which leads me to the NHS setting itself a target of 50:50 representation on executive boards. On the face of it, this sounds both punchy and admirable; punchy because it would appear a very difficult thing to do, and admirable because it would be great to see the UK’s most significant employer showing big business what progressive thinking can achieve.

However, just how punchy and admirable would a gender balanced board really be in the context of the NHS?

Not very.

The punchiness of all large corporates achieving NED gender quality is unquestioned, and in some sectors (engineering for example) it may be that Executive Boards, made up of the products of decades of ill-informed GCSE choices and hiring decisions, are chasing an unachievable dream. However, in truth, the NHS should be able to create balanced boards, in every case. Approaching 40% of Trust CEOs are women, and I think it’s reasonable to assume that if an uplift to 50:50 is in sight for the top job, then it should attainable for the board as a whole. Look at Birmingham Women’s NHS Trust: 10 women and 2 men on its Executive Board. 

So, the punchiness of the target might be questionable, but surely this should make the NHS all the more admirable as an employer for upholding the principles of gender diversity? 

Sadly not.

The NHS has a huge advantage over many corporates when it comes to gender diversity: a workforce which is around 80% female. In that sense it has a huge pool of female talent to nurture, and hence achieving 50:50 representation is a good deal less impressive then it would be in the engineering industry (94:6 - male:female). In fact, in many ways, a 50:50 split is perhaps letting the NHS off the hook and, if it weren’t a public employer whose diversity should be representative of the UK demographic rather than its workforce, then that would definitely be the case. Perhaps this is an important lesson for all those who would seek to impose targets in and on the NHS. 

Make the targets easier.

Steve Rutherford is the Managing Partner at Interim Partners.

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