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There is an additional concern when you consider that women give birth, do more child care and live longer. All of this means women probably outnumber men as service users overall too. Many commercial industry boards have found they considerably improve productivity when their boards are reflective (in style as well as well as look) of both front line staff and service users. Leadership style at the top should reflect the style on the front line required. In other words. If you want a culture of service, empowerment and partnership between service providers and service users you need to see this "service culture" modelled down through the organisation. The NHS is not a military. We don't need a culture of command and control. We need servant leadership. The clue is in the title. It is a national health "service" .