Education on gender equality should be included in NHS staff contracts and performance review, deputy ombudsman Hilary Scott said last week.

Giving the annual Barbara Diamond memorial lecture at the University of Westminster, Ms Scott pointed out that, despite all the effort promoting gender equality, women still hold only 10 per cent of senior clinical and managerial roles.

Though comprising 70 per cent of the total workforce, there are still only a handful of women at chief executive level in the NHS.

'There are a disproportionate number of women at junior management level, a disproportionate number are single or childless, and a disproportionate number leave.

'The national women's unit in the early 1990s changed things for a while but not in the longer term - the number of women in senior positions is not any higher now than 10 years ago, ' she said.

As a former senior NHS manager, most recently as chief executive at the then Tower Hamlets Healthcare trust, Ms Scott said she had not personally experienced the 'glass ceiling'. But, she added:

'Women are leaving because they're not getting anywhere - It is not just about kids and families and the rest. '

Both as a provider of services and as an employer, Ms Scott suggested, the NHS still had a long way to secure equality for women.

Traditional methods of promoting equality, including mentoring, flexible working and assertiveness training hadn't worked because 'they concentrate on fixing the women and not fixing the organisation', she told the audience.

Ms Scott pointed to the strategy of management consultants Deloitte & Touche which had insisted that all its executives attend a two-day workshop on gender issues, 'having made the connection between losing talent and profits'.

She urged the NHS to take urgent steps to increase the involvement of women in three key areas: research, healthcare planning through user participation, and organisation.