HSJ’s research has found there are more female leaders in the NHS than there were 12 months ago, but this good news shouldn’t distract us from the barriers still facing women in the service

There are more female leaders running NHS organisations than there were last year. The rise is a relatively small one and the proportion of male to female leaders is still unacceptable – but the trend is in the right direction and should be a cause for celebration.

‘Celebration of progress and inspiration should not blind us to the challenges still facing female leaders’

What is particularly encouraging is that the increase in female leadership is reasonably consistent across the commissioning and provider sectors, and in each discipline. We are now approaching equality or critical mass in important areas.

There are, for example, only 25 more men than women filling the role of accountable officer on clinical commissioning groups. Many might also be surprised to discover there are, to single out two male dominated domains, 91 NHS providers with female chief executives and 56 where the finance director is a woman.

In the light of HSJ’s findings, it feels especially appropriate that tonight at 8pm we will reveal our second annual list of healthcare’s most inspiring women. It will not just be women who can draw inspiration from the achievements of those chosen by our judges. It is also an unusual and exciting list that contains talent ranging from service users to chief executives.

The debate over female leadership was given fresh impetus by last year’s launch of HSJ’s Most Inspirational Women in Healthcare. Within weeks there were moves to bring the women together to debate how their example could be used to improve levels of representation. We hope and trust the women who constitute the class of 2014 will give that debate even more momentum.

‘The nature rather than the level of criticism is different for female leaders, and it tends to be more pernicious’

However, celebration of progress and inspiration should not blind us to the challenges still facing female leaders. Many of these are well known and discussed, such as the lack of role models and the need to balance family and work life. Yet there is one challenge that often goes unrecognised – and that is how women are treated when they are perceived to be struggling or failing.

The nature of HSJ’s role means we often deal with the failure of leaders. When that leader is a woman something very distinctive happens.

Many times the views expressed will suggest that while male leaders fail because they are insufficiently good at their job, female leaders have some kind of character flaw that has proven to be their nemesis.

Character assassination

It is not that male leaders do not receive unfair criticism. Witness, for example, the pitiful schadenfreude displayed towards Salford Royal Foundation Trust chief executive Sir David Dalton over the failings within the trust’s surgery department.

It is the nature rather than the level of criticism that is different for female leaders, and it tends to be more pernicious and undermining of a leader’s resilience.

Time and again it is suggested to HSJ that a female leader is struggling because she is neurotic, devious, scatter-brained and/or self-centred; or that her troubles have arisen because she is a flirt or a sycophant and has been overpromoted as a result.

‘We must all be alive to criticism that is skewed by prejudice and hold ourselves and others to account to combat it’

And before female readers get too angry at their male colleagues, the critics are just as likely to be women – or indeed, those who would normally consider themselves strong supporters of equality.

Female leaders know this character assassination takes place – they hear it on the way up. They understand that people are more unforgiving of women who make the difficult decisions that face most leaders, especially if not all goes to plan. This creates another barrier to progression.

The answer to these double standards is simple: we must all be alive to criticism that is skewed by prejudice, however subtle, and hold ourselves and others to account to combat it.