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Dame Carol Black: Advancing women in healthcare

Advancing women in healthcare

Dame Carol Black DBE FRCP FMedSci, Principal of Newnham College, Cambridge University, and Expert Adviser on Health and Work, Department of Health and Public Health England

The Ludwig Boltzmann Forum on Women’s development and leadership was held on Monday 16 May 2016 in Tokyo in honor of Dame Carol Black’s visit to Japan.

View the full workshop program here.

(Summary of Dame Carol Black’s keynote written by Gerhard Fasol)

Dame Carol Black DBE FRCP FMedSci
Principal of Newnham College, Cambridge University.
Dame Carol Black has held top positions in medicine and now holds high-level policy advisory positions on health and work in the United Kingdom.

Women in healthcare – Women in the British National Health Service

The gender imbalance in the National Health Service is reflected by the facts that 77% of the total workforce is female, while only 7% of female staff are doctors or dentists, ie only 5.4% of total workforce are female doctors or dentists.

41% of Chief Executives are women.

81% of non-medical staff are women.

Alison Wolf and the XX Factor

Alison Margaret Wolf, Baroness Wolf of Dulwich CBE, is a British economist, and the Sir Roy Griffiths Professor of Public Sector Management at King’s College London, see:

In her book “The XX Factor: How Working Women Are Creating A New Society” (Profile Books 2013), Alison Wolf writes that women are split into two groups: one group sacrificing family for rapid professional advancements, while the other group of women opts for having children at a young age, and remain in low level positions. As a result, inequality is growing faster among women than among men, and low status and low paid jobs are predominantly done by women:

  • 97% of secretaries are female
  • 92% of registered nurses are female
  • 89% of nursing, psychiatric and home health aides are female
  • 90% of maids and housekeeping cleaners are female

The fundamentals: what are the essential characteristics of “good employment”?

  • Good work: is stable and safe, allows individual control, is flexible, gives opportunities, promotes wellbeing, reintegrates sick or disabled people if possible.
  • Good workplaces: have visible senior leadership and well trained managers, enable staff engagement, empower employees to care for their own health

Good news for medicine, less good news for academic medicine

Generally we have achieved a good situation regarding gender equality in medicine. We have achieved meritocracy, and their are no reports providing evidence for systematic barriers against women’s professional advancement. Both intake and retention for women in medicine is high, and the pay scales are the same.

A study (Royal College of Physicians (RCP) Working Party 2009), investigated the female share of Consultants (= established Senior Medical Professionals in the UK), and showed the ratio of women is highest (38% – 49%) in “more plan-able” and “more people oriented” specializations such as general practice or paediatrics, while women’s share is lowest (8% – 23%) in “more technology oriented” and “more unpredictable” specializations such as anaesthetics or surgical specializations.

There is far less progress in academic medicine, and cultural stereotypes and bias remain, see:

Women’s advance into top leadership positions suffers from “cultural” prejudices, e.g. prejudices that women too kind, too caring, not logical or strong enough, or otherwise unsuited to lead.

Prominent leadership roles for women, Prominent medical leadership

Prominent leadership roles need investment in the “extras”, leads leadership dimension in each speciality, and requires career single-mindedness.

Prominent medical leadership requires investment of time “over and above” the ordinary duties, requires professional “stewardship contributions”.

The top 200 leadership positions will naturally go to those who pursue their career goals with a high degree of single-mindedness.

Women choosing the route towards prominent leadership roles need encouragement and support, they need:

  • role models
  • mentors, and
  • sponsors

Role models: Prominent women leaders in UK medicine

  • Una O’Brien, Permanent Secretary, Department of Health
  • Professor Dame Sally Davies, Chief Medical Officer
  • Dame Julie Moore, CEO, University Hospitals Birmingham, NHS FT
  • Claire Murdoch, CEO, Central and NW London NHS Foundation Trust
  • Professor Jane Dacre, PRC Physicans
  • Clare Marx CBE, PRC Surgeons
  • Dr Suzy Lishman, PRC Pathologists
  • Dr Maureen Baker, Chair, RC General Practitioners

Need to debunk leadership myths

Its important not to fall into the traps of common leadership myths, e.g. that leadership is inborn, that leadership is that of a lone genius, that they must inspire others to follow their vision, the leadership requires formal authority, or that all leaders have common personality features.

We need to avoid similar leadership myths in medicine, e.g. that men naturally make better leaders.

Dame Carol Black: From a shoe-making village in decline to Government Advisor

Dame Carol Black is born in the shoe-making village of Barwell, Leicestershire, went to Grammar School in Market Bosworth, were she became Head Girl, despite her working class background.

Dame Carol Black studied first History, then Medical Social Work and finally Medicine at the University of Bristol, specialized in Rheumatology research, focusing on Scleroderma. Later advanced to Medical Director, Royal Free Hospital, President of the Royal College of Physicians, Chairman of the Academy of Medical Royal Colleges, Chair of the Nuffield Trust on Health Policy, then advising Government as National Director for Health and Work, and now Principal of Newnham College, Cambridge.

A major step was Dame Carol Black’s advancement to Medical Director of the Royal Free Hospital, since this meant not just responsibility for an institution or a group or a department, but also responsibility for the health of a population.

Leading the Royal College of Physicians

The Royal College of Physicians was founded by Royal Charter by Henry VIII on 23 September 1518 with the aim to promote the highest standards in medicine.

The skills required were: understanding a wide landscape, consensual leadership, standing ground when necessary, negotiating with Whitehall (= British Government) and building trust.

Chairing all the Medical Royal Colleges – The Academy, 2006-2009

Dame Carol Black from 2006-2009 chaired this group of 21 independent organizations. As Chair, Dame Carol Black had no executive powers, needed to lead by persuasion and with consensus.

Advising Government

Dame Carol Black shared several of her experiences advising Government and highest ranking Government officials and Ministers.

Key was to become valuable in the eyes of Government officials by giving independent advice based on scientific evidence, in combination with remaining totally unpolitical.

Dame Carol Black became a champion for the “cause” of health and work, and kept totally out of politics, never revealing any political views or opinion, and wrote three major reports.

The Confidence Code – forget perfection…Striving for perfection can waste women’s time, and hold back the best from reaching the top

Perfectionism and lack of confidence is large a female issue, see Katty Kay and Claire Shipman: The Confidence Code – the science and art of self-assurance, and what women should know.

Women tend to be held back by striving for perfection, while men tend to take more risks. Striving for perfection can waste women’s time, and hold back the best from reaching the top.

Women in healthcare, Women and careers, women in scientific careers

The issue of Women in Scientific Careers was examined in the “Science and Technology Committee – Sixth Report – Women in scientific careers” by the British House of Commons Science and Technology Committee in February 2014, which can be downloaded here as a pdf file:
http://www.publications.parliament.uk/pa/cm201314/cmselect/cmsctech/701/701.pdf

This UK House of Commons report finds some common traits which hold women back from reaching top leadership positions, including that women may perceive promotions as undesirable, wait until they meet all perceived criteria for promotion while men often take higher risks and may behave more speculatively, and women may think that “political” skills are required to reach the top.

Finally, to reach top leadership positions, we need:

  • self confidence
  • aspiration
  • risk taking
  • resilience
  • speaking out
  • staying motivated after failure
  • mentors, sponsors, role models
  • networks
  • personal values aligned to organisational values
Dame Carol Black DBE FRCP FMedSci: Advancing women in healthcare
Dame Carol Black DBE FRCP FMedSci: Advancing women in healthcare
Dame Carol Black DBE FRCP FMedSci: Advancing women in healthcare
Dame Carol Black DBE FRCP FMedSci: Advancing women in healthcare
Dame Carol Black DBE FRCP FMedSci, Principal of Newnham College Cambridge, and  Professor Kyoko Nomura, Associate professor, Department of Hygiene and Public Health, Teikyo University, School of Medicine
Dame Carol Black DBE FRCP FMedSci, Principal of Newnham College Cambridge, and Professor Kyoko Nomura, Associate professor, Department of Hygiene and Public Health, Teikyo University, School of Medicine

Notes

Summary of Dame Carol Black’s keynote written by Gerhard Fasol, view the full workshop program and summaries of all other keynotes here.

Copyright (c) 2016 Eurotechnology Japan KK All Rights Reserved

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Leadership Ludwig Boltzmann Symposia

Ludwig Boltzmann Forum on Women’s development and leadership – objective

Ludwig Boltzmann Forum on Women’s development and leadership – workshop objective

The Ludwig Boltzmann Forum on Women’s development and leadership was held on Monday 16 May 2016 in Tokyo.

View the full workshop program here, Gerhard Fasol’s keynote lays out the objectives of the workshop in the present article.

Gerhard Fasol CEO, Eurotechnology Japan KK, Board Director, GMO Cloud KK. former faculty Cambridge University, and Trinity College, and Tokyo University

Gerhard Fasol
CEO, Eurotechnology Japan KK,
Board Director, GMO Cloud KK.
former faculty Cambridge University, and Trinity College, and Tokyo University

Ludwig Boltzmann Forum on Women’s development and leadership: objectives

There are two immediate objectives for the Ludwig Boltzmann Forum on Women’s Development and Leadership:

  1. empower women leaders with global leverage
  2. lets change mind sets

I am building the Ludwig Boltzmann Forum as global leadership platform honoring my great-grandfather, and the Ludwig Boltzmann Forum on Women’s Development and Leadership is part if this initiative:

  • drive innovation based on science and technology
  • “there is no other forum for open discussions among leaders in Japan other than the Ludwig Boltzmann Forum” (said one of Japan’s top technology leaders, former Board Director of Japan’s largest Telecommunications Operator, former President of a large University, and former President of one of Japan’s most important technology organizations)

and as an additional bonus we will create new cooperations and new initiatives.

Ludwig Boltzmann Forum on Women’s development and leadership – my actions so far

Several confidential preparations with Japanese Ministry officials and foreign Embassies in Japan.

One key conclusion from preparations: top priority and most difficult is to change mindsets in Japan regarding empowering women and gender issues

At the 8th Ludwig Boltzmann Forum on 18 February 2016 at the Embassy of Austria in Tokyo, honored by the participation of Her Imperial Highness, Princess Takamado, and Nobel Prize Winner Shuji Nakamura, invited Professor Kyoko Nomura to give the keynote “Gender inequality in Japan: a case report of women doctors“.

Next step is today’s (16 May 2016) “Ludwig Boltzmann Forum on Women’s development and leadership”.

How to change mindsets? Expand the solution space and add new dimensions!

The basic issues, empowering women and men to combine child care and professional development, work towards greater equality and improving decision making by implementing diversity of decision makers are similar all over the world, especially in Europe and Japan.

Learning solutions from each other, expands the dimensionality of the solution space.

Expanding the solution space: learning about The Federal Ministry for Families and Youth

When we are looking for solutions to solve difficult problems, our search for solutions is limited by our experience, knowledge and imagination. Our search for solutions is in space of limited dimensionality. In many cases solutions exist outside the space we are considering.

Therefore to reach better solutions, its necessary to expand this solution space. Looking how other countries solve similar problems is one straight forward way to expand the dimensionality of the solution space, and that is where the Ludwig Boltzmann Forum aims to contribute.

As an example, many people in Japan do not know that most European countries have a Family Ministry (家族省), which represents Families at the Cabinet level. In fact, most Japanese people I have been discussing this issue with are perplexed by the possibility of a Family Ministry (家族省), and usually in response ask, what the tasks of a Family Ministry would be.

If your country does not have a Family Ministry, if you have never heard about a Family Ministry, its difficult to come up with the proposal to create a Family Ministry, and its difficult to imagine what a Family Ministry should do.

At the same time, in today’s internet age, its in theory only a click away to have a look at a Family Ministry: here is the webpage of Austria’s Family Ministry: Das Österreichische “Bundesministerium für Familien und Jugend” (The Austrian Federal Ministry for families and youth, オーストリア連邦家族・青年省)

And here is the current Austrian Minister for Family and Youth, Dr. Sophie Karmasin. 49 years old, with two children, Dr Sophie Karmasin has achieved a Doctorate in Psychology on “consumer behavior in the health market”, from 1993 to 2013, for 13 years she has pursued a very successful career in industry, most recently as Managing Director/CEO of a major market research company, before becoming party independent Minister of Family and Youth. She is not affiliated with any political party, but independent politician since 2013.

Expanding the solution space: wouldn’t it be better to have at least one woman on a committee promoting women’s empowerment?

Compare Family and Youth Minister Dr Sophie Karmasin with the all-male “woman act.” committee promoting women’s equality in Japan’s Kanagawa Prefecture, wouldn’t it be better to have at least one woman on a committee promoting women? But unless you are familiar on how this is done in other countries, your solution space is limited to what you know.

Why did today’s Ludwig Boltzmann Forum on Women’s development and leadership happen? Because of Trinity College Cambridge

At a recent event of Trinity College Cambridge in Hong Kong, I met with Dame Carol Black, and our meeting led to today’s Forum.

Trinity College was founded By King Henry VIII in 1546 by combining the two older colleges King’s Hall and Michael House and seven Hostels. Sir Isaac Newton worked at Trinity College and about 32 Nobel Prize winners are or were members of Trinity College. Trinity College is part of the University of Cambridge

More about Trinity College Cambridge, for example on the website of our Trinity in Japan Society.

Why Ludwig Boltzmann Forum? Who is Ludwig Boltzmann?

Ludwig Boltzmann is one of the world’s most important physicists and we use his results and tools every day. Here are some examples of his work:

  • How we measure temperature (Kelvin, Celsius) is directly linked to Boltzmann’s constant k, especially after the new definitions of the SI International System of measurement units
  • S = k log W, linking macroscopic entropy to the microscopic statistics of molecules, and linking statistical mechanics with measuring information, and the arrow of time
  • the Stefan-Boltzmann radiation law
  • Boltzmann transport equations are used to design jet engines and aircraft and in semiconductor physics and many other areas
  • philosophy of nature
  • and much much more….

I am developing the Ludwig Boltzmann Forum a global leadership platform in honor of my great-grandfather.

Ludwig Boltzmann and women’s development and leadership

1872 Ludwig Boltzmann met Henriette von Aigentler (my great-grandmother), who was refused permission to unofficially audit lectures at Graz University, where Ludwig Boltzmann later became University President. Ludwig Boltzmann advised her to appeal, in 1874 Henriette passed the exam as high-school teacher, and on 17 July 1876, Ludwig Boltzmann and Henriette von Aigentler married.

One of Ludwig Boltzmann’s students is Lise Meitner (November 1878 – 27 October 1968). She was only the second woman to be awarded a PhD in Physics from the University of Vienna. Later she was part of the team that discovered nuclear fission, Otto Hahn was awarded the Nobel Prize for this work. Element No. 109, Meitnerium, is named after Lise Meitner.

Ludwig Boltzmann Forum on Women’s development and leadership – outlook and next steps

  • Lets build the Ludwig Boltzmann Forum on women’s development and leadership together
    • Lets empower women leaders
    • Lets change mind sets
  • Lets build the Ludwig Boltzmann Forum into a global leadership platform based on science and logic
    • lets expand the solution space for important problems, and work towards implementing these solutions
Ludwig Boltzmann Forum on Women’s development and leadership
Ludwig Boltzmann Forum on Women’s development and leadership
Ludwig Boltzmann Forum on Women’s development and leadership
Ludwig Boltzmann Forum on Women’s development and leadership
Ludwig Boltzmann Forum on Women’s development and leadership
Ludwig Boltzmann Forum on Women’s development and leadership
Ludwig Boltzmann Forum on Women’s development and leadership
Ludwig Boltzmann Forum on Women’s development and leadership

Ludwig Boltzmann Forum on Women’s development and leadership: Notes

Ludwig Boltzmann Forum on Women’s development and leadership summary written by Gerhard Fasol, view the full workshop program and summaries of all other keynotes here.

Copyright 2016 Eurotechnology Japan KK All Rights Reserved