Policy and organizational implications of gender imbalance in the NHS

Purpose – The purpose of the paper is to examine the policy and organizational implications of gender imbalance in management, which research suggests exists in the NHS. Design/methodology/approach – The research in this paper involved a qualitative approach with an analysis of élite interviews conducted with a non‐random sample of officials involved in health policy and interviews with a random sample of senior managers in NHS Scotland. The research formed part of a larger study, which explored the enablers and inhibitors to female career progression in various Scottish sectors. Findings – The paper finds that gender imbalance in management exists in the NHS. This is manifested in a masculine organizational context, leadership and policy decision‐making process, which have implications for female career advancement opportunities and subsequently access to macro policy decisions. Research limitations/implications – The paper involved a sample (30 percent) of senior managers and examined policy processes in NHS Scotland. To improve the external validity of the findings further research should be conducted in NHS organizations in England and Wales. Practical implications – The findings in the paper suggest that gender imbalance in management and a masculine organizational context and leadership style within the NHS create a less than conducive environment for female employees. This has practical implications in terms of levels of part‐time employment, career progression and attrition rates. Originality/value – The paper adds to the debate of gender and organizational studies by examining the health sector, which has high levels of female employment but low levels of female representation at senior management levels. The paper therefore adds to an often‐neglected area of study, women in leadership and senior managerial positions. The paper is original in its approach by examining the micro and meso organizational dimensions which impact on women's ability to influence macro health policy.