Top hospitals show bias for male nurse directors

17 August 2010 | By Steve Ford, Charlotte Santry, Sally Gainsbury

Male nurses are twice as likely to hold a top job in England’s leading hospitals, a Nursing Times investigation has revealed.

In a survey of 84 acute trusts, 47 of which had foundation status, 8.1 per cent of non-foundation trust nursing directors were men but the figure jumped to 14.9 per cent among foundations.

Men make up:
7.9% of acute nursing workforce
8.1% of acute non-foundation trust nurse directors
14.9% of acute foundation trust nurse directors

By contrast, men make up just 7.9 per cent of the total acute nursing workforce.

The figures are being blamed on the “business ethos” of foundation trusts deterring women from applying for leadership roles or being picked for top jobs.

Unison head of nursing Gail Adams called the figures “worrying”. They could be due to foundation trusts focusing on their business models instead of “moral and ethical” concerns over equality, she said.

She urged foundation trusts to investigate whether women had been disadvantaged because of career breaks or biased recruitment processes.

Julie Stevens, West Middlesex University Hospital Trust consultant lead nurse in tissue viability, said: “The perception is that [in an FT] you need to have more of a financial head.”

Men might be seen as more “financially canny” than women, she added. Nurses had little training in business, but men were more able to “put on a front”.

Royal College of Nursing head of policy Howard Catton agreed foundations were perceived to have a “harder style”. He said that, added to the lack of senior clinical leadership at regulator Monitor, could be associated with a male bias.

The same trend was apparent when deputy nursing directors were included in the figures. Taken together, nursing directors and deputies were 10.8 per cent male in non-foundation trusts but 15.5 per cent in foundations.

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Equality and Diversity

Derby Hospitals Foundation Trust director of nursing Brigid Stacey said, as male nurses were in the minority, “they might want to fight harder to get to the top - to be the big fish”.

“It might be that men want to strive harder for those prestige [foundation trust] jobs,” she said.

However, NHS South Central chief nurse and director of clinical standards Katherine Fenton said she was “really, really surprised” at the figures.

She said: “My personal experience is that it [gender] has never held me back, and it’s not included as a factor in our appointment panels. It might have been true 25 years ago but it’s down to merit now.”

A smaller sample of 27 mental health trusts, where men make up a bigger proportion of the nursing workforce, shows a similar pattern as acutes.

Among mental health foundation trusts, 37.5 per cent of nursing directors were male, compared with 27.3 per cent of nurse directors at mental health non-foundations.

David Robinson, Barnet, Enfield and Haringey Mental Health Foundation Trust director of nursing, quality and safety, said his trust, where three quarters of senior nurses were female, was an “exemplar”.

He said: “We try and ensure gender and ethnic balance throughout the organisation by nurturing talent. Flexible working applies right up to director level.”

Claire Murdoch, a former nurse who is now chief executive of Central and North West London Foundation Trust, admitted women had to break through a “glass ceiling” to get to the highest positions.

However, she said some of the gender imbalance was due to women consciously staying in their “comfort zone” rather than pushing themselves into more senior roles, which were harder to juggle with childcare.

She said while employers should allow staff flexibilities to cope with senior roles and child care, there needed to be a “reality check” about how far that could go as board positions were largely full time jobs.

NHS Employers employment service deputy head Caroline Waterfield said Nursing Times’ findings did not show there was a “glass ceiling” for women, but rather that “there isn’t a glass ceiling for men”.

Nursing Times’ research suggested the gender imbalance was less pronounced among primary care trusts. As PCTs will be abolished from 2013, this could lead to many senior female nursing leaders being made redundant.

A Monitor spokesman said it was up to boards to choose the right person for the job.

Readers' comments (68)

mike | 17-Aug-2010 1:29 am
Doesn't this make up for the blatant sexism men get on the way up there? (Ducks and runs for cover!)
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Anonymous | 17-Aug-2010 9:17 am
I don't see the point of this 'investigation'. Nobody ever bothers making anything out of the fact there are far more female nurses than male ones???
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simon williams | 17-Aug-2010 9:22 am
neither do I
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Anonymous | 17-Aug-2010 11:25 am
If they are mainly gay men does this make it all right?
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Anonymous | 17-Aug-2010 5:01 pm
as a male I agree with the female respondents who rightly say 'if you want the tops jobs then go and get them' -stop bloody moaning and trying to play the 'discrimination card'. The male/female ratio is irrelevant, as is the so-called 'male attributes' argument. I have met some very powerful (and nice!) female leaders who did not sit around examining statistics but worked hard and got to the top.
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EJML | 17-Aug-2010 6:48 pm
i've been asked quite a few times if i'm going to go into managment in the future. even got offered a job in second year of my training becuase they said we didn't have enough men, out in the community. not to mention in the past i have been told off from reading children's stories to kids becuase they have been sat on my lap, which is normal for a kid to do! it's so stupid, the majority of nurses have been okay but this is just from being a student god knows what it's going to be like when i'm a registerd nurse.
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Anonymous | 17-Aug-2010 9:20 pm
It's got nothing to do with going and getting the top jobs if you want them, it has everything to do with who you know and whether your face fits I'm afraid, male or female.
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Steve Williams | 18-Aug-2010 1:23 am
Oh oh here we go again. Wheel out the old stereotypical arguments...

I'll just say this (before I join mike in ducking and running for cover...) The Americans have a saying that anyone can become President – if they want and work hard enough for it. Witness President Obama.

The same holds true in other countries (regardless of gender) witness Golder Meyer, Margaret Thatcher, Cleopatra and Indira Gandhi. If you want it hard enough you'll get it.

So... Not getting the top positions even though you make up the majority of the workforce? Go figga!

Move over mike, make room in the bunker, I'm headed your way!
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Anonymous | 18-Aug-2010 2:43 am
I find this amazingly frustrating. I work as a band 6 in an Emergency Department, and when I ask around most of my colleagues if they would go for a senior post, most say "No, I can't be bothered with the hassle, it is too much responsability. It is not worth the money." Well, I went for it, I got the job.
Now, they say that I got some sort of preferential treatment, because I am a man?!?!?
Please, give us a break!
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Anonymous | 18-Aug-2010 9:45 am
Hey lets face it, they're only top hospitals because the nursing directors are male.

JOKE.
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Anonymous | 18-Aug-2010 9:49 am
I am "Anonymous | 18-Aug-2010 9:45 am" and thought I'd add this before a war breaks out (I know many nursingtimers have no sence of humour).

Seriously, the situation is the way it is just because that's how it is. It hasn't been shaped that way and it shouldn't be shaped any other way either. Men have the managerial roles because it's what they want and are possibly better at. Just as women have the clinical roles because it's what they want and it's what they're better at. Nobody is stopping anybody from getting where they want to be, the only barrier is themselves.

If you want it, work for it.
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Anonymous | 18-Aug-2010 10:47 am
There iare lies. damn lies and statistics! What are these percentage figures really saying ... maybe standardising to the population would be a way forward. Saying that I did meet a gay, male nurse recently who readily admits using his gender and sexuality toget to the top really quickly! As a gay male he is more flexible in relation to hours and location and will not have child care issues!
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Anonymous | 18-Aug-2010 10:57 am
As a single (gay - not that it matters!) male nurse who was constantly passed over for promotion in my clinical career in favour of the ward manager's best (female) friend, and told on another occasion that the married female colleague needed the promotion more than I did (even though less qualified) as she had a family and children to help support, I think that the whole argument about male promotion is bunkum. Yes, more men may get to the top posts in these hospitals... but their absolute numbers is meaningless and sorry, yes... I too can concurr with the experiences of others that many of my former female colleagues just couldn't be bothered to make the extra effort to get promoted - or didn't want the responsibility. They wanted a wage, not a career, and were the first to take time off at regular periods for spurious reasons - or didn;t want to work weekends or bank holidays. Sorry to dissuade you, but nursing is a 24/7 career ladies! As for men putting on a good show when talking about financial matters - how patronising. I came into nursing after a very successful banking and finance career (with the requisite qualifications in addition to my nursing ones, so in my case no need to 'put on a front' as your previous contributor suggests. In a nursing career spanning 21 years I have encountered endless and persistent anti-male bias, sentiment and yes.. frankly, bullyinig! It has not changed and I also saw it in my teaching career when working in the UK where promising male students have been bullied or intimidated by female colleagues who quite frankly, were jealous of anyone who wanted to aspire to somthing more than the mediocrity and 'don't rock the boat' solidarity of a female cabal who only wanted an easy life and the most convenient shifts to fit around their life choices with little professional ambition at all. I now live outside the UK where sex or gender isn't an issue at all and people are promoted on merit! Grow up people. Time to move on and start talking about things that really matter to patients!!!
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Anonymous | 18-Aug-2010 11:08 am
How typical of NT to persist in a debate which is as stale as much of the news they report. The NHS is facing the most swingeing cuts ever.... nurses' and other public health workers' salaries are threatened by wage freezes in an age of increasing inflation... and all NT can do is try to reignite a gender battle which quite frankly, is irrelevant to most nurses and their patients!
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June Bowden | 18-Aug-2010 11:54 am
My experience of 36 years in the NHS working in about 10 different hospitals and 5 different Trusts is that promotion depends upon the culture within the hospital. I have worked in departments where Male nurses ARE fast tracked and most of the management are men, and in departments where male nurses are marginalised. Basically you cannot generalise.Nor can you say that male of female nurses might or might not lack ambition. I have met male nurses happy to remain staff nurses and female nurses who have pushed and pushed for top posts and blagged their way into them. It took me 30 odd years to get to my senior position and not from lack of trying, but I am not very good at blagging!
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EJML | 18-Aug-2010 2:27 pm
does anyone know if there has ever actually been a male winner of the Florence Nightingale medal? haven't a quick loon on the internet and it dosen't look there ever has. that seems a bit weird to me.
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Anonymous | 18-Aug-2010 3:24 pm
Perhaps after reading the above it might be said to come down to this. Nursing a traditionally female role was a vocation and not about the numbers. Men by contrast from experience have bypassed this emotion to a greater extent and see our profession as a career, something to progress through not work within. I appreciate before the wave of scorn follows that this opinion is not so black and white and both genders strive to develop but lets face it a lot of men in the profession know how to display the caring front for as long as it takes to treat, discharge and move on to the next patient. sorry to say but i think its about time my female colleagues stopped playing the 'male' card. Seems now we no longer have the'Masons' to blame for men getting to the top its time to stop playing that old broken record. By contrast to the figures projected from my immediate line manager up to board level there are only two men with 5 women holding comparable / senior roles.
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mike | 18-Aug-2010 6:45 pm
Steve, is it okay to pop my head up out of cover yet? Ha! To be fair there haven't been as many feminists getting on their high horses as I thought there would be!! Ha! (Dives back into cover!)

Anonymous | 18-Aug-2010 3:24 pm, perhaps it is more down to the fact that men are less willing to be used and abused, maybe it is just because we look after OURSELVES just as much as our patients?
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mike | 18-Aug-2010 6:49 pm
And another point, isn't 8.9% and 14.9% still low numbers? Why not say the trusts were biased toward women in 91.1% and 85.1% of cases? Bias toward men my arse! Ha!
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mike | 18-Aug-2010 6:49 pm
Sorry, editing mistake, should have been aren't, not isn't.
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