Healthcare systems need more women at senior level

Professor Nora Colton is on a mission to improve healthcare systems around the world

DiversityQ caught up with Professor Nora Colton, Inaugural Director of the Global Business School for Health, to discuss the need for better diversity and promoting more women to the top table. This is what she had to say…

Healthcare systems need to change, emphasising value rather than cost and providing more opportunities for diversity in senior roles.

The new Global Business School for Health (GBSH), based at University College London (UCL) East, aims to achieve this by supporting improvements at clinical, operational, strategic and policy levels.

According to its website, the school’s guiding principle is “to deliver the United Nation’s Sustainable Development Goal of Universal Health Coverage worldwide with effective, quality and affordable health services”. GBSH offers four programmes: an MBA in health and MSCs in global healthcare management, biotech and pharmaceutical management and digital health and entrepreneurship. Each course is available as one-year full-time or part-time over two years.

The school’s Inaugural Director, Professor Nora Colton points out: “We don’t teach science but the business side of those industries. In all of them [the courses] is the notion that you have to be an innovator, you’ve got to be a fearless, courageous leader, willing to put yourself out there and make meaningful change to the sector that so badly needs it.”

She explains that the school was created to address an area that had been neglected. The COVID-19 pandemic had provided the impetus for establishing the school as it had exposed weaknesses in healthcare systems around the world. Also, because healthcare systems are different, it was essential to have a comparative global perspective.

Healthcare systems need a rethink

Colton was appointed in January this year. One of her first actions was to interview people in the NHS and the private sector about the impact of the pandemic and healthcare systems generally. “The answer was always the same,” she reveals. “That we’ve put a band-aid on crisis and got through it, but we’re a far cry from solving this tsunami of healthcare needs that are coming along the way. Health systems cannot just tinker the edges; they need a complete rethink.”

Creating a professional school with academic rigour and that meets a societal need attracted her to the role. She brings significant senior leadership experience to the job, most recently as UCL’s Pro-Vice-Provost for Postgraduate Education and as Joint Director of Education at the Institute of Ophthalmology and Moorfields Eye Hospital. She has an academic background as a development economist. Before joining UCL, she was Dean of the Royal Docks Business School and Deputy Vice-Chancellor at the University of East London. 

A key issue within healthcare was that, while women made up the lion’s share of the workforce, very few were at the top table. Says Colton: “Part of it is historical. When I was a child and thought of a nurse, it was female, and a doctor was male. It is even starker in low-and middle-income countries; less than 5% of healthcare leaders are women.

“So, we created a scholarship programme to develop women leaders in healthcare – and I’m hoping to raise much more in scholarships and funds – because I wanted to elevate this topic. It’s not just about mandating people to the top table; we’ve got to help build up women’s confidence. As women, we always feel like we have to earn our spot there, and we’re not very good at promoting ourselves.”

Unfortunately, Colton has found that working from home, far from being an advantage for women, had put them under undue pressure, particularly if they had children. She feels that the pandemic has been “a perfect storm for women” and adds: “In the first lockdown, publications by male academics went through the roof, but those from women went through the floor.”

Value over costs

Healthcare generally needed to be more patient-centric, whereas it tended to be delivered for the clinicians and consultants. There was also too much focus on containing costs, and that healthcare had been unfairly compared with other sectors that were easier to automate.

“For example, textiles where I can buy a shirt for less than the price of a hamburger,” Colton argues. “We have not valued the professionals that make up the healthcare workforce. Instead of saying that, as a society, we can spend less on clothes and more on healthcare and education, we’ve said we need to contain costs and keep wages down.

“It breaks my heart when I see a talented nurse go on to be an airline stewardess because she’s got to feed her kids. So, for me, it’s about being patient-centric and learning more about the value of healthcare, rather than the cost.”

In addition to the scholarship for women, the GBSH also has ones for those from low-and-middle-income countries and people from East London, where the school is based. By September 2022, there will be a coaching/mentoring programme for women.

“My desire would be to track the women back into the workforce, maintain that relationship and be able to measure if we’d made a difference,” says Colton. “It’s not all about changing the person; it’s also about changing society. It’s not a magic wand, just part of what we need to highlight the issue. We need to get leaders to realise that they’re not doing well enough and that they need to bring their colleagues to the top table in more significant and aggressive numbers.

Diversity of staff and students

“We’re trying to encourage more men not to be fearful of losing their positions and to recognise the value of having more female colleagues in senior roles. Part of how we do this is to show them the data. The research is decisive: when you have diverse groups of people, you can create a high functioning team where everybody’s voice gets heard, and you have better outcomes and happier workforces.”

She believes that the school’s programmes will help people reflect on their practice without feeling threatened and foster a more enlightened attitude when they return to work.

As well as attracting a diverse group of students, the school is also keen to recruit an equally diverse group of staff to teach the programmes. “We want our students to see themselves in the lectures and for the lecturers to be highly attuned to building a healthy ecosystem in terms of content, the papers and culture,” Colton states.

She is looking forward to seeing how the graduates will make a difference in the coming years. Colton concludes: “Building a successful school and making sure that our programmes are authentic is about partnering and collaborating with the larger health community and society generally if we’re going to make positive change. It’s not just about changing the student; it’s also influencing and helping to shape the environment that the student works and lives in.”

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