In the health sector 70% are women, many in the wards but still too few at the top
In the general management of health care companies, the female share stands at 23.6%, while in other strategic management roles it is around 40%
Key points
The health sector is characterised by high organisational complexity and the need to operate with limited resources. In this context, gender equity in leadership is a key factor in improving the quality and sustainability of the health system. Evidence from the literature shows how heterogeneous leadership fosters the integration of different viewpoints and competences, stimulating the organisations' ability to face the challenges of the sector and develop innovative solutions, also thanks to a focus on the relational dimension and an inclusive vision that favours teamwork.
To date, gender equity in leadership in the health sector is still far from being achieved. How can we steer change in the right direction? It is crucial to start with an analysis of the current situation using data and the identification of good practices adopted by public and private institutions. This information makes it possible to fuel a debate for the identification of solutions for equal career opportunities, through the definition of both public policies and strategies within individual organisations.
The Observatory on Gender Equity in Leadership in Health Care
In this scenario, as of 2021, the Observatory on Gender Equity in Leadership in Healthcare set up by LEADS aims to promote a new narrative on gender equity, identifying gender equality in leadership as a founding element of equity and sustainable development. The Observatory, by providing quantitative and qualitative data, represents a place for meeting, analysis, in-depth analysis and comparison capable of fuelling debate among all the stakeholders in the health sector in order to identify viable paths of change in different contexts. From the analyses of the 2025 Report, carried out in collaboration with the University of Milan, it emerges that the National Health Service - whose data are available in open source on the website of the Ministry of Economy and Finance - is the sector with the most critical issues. Women account for 70% of those employed, but their presence at the top remains low and uneven.
The numbers: still few women at the top
In particular, in the general management of health establishments the female share stands at 23.6%, while in the other strategic management roles it is around 40% (administrative management 44.7%, health management 40% and socio-health management 48.2%). In the management of complex structures (the primariats), women are only 23%, with large differences between disciplines. In terms of male presence, surgery and orthopaedics stand out, where out of 100 chiefs only 6 and 4, respectively, are women. The disciplines that show a female-dominated situation are child neuropsychiatry and psychology, reflecting a greater openness to female leadership in areas traditionally considered to have a greater relational and psychosocial component (which nonetheless count a significantly lower total number of primariats than the male-dominated specialities). In the management of the health professions, women account for 56.8%, an encouraging figure, although one that can still be improved, considering that women make up 75.7% of the workforce in this category. The situation is the same in the area of administrative functions, where women occupy 45.6% of top positions, but 60.7% of the workforce. The only professional category in the NHS in which there is a situation of almost equal representation is that of pharmacists.
Pharmaceuticals the most virtuous
MIUR data show that a picture of under-representation of women also emerges in the academic world. Although among researchers in the area of medical sciences women have grown over the years to outnumber men, only 22% of full professors are women. A slightly different picture emerges from the analysis of the private sector, conducted with the cooperation of the respective professional associations. The pharmaceutical sector represents the most virtuous area, with substantial gender equity in leadership roles. The situation is different in the medical devices sector, where only one out of four leaders is a woman. The Observatory's estimates indicate that ceteris paribus on average, the gap in the SSN could close in about 30 years, which becomes 180 if we limit ourselves to primary positions. The data therefore highlight the need for the development and adoption of structured policies and strategies in order to identify concrete solutions to accelerate the cultural change and ensure effective equity in the top positions of our health sector.
