The following is an extract of my talk and resources included in the RACMA’s Quarterly Journal (Q2 2021), “Changing Workplace Culture in the Health System”
Gender Equity: I’m Not Biased, so What’s the Big Issue?
Medical Administrators have a crucial role to play in bridging the gender gap at the leadership level of Australia’s healthcare system — consciously and sub-consciously. On the world stage we have seen some monumental gains on the road to gender equity across sport, politics, and workplaces. But for all these advances, a silent undertow continues to stifle true gender parity, particularly in Australia.
According to the 2020 World Economic Forum’s Gender Gap Index, Australia is currently ranked 44, down from 15th in 2006. On a positive note, New Zealand is ranked six on this index.
Why, then, is Australia in this position?
President of the Australian Federation of Medical Women (AFMW) and well-known gender equity commentator, Associate Professor Magdalena Simonis, believes we are faced with breaking down generations of enculturation. The General Practitioner of 30 years says this has created a subconscious bias in the majority of the Australian population without the majority of people even realising.
“Culture is inherited, and it takes a long time to change,” Associate Professor Simonis said.
“If we wait for culture to change, we are going to be waiting another 100 years.” While the ongoing subconscious conversation cannot be controlled, behaviour is much easier to be governed,
Associate Professor Simonis says.
“It is the conscious, external conversations we can be correcting in the workplaces,” she said.
“This is where the Take a Stand Program is critical in workplaces. It is a positive bystander program that promotes safe, productive and respectful workplaces. The bystander responsibility is really important because it ensures everyone feels confident and reassured to call out inappropriate behaviour.
“All employees must be meaningfully engaged for gender equality to be effective.”
According to Associate Professor Simonis, the healthcare sector is poised to ignite a widespread shift in gender imbalance given the far-reaching trust in doctors and nurses and the positive influence they carry beyond the hospital.
However, Associate Professor Simonis said it is of key importance to bridge the gender gap at the decision-making, leadership level with real, strategic targets and goals with equitable outcomes. Hence, the crucial role of Medical Administrators.
“Firstly, there needs to be an evaluation of where the workplace is on the gender equity scale and how it measures in terms of representation of gender in leadership,” she said.
“You might have 90 per cent gender equity across all employees, but yet all the leadership is male. Change happens at the leadership level and it is where culture is best demonstrated.
“We know change doesn’t necessarily happen overnight, but it is important to make the decision for a new vision and take people on the journey.”
In 2003, Norway introduced a law on 40:40:20 for company boards. In short, the 40:40:20 ratio is about aiming for diversity of gender in workplace leadership, be it senior leadership teams or on the Board. It refers to 40% men, 40% women, 20% of any gender.
This movement is now gaining momentum as global organisations and corporations adopt the practice. Associate Professor Simonis said it was time the 40:40:20 rule was implemented across the board in Australia, particularly in the healthcare system.
“It is a very good model we should be using,” she said.
“Even though some women, or even people from different backgrounds, might not have leadership experience, they have the voice. The voice and the perspective are just as important.
“And if we don’t include that voice in our decision making, those minorities and groups will always be left behind, which is what’s been happening traditionally.”
Associate Professor Simonis suggested organisations could introduce the co-optation strategy as another step towards achieving gender equity.
“We have board tenures we need to stick to, but why can’t we give board members the opportunity to mentor someone new half-way through their tenure and have a co-opted person on the board?” she said.
“This provides plenty of time and opportunity to train and prepare the new member for equitable board participation.
“It’s not about disabling or destabilising existing leaders. It is creating an achievable and smooth transition plan.”
As healthcare is a service-focused industry, Associate Professor Simonis believes the governance structures should shift from the current corporate orientation to ensure fair
representation of the people they serve.
“I think that’s the connection that we’re probably missing,” she said.
“If we marry the gender equity issue with the people that we serve, it puts the focus on the job at hand and the outcome for the patients. Even people who believe that the gender equity issue no longer exists for women, still care about positive health outcomes in the community.
“It also puts the real onus on the leaders and the organisation as a whole rather than making individuals feel like they have to make the change on their own. That’s what it should be about: making organisational change to achieve the outcomes and better serve the population, as gender equity benefits all of society.”
Positive steps are continuing to be taken on various fronts, with the Victorian Government setting the bar for others to follow. In March this year, the Gender Equality Act 2020 came into effect, which aims to improve workplace gender equality in the Victorian public sector, universities and local councils. The provision of education and enforcement of compliance to the Act is overseen by the Gender Equality Commissioner, Dr Niki Vincent.
“This will promote gender equity training in schools and organisations, so that the processes that support conscious and subconscious enculturation of society around the primary role of women being carers and nurturers based upon their biology, is corrected,” Associate Professor Simonis said.
“Expanding knowledge and creating impetus in this space requires effort and encouragement at all levels of society. Supporting the people who are making the changes and improvements is just as crucial as accepting and adopting the changes.
“By the very nature of our choice of profession, doctors want to feel like we are making a positive difference. So, let’s make sure the decision-makers feel good about what they are doing by normalising this transition.”
Associate Professor Simonis said a good way to start this was to create Gender Equity Working Groups within every organisation. This group would be responsible for overseeing the process and providing guidance to the leadership, using tools now available.
“This will ensure a consistent process and measure change or lack thereof which can be quantified and reported on,” she said.
“The flow-on effect of installing a Gender Equity Working Group, demonstrates a commitment to the overall goal of gender equity — consciously and sub-consciously.
“The roadmaps for change have now been created and we just have to follow them. There are simply no excuses for not acting on this now.
Useful Resources for Gender Equity in the Workplace
RACMA Diversity, Inclusion & Equity Statement
RACMA is committed to achieving diversity across the College, enhancing cultural competency in our Members, and improving our ability to provide inclusive Medical Leadership across the health system.
Creating Healthcare Cultures of Safety and Respect Conference
RACMA-led panel: “Merit: Challenging the Status Quo.”
This Conference was a joint collaboration between RACMA, St Vincent’s Health, RACS and Macquarie University. The panel explored interventions and approaches for change.
Workplace Gender Equality Agency
https://www.wgea.gov.au/newsroom/gender-equality-in-australia-a-guide-to-gender-equality-in-2020
The Workplace Gender Equality Agency is an Australian Government statutory agency with a vision for women and men to be equally represented, valued and rewarded in the workplace. It:
- Promotes and improves workplace gender equality
- Administers the Workplace Gender Equality Act 2012 (Act)
Victorian Government Gender Equality Act 2020
https://www.genderequalitycommission.vic.gov.au/about-gender-equality-act-2020
The Gender Equality Act 2020 will improve workplace gender equality in the Victorian public sector, universities and local councils. The Act commenced on 31 March 2021.
The Act promotes gender equality by:
- Requiring the Victorian public sector, local councils and universities to take positive action towards achieving workplace gender equality
- Requiring these organisations to consider and promote gender equality in their policies, programs and services
- Establishing the Public Sector Gender Equality Commissioner
Women’s Health Victoria
Accredited Gender Equity Training Project
https://whv.org.au/our-focus/gender-equity
Women’s Health Victoria is dedicated to improving the health and wellbeing of all Victorian women. It delivers a range of online and interactive training for individuals and workplaces, all with a focus on improving the lives of women through addressing gender inequality in the workplace and building individual and collective capability to contribute to the prevention of violence against women.
Take a Stand Program
https://whv.org.au/training/take-a-stand-program
Take a Stand is an award-winning program that supports workplaces to prevent and respond to domestic violence, by taking a stand against sexism and promoting a respectful and safe workplace
for all. The first of its kind in Australia, Take a Stand continues to lead the way as a workplace bystander program to prevent domestic violence and other forms of violence against women.
40:40:20 Gender Rule
Women on Boards
https://www.womenonboards.net/en-au/resources/wob-advocacy/40-40-20
Women on Boards has been working since 2006 to address gender inequity in the boardroom and across leadership roles with an aim to have 40% of these roles occupied by women by 2025. It is
a recognised leader in the ecosystem of organisations and networks promoting and supporting women; dedicated to breaking down barriers to entry into leadership and onto boards.
Male Champions of Change
Male Champions of Change is a coalition of CEOs, secretaries of government departments, nonexecutive directors and community leaders. Established in 2010, by then Australian Sex Discrimination Commissioner Elizabeth Broderick, its mission is to step up beside women to help achieve a significant and sustainable increase in the representation of women in leadership.
“Unless we actively and intentionally include women, the system will unintentionally exclude them.” Elizabeth Broderick AO Founder, Male Champions of Change
View the full report here: https://racma.edu.au/resources/racma-publications/the-quarterly/
Associate Professor Magdalena Simonis AM is the Immediate Past President of the AFMW (2020-2023), former President of VMWS (2013 & 2017-2020) and current AFMW National Coordinator (2024-2026). She is a full time clinician who also holds positions on several not for profit organisations, driven by her passion for bridging gaps across the health sector. She is a leading women’s health expert, keynote speaker, climate change and gender equity advocate and government advisor. Magda is member of The Australian Health Team contributing monthly articles.
Magdalena was awarded a lifetime membership of the RACGP for her contributions which include past chair of Women in General Practice, longstanding contribution to the RACGP Expert Committee Quality Care, the RACGP eHealth Expert Committee. She is regularly invited to comment on primary care research though mainstream and medical media and contributes articles on various health issues through newsGP and other publications.
Magdalena has represented the RACGP at senate enquiries and has worked on several National Health Framework reviews. She is author of the RACGP Guide on Female Genital Cosmetic Surgery and co-reviewer of the RACGP Red Book Women’s Health Chapter, and reviewer of the RACGP White book
Both an RACGP examiner and University examiner, she undertakes general practice research and is a GP Educator with the Safer Families Centre of Research Excellence, which develops education tools to assist the primary care sector identify, respond to and manage family violence . Roles outside of RACGP include the Strategy and Policy Committee for Breast Cancer Network Australia, Board Director of the Melbourne University Teaching Health Clinics and the elected GP representative to the AMA Federal Council. In 2022. she was award the AMA (Vic) Patrick Pritzwald-Steggman Award 2022, which celebrates a doctor who has made an exceptional contribution to the wellbeing of their colleagues and the community and was listed as Women’s Agenda 2022 finalist for Emerging Leader in Health.
Magdalena has presented at the United Nations as part of the Australian Assembly and was appointed the Australian representative to the World Health Organisation, World Assembly on COVID 19, by the Medical Women’s International Association (MWIA) in 2021. In 2023, A/Professor Simonis was included on the King’s COVID-19 Champion’s list and was also awarded a Member (AM) in the General Division for significant service to medicine through a range of roles and to women’s health.