Health Care Executive Management Composition—The Good, the Bad, and the Ugly
In Chapter 4, we explore the specificity of board composition in LHINs’ 126 acute care hospitals.
Boards are transitory, and hospital system characteristics are historical.
Subsequent research could have different results as the number of board members and their gender could change. In addition, hospital performance will vary and could be dependent on changes in the hospital environment such as use of LEAN Processes on administrative services.
We identify the board as the strategic decision-making team comprised of the upper echelons in organizations. Nonvoting members of the board are included if identified on hospital board listings as contributors to the strategic decision-making process.
Researchers have confirmed that diversity on boards provide better governance, experience, and opinions. Women who lacked corporate board experience could be appointed as nonexecutive directors. However, talented corporate women are leaving their positions to start their own businesses. Because of changing goals such as work–life balance, male-dominated boards are increasing and fewer role models exist for women in the ranks. These transitions are felt across North America and the UK.
In 2014, the total number of hospital board positions in Ontario was 2,138. The average number of hospital board positions filled by males and females was respectively 11 and 7. The average hospital board size was 18.
North East LHIN had the highest number of board positions—313. Central West LHIN had the lowest number of board positions—34. Toronto Central LHIN had the highest average number of males on hospital boards—17. North West LHIN had the lowest average number of males on hospital boards—six.
See Figure 4.1 for the total hospital board positions by LHIN in 2014.
See Figure 4.2 for distribution of hospital board gender by LHIN in 2014.
See Table 4.1 for the average board size by LHIN in 2014.
Figure 4.1 Total hospital board positions by LHIN in 2014
Figure 4.2 Distribution of hospital board gender by LHIN in 2014
Table 4.1 Average hospital board size by LHIN in 2014
The total number of hospital LHIN board members was 1,265 males and 861 females, with 12 positions vacant.
• South West LHIN had the highest number of male board members—174.
• North East had the highest number of female board members—141.
• Central West LHIN had the lowest ratio of male-to-female board members—22:12.
• North West LHIN had the highest percentage of females—52 percent.
See Table 4.2 for the number of males and females on hospital boards by LHIN in 2014.
See Figure 4.3 for the distribution of hospital boards.
Table 4.2 Number of males and females on hospital boards by LHIN in 2014
Figure 4.3 Distribution of hospital’s board gender by LHIN in 2014.
Controversial discussions are prevalent regarding the number of women to men on boards in support for gender diversity in the boardroom. Legislation by several countries such as Norway, Sweden, and Germany to enact mandatory female representation on boards is up to 40 percent. Compliance by Norwegian companies was achieved in 2008.
The EU has proposed similar targets by 2020 for listed companies. However, regulating gender parity in the boardroom ignores the lack of evidence to support a significant difference in organizational performance. The scarcity of evidence and empirical studies to support gender quotas are inconclusive.
In Australia, compliance and reporting by corporations included gender diversity, age, ethical, and cultural backgrounds. In South Africa, the limited resources and skills shortages affect all industries regardless of gender diversity. Quota legislation to fill 30 to 40 percent of board positions with women could lead to inexperienced and underqualified females assuming decision-making roles.
The underrepresentation of women on corporate boards is receiving attention from several governments. According to Catalyst (2013), in the U.S., of the 46.9 percent women in the workforce, only 14.4 percent of top executive roles are held by women. The Status of Women Canada (see www.swc-cfc.gc.ca/fun-fin/index-eng.html) reported that of 48 percent women in the workforce, only 15.9 percent were represented on corporate boards. Qualifications are not the limiting factor because women are earning more university degrees than men. [see www.aei.org/publication/stunning-college-degree-gap-women-have-earned-almost-10-million-more-college-degrees-than-men-since-1982/]
4.3 Board social responsibility
Research reveals that increased number of women in TMTs indicates higher corporate earnings. However, underrepresentation of half of the population is not translating into better management culture, meeting the needs of both men and women at work. Although diversity is a desirable goal for the customers and community that organizations serve, a visual demonstration of support is necessary to attract top female talent.
The debate on gender diversity is not limited to the lack of women on boards but illustrates the reasons for barriers that prevent women from achieving board appointments. In particular, the old boys’ club and a closed network are gatekeeping board positions for friends and relatives. Moral value and equal opportunity for women in the boardroom may appear to be a better argument than for gender diversity. Nevertheless, the intellectual segregation is discriminatory because of preferential tendency toward men accessing leadership roles.
Other factors such as stress, working 20 hours a day, child care, work–life balance, conflict, failure, and workplace harassment are common complaints from women. Regardless, the aspirations of women are self-defeating with interests fading as they climb the corporate ladder. Women may be the most significant barrier in attaining board appointments because of their high expectations in contributing to improving organizational performance.
Although the beliefs of board members are socially reproduced through interactions, their relationships and functional conditioning could negatively affect decision making. A longer tenure in upper echelons follows more persistent strategies. International experience increases social performance, whereas tenure diversity increases tolerance, environmental awareness, and risk adversity.