Introduction I propose introducing delegates to the main themes of a workshop with this title, which I co-chaired with Professor Gerda Van Dijk at the 6th International Conference of Public Policy, Toronto, 2023. The title refers to overcoming the gap between the increasing representation of women in public policy and the continued gender-based difference in their ability to influence policy design, selection, and implementation.

Aims and objectives of the research project or activity A just society happens when political, economic and social participation in public and private lives is possible for all to consider equally, regardless of their current position in society. Women remain the largest disempowered group worldwide, despite decades of action in every public programme or policy. There are currently 30 women heads of state or government, so equal representation will take 130 more years. Ministerial or leadership portfolios typically reflect traditional female roles. For public organisations, achieving equality has been a numbers game, with equal numbers, especially in senior cadres signalling the end of prejudice. But, women’s equality needs to move beyond representation to ensuring women’s voices carry the weight they deserve. The workshop sought realistic paths which might achieve this.

Method or approach ICPP6 is usually an academic conference of social scientists analysing public policy. This workshop differed in including practitioner leaders in healthcare, who engaged and shared accounts of their practice in the ICPP workshop presentation format, commentary by another workshop member (pre-warned) and subsequent discussion. By the triangulation of academic thought and data with practitioners’ experience of taking leadership as women, themes were developed that could both act as route maps to effectiveness for future female leaders and provide hypotheses which could be subject to empirical testing.

Findings The findings are due to be summarised in a multi-author, edited book. Interim findings include: interventions have to be coordinated at the micro (individual) meso (local) and macro (national and above). Men and women must both be engaged. The gendered relationships between individuals and economic activities must be actively identified and challenged if they drive towards inequality. The vital importance of motherhood and children to society as a whole gives opportunities for women to effectively extend their voices into policy design at meso and macro levels and generalise their influence. The traditional role of women is thus two-edged, as their ability to leverage their position as custodians of society’s future also enables the religious and societal taboos that set unfair limits on that role. At the micro level, transgenerational expectations and relationships may transmit empowering and disempowering messages to youth, with Indian evidence suggesting that the general trend is for more female autonomy despite persisting biases. Unfortunately, pushing back against hierarchical expectations can expose those pressing to maltreatment, with the protections associated with traditional roles being withdrawn and victims made responsible for the perpetrators’ behaviour by recourse to traditional (in China Confucian) ethical systems.

Key messages Healthcare (the source of the practitioners in the workshop) is particularly well-placed to accelerate effective female leaders, as it encompasses both traditional female roles and policy design imperatives which affect all levels of society.

Professional organisations and government administration are systems which can work across scale from the micro to the macro, giving the opportunity to create the policy environment where female leaders’ voices will be heard and given effect.

To be successful in this, the public sector of healthcare will need to engage more with gendered economic relationships and involve men in the organisational transformation that will be necessary.

The history of healthcare is replete with the compassionate use of evidence to successfully challenge dangerous or unhelpful traditions and customs. It can thus work as a seeding culture for empowering female leaders more widely in society, and demonstrate how abuse and maltreatment may be corrected without damaging its institutions.