Speech by Christine Lagarde, President of the ECB, on the first Journée de réseaux de femmes dans la santé en Région Sud in Provence-Alpes-Côte d’Azur organised by Agence Régionale de Santé in Aix-en-Provence, France
Aix-en-Provence, 4 June 2026
It’s a pleasure to be right here in Aix-en-Provence to mark the launch of Essenti’Elles Santé for Provence-Alpes-Côte d’Azur. In the present day is concerning the ladies who’re shaping healthcare on this area.
For many of historical past, societies have been readier to boost ladies up as symbols than to allow them to lead.
We would not have to look far for an instance. Aix’s most well-known landmark, the Fontaine de la Rotonde, is topped by three feminine figures: Justice, Agriculture and the Advantageous Arts – symbols of this metropolis’s highest aspirations when it was constructed within the mid-nineteenth century.
One can find such figures on monuments throughout France and effectively past it: Marianne presides over our city halls; Liberty raises her torch above the harbour of New York. Societies have lengthy chosen ladies to embody their loftiest beliefs.
However at all times as allegories. The ladies carved above the doorway weren’t, as a rule, the folks admitted by way of it. What about ladies as leaders?
In healthcare, that query is particularly sharp.
Healthcare is without doubt one of the most feminised sectors within the French financial system. Ladies are within the majority at each stage of preliminary well being coaching. In France’s public hospitals virtually 80% of workers are feminine. But solely round one-quarter of hospital administrators are ladies.
The challenges going through ladies within the French healthcare sector are a window onto one thing a lot broader.
The identical sample is seen in personal companies and public administrations worldwide: ladies enter the workforce in abundance, however the pipeline to management narrows extra sharply for them than it does for males.
In the present day I want to discover why that pipeline narrows, and what it takes to widen it.
Why the pipeline narrows
For a lot of historical past, authorized obstacles stored ladies out of management fully, or made entry conditional in ways in which didn’t apply to males. And that is inside residing reminiscence. After I was a toddler, French ladies nonetheless wanted their husbands’ consent to work. That modified solely in 1965.[1]
The France of in the present day is a far cry from the France of my childhood – fortunately.
The authorized image has modified for the higher in current many years. The emphasis has shifted from eradicating prohibitions to actively encouraging ladies’s entry to senior management. And right here, France has gone additional than most nations.
A significant reform in 2023 is one instance. It raised the required share of every gender in new appointments to senior civil service posts from 40% to 50%, which took impact initially of this yr. That features senior posts in public hospitals.[2]
That is real progress. And it helps to clarify why, earlier this yr, France ranked fourth in a world index of authorized rights underpinning ladies’s financial participation.[3]
And but, should you ask ladies navigating their careers in the present day whether or not they really feel that progress, the reply is much extra ambivalent. Of their expertise, the pipeline nonetheless narrows, suggesting there’s a mismatch between the letter of the legislation and on a regular basis expertise.
Why? Legal guidelines of this sort are inclined to function in direction of the highest of the pipeline, whereas the narrowing begins a lot additional down.
On this respect, a current report on company America reveals a sample that might be acquainted to many ladies on this room.
It’s the first promotion – the step-up from entry degree to supervisor – the place ladies already start to fall behind. For each 100 males promoted at that step, solely 93 ladies are promoted.[4] The shortfall is modest at first, but it surely compounds at each step above.
To elucidate why, we’ve to look past the legislation – at how organisations historically reward work and the way they distribute it. And right here, there are two key obstacles that slender the pipeline extra sharply for girls than for males: availability and promotability.
Let me contact on the primary.
Throughout many organisations in the present day, the rewards nonetheless go to those that work lengthy, unpredictable hours: the one who can keep late and be reached at quick discover. The one that is, in a phrase, accessible.
The work of the Nobel laureate Claudia Goldin is illuminating right here. She has proven that girls’s and males’s earnings paths diverge after the delivery of their first little one.[5]
For a lot of {couples}, there was a monetary incentive to specialise: one associate takes the function that calls for fixed availability, whereas the opposite takes the pliability to handle care at residence. The family can find yourself incomes extra this fashion.
However the associate on the versatile path advances extra slowly and earns much less over the course of a profession. And that path falls overwhelmingly to ladies.
Throughout superior economies, ladies nonetheless spend roughly twice as many hours as males on unpaid care. France is among the many higher performers, but ladies right here nonetheless carry extra of this work than males.[6]
Typically this collision comes on the worst second: the primary promotion to supervisor, when a profession typically begins to demand extra availability and when household duties might also be heaviest. And so the potential for momentum is misplaced exactly when it issues most.
However availability is just a part of the story.
Even amongst people who find themselves equally current – equally keen to remain late and be reachable – the identical narrowing seems. This brings us to the second barrier: promotability.
Inside the identical organisation, persons are not given the identical type of work.
Some duties construct visibility and result in promotion. Others are vital however do little for the profession of whoever carries them out. That might embody serving on low-visibility committees, organising logistics and filling gaps when colleagues are away.
These duties are essential for the organisation. However the issue is commonly how they’re distributed.
Current work finds that girls are extra seemingly than males to be requested to do duties with low promotability, and extra prone to settle for them.[7] One cause is expectation. If everybody believes ladies usually tend to say sure, ladies might be requested extra typically.
Crucially, this sample may be strengthened by the organisation itself. If the work tradition is such that low-visibility work is allotted by ready for volunteers, or by asking the individual most anticipated to agree, the identical folks will carry extra of it.
So at the same time as we’ve seen progress on the authorized entrance, these two obstacles endure. Availability and promotability slender the pipeline simply as absolutely as any legislation as soon as did – and they won’t fall away on their very own.
What may be performed
Confronted with these obstacles, the acquainted response has been to look to the ladies who made it by way of – to function fashions.
I can perceive why. I typically communicate to youthful ladies who inform me they’ve drawn encouragement from the trail I used to be capable of comply with, and I take this accountability critically.
And I inform them my very own story.
As a younger mom practising legislation, I labored in a occupation the place there have been only a few ladies within the room, and the place very lengthy hours have been the norm. And sure, that was troublesome.
If I used to be capable of carve out Wednesday afternoons for my sons – for swimming classes and chess membership – it was as a result of I made up for it by working deep into the evening. Years later, I might commute between Chicago and Paris as typically as I might simply to be residence for the weekend.
However once I inform younger ladies my story, I’m at all times conscious of the danger that comes with it. Once we look to the ladies who made it by way of, our consideration rests on them, and never on the obstacles that narrowed the pipeline behind them.
Specializing in a job mannequin dangers individualising the issue, turning it right into a query of what may be endured as a substitute of what may be modified.
A few of that change lies at residence, in expectations about who manages care. These expectations are shifting family by family – and sure, they should shift sooner.
However organisations aren’t bystanders on this. A lot of what narrows the pipeline for girls is of their making, which suggests a lot of it’s theirs to undo.
Two levers lie inside their energy: how they measure dedication, and the way they distribute alternative.
Take the primary: dedication.
Too typically, we deal with flexibility as its reverse – as if wanting to depart for the college run marked somebody out as much less devoted. That’s actually the way it felt once I was a younger mom. However flexibility and dedication aren’t enemies, and we must always cease treating them as such.
The hot button is to decrease the price of being away. When work may be handed over cleanly, no single individual needs to be completely on name.
In the USA, there have been clear examples of how modifications within the construction of labor have led to ladies coming into sure fields in rising numbers and the gender earnings hole narrowing.[8]
As team-based apply has unfold by way of specialties equivalent to paediatrics and anaesthesiology, a affected person can go from one physician to a different with none lack of care. The premium as soon as paid for being the identical individual, at all times current, has fallen – and with it, the penalty lengthy borne by ladies.
Some availability, after all, can’t be eliminated. Emergencies can’t be scheduled, and sufferers want continuity. However a lot of what we demand was constructed round older assumptions about residence and work, and that half may be reshaped.
The ECB has been pulling this lever.
We’ve got launched core hours – set durations when colleagues are anticipated to be reachable – with flexibility round them. Workers can work at home for as much as ten consecutive days. And we discourage non-essential emails within the evenings and on the weekend.
The work nonetheless will get performed. It’s merely performed with extra freedom – and individuals who have that freedom are inclined to deliver extra of themselves to the job. Removed from undermining dedication, flexibility typically deepens it.
However organisations even have a second lever to tug: alternative. Who’s given the work that builds a profession, and who’s left with the work that merely retains the place operating?
The primary transfer is to alter how this work is allotted. Managers can rotate low-visibility duties extra pretty throughout the workforce. And if that work counts in direction of promotion, extra folks wish to take it on – so it not falls to the identical few by default.
However we additionally should be real looking. Given the realities of labor in giant organisations, allocating duties pretty throughout each workforce might merely not be doable.
When the share of girls advancing nonetheless doesn’t shift, organisations can go additional – setting targets at every degree of the hierarchy, with clear accountability for assembly them.[9]
On the ECB, we’ve performed precisely this.
Our most up-to-date gender technique set targets not just for senior administration however throughout the pipeline that feeds it – at analyst, knowledgeable, and team-lead ranges – as a result of that’s the place traditionally the narrowing has begun.
We’re seeing progress. Ladies now maintain near 40% of our senior administration roles, up greater than eight share factors since 2019, the yr I arrived on the ECB.
However I can’t fake the work is completed. Some targets we’ve met; others, together with these decrease within the pipeline, we’ve but to fulfill.
But we’re working at it – designing our recruitment course of to draw extra ladies. That features utilizing inclusive language in our job ads in addition to extending or halting a job marketing campaign when fewer than a 3rd of candidates are ladies.[10]
These two levers – the way to measure dedication, and the way to share alternative – are inside attain of any organisation keen to make use of them.
Conclusion
However few organisations attain for them unprompted. The push normally comes from these with most at stake. That’s the reason networks like Essenti’Elles Santé for PACA matter.
This initiative provides a collective voice to the expertise of the ladies who make French healthcare work.
In a sector the place ladies kind the overwhelming majority of workers however a minority throughout most senior ranges, that collective voice is precisely what is required to widen the pipeline that runs from one to the opposite.
Let me return to the place I started: to the Fontaine de la Rotonde, and the figures who crown it.
They have been positioned excessive above, for these beneath to admire from a distance. Honoured in stone, and powerless in actuality.
We inform ourselves we’ve moved past that age. And in essential methods, we undoubtedly have.
However once we have a good time a lady mainly for the steepness of the climb she endured, we’re nonetheless admiring her from beneath. Our focus is on her achievement quite than on the obstacles that made the climb so steep.
The world has sufficient monuments. What it wants now could be for organisations to do the more durable factor: to alter how they measure dedication and the way they share alternative, in order that the pipeline doesn’t slender extra sharply for her than for him.
I sit up for seeing what this community can obtain.
Thanks.
