Women and leadership: widening the pipeline

Speech by Christine Lagarde, President of the ECB, at 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 is a pleasure to be here in Aix-en-Provence to mark the launch of Essenti'Elles Santé for Provence-Alpes-Côte d'Azur. Today is about the women who are shaping healthcare in this region.

For most of history, societies have been readier to raise women up as symbols than to let them lead.

We do not have to look far for an example. Aix’s most famous landmark, the Fontaine de la Rotonde, is crowned by three female figures: Justice, Agriculture and the Fine Arts – symbols of this city's highest aspirations when it was built in the mid-nineteenth century.

You will find such figures on monuments across France and well beyond it: Marianne presides over our town halls; Liberty raises her torch above the harbour of New York. Societies have long chosen women to embody their loftiest ideals.

But always as allegories. The women carved above the doorway were not, as a rule, the people admitted through it. What about women as leaders?

In healthcare, that question is especially sharp.

Healthcare is one of the most feminised sectors in the French economy. Women are in the majority at every stage of initial health training. In France’s public hospitals almost 80% of staff are female. Yet only around one-quarter of hospital directors are women.

The challenges facing women in the French healthcare sector are a window onto something much broader.

The same pattern is visible in private firms and public administrations worldwide: women enter the workforce in abundance, but the pipeline to leadership narrows more sharply for them than it does for men.

Today I would like to explore why that pipeline narrows, and what it takes to widen it.

Why the pipeline narrows

For much of history, legal barriers kept women out of leadership entirely, or made access conditional in ways that did not apply to men. And this is within living memory. When I was a child, French women still needed their husbands’ consent to work. That changed only in 1965.^[1]

The France of today is a far cry from the France of my childhood – thankfully.

The legal picture has changed for the better in recent decades. The emphasis has shifted from removing prohibitions to actively encouraging women’s access to senior leadership. And here, France has gone further than most countries.

A major reform in 2023 is one example. It raised the required share of each gender in new appointments to senior civil service posts from 40% to 50%, which took effect at the start of this year. That includes senior posts in public hospitals.^[2]

This is genuine progress. And it helps to explain why, earlier this year, France ranked fourth in an international index of legal rights underpinning women’s economic participation.^[3]

And yet, if you ask women navigating their careers today whether they feel that progress, the answer is far more ambivalent. In their experience, the pipeline still narrows, suggesting there is a mismatch between the letter of the law and everyday experience.

Why? Laws of this kind tend to operate towards the top of the pipeline, while the narrowing starts much further down.

In this respect, a recent report on corporate America reveals a pattern that will be familiar to many women in this room.

It is the first promotion – the step-up from entry level to manager – where women already begin to fall behind. For every 100 men promoted at that step, only 93 women are promoted.^[4] The shortfall is modest at first, but it compounds at every step above.

To explain why, we have to look beyond the law – at how organisations traditionally reward work and how they distribute it. And here, there are two key barriers that narrow the pipeline more sharply for women than for men: availability and promotability.

Let me touch on the first.

Across many organisations today, the rewards still go to those who work long, unpredictable hours: the person who can stay late and be reached at short notice. The person who is, in a word, available.

The work of the Nobel laureate Claudia Goldin is illuminating here. She has shown that women’s and men’s earnings paths diverge after the birth of their first child.^[5]

For many couples, there has been a financial incentive to specialise: one partner takes the role that demands constant availability, while the other takes the flexibility to manage care at home. The household can end up earning more this way.

But the partner on the flexible path advances more slowly and earns less over the course of a career. And that path falls overwhelmingly to women.

Across advanced economies, women still spend roughly twice as many hours as men on unpaid care. France is among the better performers, yet women here still carry more of this work than men.^[6]

Often this collision comes at the worst moment: the first promotion to manager, when a career often begins to demand more availability and when family responsibilities may also be heaviest. And so the potential for momentum is lost precisely when it matters most.

But availability is only part of the story.

Even among people who are equally present – equally willing to stay late and be reachable – the same narrowing appears. This brings us to the second barrier: promotability.

Inside the same organisation, people are not given the same kind of work.

Some tasks build visibility and lead to promotion. Others are necessary but do little for the career of whoever carries them out. That could include serving on low-visibility committees, organising logistics and filling gaps when colleagues are away.

These tasks are important for the organisation. But the problem is often how they are distributed.

Recent work finds that women are more likely than men to be asked to do tasks with low promotability, and more likely to accept them.^[7] One reason is expectation. If everyone believes women are more likely to say yes, women will be asked more often.

Crucially, this pattern can be reinforced by the organisation itself. If the work culture is such that low-visibility work is allocated by waiting for volunteers, or by asking the person most expected to agree, the same people will carry more of it.

So even as we have seen progress on the legal front, these two barriers endure. Availability and promotability narrow the pipeline just as surely as any law once did – and they will not fall away on their own.

What can be done

Faced with these barriers, the familiar response has been to look to the women who made it through – to role models.

I can understand why. I often speak to younger women who tell me they have drawn encouragement from the path I was able to follow, and I take this responsibility seriously.

And I tell them my own story.

As a young mother practising law, I worked in a profession where there were very few women in the room, and where very long hours were the norm. And yes, that was difficult.

If I was able to carve out Wednesday afternoons for my sons – for swimming lessons and chess club – it was because I made up for it by working deep into the night. Years later, I would commute between Chicago and Paris as often as I could just to be home for the weekend.

But when I tell young women my story, I am always aware of the risk that comes with it. When we look to the women who made it through, our attention rests on them, and not on the barriers that narrowed the pipeline behind them.

Focusing on a role model risks individualising the problem, turning it into a question of what can be endured instead of what can be changed.

Some of that change lies at home, in expectations about who manages care. Those expectations are shifting household by household – and yes, they need to shift faster.

But organisations are not bystanders in this. Much of what narrows the pipeline for women is of their making, which means much of it is theirs to undo.

Two levers lie within their power: how they measure commitment, and how they distribute opportunity.

Take the first: commitment.

Too often, we treat flexibility as its opposite – as though wanting to leave for the school run marked someone out as less dedicated. That is certainly how it felt when I was a young mother. But flexibility and commitment are not enemies, and we should stop treating them as such.

The key is to lower the cost of being away. When work can be handed over cleanly, no single person has to be permanently on call.

In the United States, there have been clear examples of how changes in the structure of work have led to women entering certain fields in growing numbers and the gender earnings gap narrowing.^[8]

As team-based practice has spread through specialties such as paediatrics and anaesthesiology, a patient can pass from one doctor to another without any loss of care. The premium once paid for being the same person, always present, has fallen – and with it, the penalty long borne by women.

Some availability, of course, cannot be removed. Emergencies cannot be scheduled, and patients need continuity. But much of what we demand was built around older assumptions about home and work, and that part can be reshaped.

The ECB has been pulling this lever.

We have introduced core hours – set periods when colleagues are expected to be reachable – with flexibility around them. Staff can work from home for up to ten consecutive days. And we discourage non-essential emails in the evenings and at the weekend.

The work still gets done. It is simply done with more freedom – and people who have that freedom tend to bring more of themselves to the job. Far from undermining commitment, flexibility often deepens it.

But organisations also have a second lever to pull: opportunity. Who is given the work that builds a career, and who is left with the work that merely keeps the place running?

The first move is to change how this work is allocated. Managers can rotate low-visibility tasks more fairly across the team. And if that work counts towards promotion, more people want to take it on – so it no longer falls to the same few by default.

But we also need to be realistic. Given the realities of work in large organisations, allocating tasks fairly across every team may simply not be possible.

When the share of women advancing still does not shift, organisations can go further – setting targets at each level of the hierarchy, with clear accountability for meeting them.^[9]

At the ECB, we have done exactly this.

Our most recent gender strategy set targets not only for senior management but across the pipeline that feeds it – at analyst, expert, and team-lead levels – because that is where historically the narrowing has begun.

We are seeing progress. Women now hold close to 40% of our senior management roles, up more than eight percentage points since 2019, the year I arrived at the ECB.

But I will not pretend the work is finished. Some targets we have met; others, including those lower in the pipeline, we have yet to meet.

Yet we are working at it – designing our recruitment process to attract more women. That includes using inclusive language in our job advertisements as well as extending or halting a job campaign when fewer than a third of applicants are women.^[10]

These two levers – how to measure commitment, and how to share opportunity – are within reach of any organisation willing to use them.

Conclusion

But few organisations reach for them unprompted. The push usually comes from those with most at stake. That is why networks like Essenti'Elles Santé for PACA matter.

This initiative gives a collective voice to the experience of the women who make French healthcare work.

In a sector where women form the overwhelming majority of staff but a minority across most senior levels, that collective voice is exactly what is needed to widen the pipeline that runs from one to the other.

Let me return to where I began: to the Fontaine de la Rotonde, and the figures who crown it.

They were placed high above, for those below to admire from a distance. Honoured in stone, and powerless in reality.

We tell ourselves we have moved beyond that age. And in important ways, we definitely have.

But when we celebrate a woman chiefly for the steepness of the climb she endured, we are still admiring her from below. Our focus is on her achievement rather than on the barriers that made the climb so steep.

The world has enough monuments. What it needs now is for organisations to do the harder thing: to change how they measure commitment and how they share opportunity, so that the pipeline does not narrow more sharply for her than for him.

I look forward to seeing what this network can achieve.

Thank you.