Mind the gap: gender pay gap in the NHS
The issue of gender pay gaps is nothing new. In fact, national gender pay gap data has been collected for years – and the UK has actually made significant progress over the last 50 years, moving from a median gap of 47.6% in 1970 to 16.8% in 2016. Last year, along with over 10,000 other organisations across the country, as part of a requirement of the 2017 amendment to the 2010 Equality Act, English NHS organisations employing more than 250 people published headline details of their gender pay gap.
Data from one million workers in England, ranging from doctors and managers to nurses and cleaners was examined, excluding bonuses and overtime that is paid on top of basic pay. The data revealed that that around nine out of 10 NHS organisations in England had a median hourly pay gap that favoured men, whilst overall, women earn 23% less. To some extent, this clearly reflects industry-wide trends that see men in more senior positions, whereas there are more women working as nurses or healthcare assistants. But that doesn’t explain the gap between women and men in the same jobs – so what’s really going on?
Let’s break it down
NHS England was established on 1 April 2013 from 162 predecessor organisations: Strategic Health Authorities (SHAs); Primary Care Trusts (PCTs) and the Department of Health. As of March 2017, the organisation had 5,445 employees, 5,226 of which were in receipt of full payment. The organisation is predominantly female, with women making up 68.58% of the workforce receiving full pay – however, when taking into account all roles across the NHS, including nurses, male staff are paid 23% more on average than their female counterparts.
So what’s going on?
95 out of the 100 highest paid consultants in England are male, and on average female consultants earn nearly £14,000 a year less than their male counterparts. Additionally, the BBC also revealed 6.5 times as many male consultants received the top platinum bonus worth £77,000 a year – and we hate to break it to you, but it’s the same across all pay grades.
Banding systems were brought in in a bid to provide a clear pay structure within the NHS, but the gender pay gap remains in each band. Out of five staff groups that make up 38% of all employees – consultants, managers, senior managers, nurses, health visitors, midwives and ambulance staff, all groups have a median pay gap in favour of men, ranging from 3.8% for midwives to 13.7% for managers and senior managers. In fact, the mean gender pay at an hourly rate is £21.42 for women and £25.54 for men, resulting in a gender pay gap of 16.1% and a median gender pay gap of 14.1%.
The Department of Health and Social Care said the gender pay gap in medicine was big because the number of highly-remunerated male doctors was a much bigger proportion of the male NHS workforce than female doctors were of the female NHS workforce. In addition, they also said that consultants actually only receive slightly more in basic pay than their female colleagues – but the gap really opens up when it comes to’additional pay’ such as overtime and time spent on call.
Why is it happening?
This is an issue for sociologists and economists, but essentially, the issue with the gender pay gap boils down to the fact that men and women tend to do different jobs. For example, outside of the NHS, 90% of engineers are male whilst 83% of primary school teachers are female – and there are very similar breakdowns in the NHS when it comes to the division of nurses versus consultants.
In addition, the jobs done by women are often undervalued, and jobs with a higher percentage of women tend to be lower paid – and as the proportion of women increases, average pay goes down further. Men are also more likely to hold more senior roles, and, of course, women pay a’motherhood penalty’ – and if a pay gap is generated after the birth of their first child, for most women it will never be recovered.
Let’s look at this through a healthcare lens: a 2013 survey of female leaders in healthcare found that half thought having children disadvantaged their career, which is pretty troubling considering that 77% of the NHS workforce and 82% of the adult social care workforce are female. Jeremy Hunt recently announced a new review of the gender pay gap in medicine that aims to eliminate the pay gap that currently exists between male and female doctors. But what is the wider healthcare sector doing to improve things both now and in the future?
Time for change
The vast majority of NHS staff are set within the Agenda for Change pay system that was introduced in 2004, partly to address gender pay differences. However, men are still disproportionately represented in higher pay bands, which means more needs to be done. According to the Gender Pay Report published by NHS England last year, solutions they are exploring to close the gender pay gap include reviewing how to attract more women into mostly male-dominated roles, improved flexible working opportunities and shared parental leave.
Other plans include coaching and mentoring to offer support to the talent development of women in the workplace, as well as talent plans to tackle occupational segregation in order to address gender representation. Considering more than three-quarters of the NHS workforce is female, and that the NHS is seriously struggling to recruit and retain enough workers as it is, one thing’s for sure: change definitely needs to happen – and fast.
Market research and moving forward
The NHS is aware of the challenge it faces and has set itself the task of NHS boards being’50/50 by 2020‘. This still leaves some way to go before it is representative of the wider workforce, but the tone for change has to start somewhere – and as diversity becomes more and more important, it’s vital that organisations keep up with the times and reflect this. With so much change going on, healthcare market research is more important than ever before. However, thanks to a complicated structure and lack of clarity about the roles and responsibilities of different staff within the NHS, it can be difficult to know who to access for market research and how to engage with them.
And that’s where we come in. GKA is a healthcare fieldwork agency, meaning we can reach a range of people for healthcare market research so you can actively onboard respondents from diverse perspectives for your market research. The NHS never stays the same for long, and organisations within it are always changing, so it’s really important that you stay up-to-date with who does what – which is why we’ve put together our researcher’s guide to the NHS. If you want detailed knowledge on the structure, roles and responsibilities of NHS staff to inform who to recruit for your healthcare market research, then look no further – download the guide here.