Women doctors paid less than men even after part time working is accounted for
BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m4904 (Published 17 December 2020) Cite this as: BMJ 2020;371:m4904Linked Opinion
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Dear Editor
This is poor reporting of a poor study.
Regarding hospital practice at least, male/female pay difference reflects different life choices and little else.
The pay scales are gender neutral are they not?
Where in the analysis is the effect of the gender difference in medical school admissions?
Of course if there are larger numbers of recent female graduates at the bottom of the pay scales compared to recent male graduates, this will lead to an average difference in pay when you include doctors at all stages of their career.
If there is discrimination in the ability of female graduates to rise up the relevant pay scale or be appointed to eg consultant posts, present that evidence.
That would be worth exposing.
Competing interests: No competing interests
Dear Editor
‘Flirtation’ with any job (hopping away into unrelated pursuits for long or short times) must trigger corresponding swings in incomes and or status related to the inconstancy of presence in the particular job.
Hopefully any resulting shortfalls in the one should be made good (if the move was to be worth the hop) by corresponding rewards (financial or emotional) accruing in the other. The loss in the one should be offset by the gain in the other if the move was well conceived in the first instance.
It would be just as unfair to have a man who has shown steadfast presence in the job come to the same status or pay grade as a woman who (temporarily) left to fulfil ‘other urges’ whilst the male peer continued to strive without interruption or let within the particular job. In such a scenario it is inconceivable to talk of equal job let alone equal pay. The ‘gap’ period must count for something in the subsequent calculations. And that “something” has everything to do with the gap, nothing with the gender.
Competing interests: No competing interests
The intersectional effects of gender and ethnicity: analysis of bonus pay gap data for the Shelford hospitals
Dear Editor,
The Department of Health and Social Care have released Mend the Gap: The Independent Review into the Gender Pay Gap in Medicine.1 This report highlights that male hospital Consultants earn 13% more than their female counterparts even when part-time working is accounted for. This report did not consider the potential intersectional effects of ethnicity alongside gender.
Clinical Excellence Awards form the large majority of bonus pay for Consultants. These are not awarded automatically and must be applied for. They recognise and reward NHS consultants who perform ‘over and above’ the standard expected for their role. Awards are given for quality and excellence, acknowledging exceptional personal contributions.
The Shelford Group trusts is a collaboration between ten of the largest teaching and research NHS hospital trusts in England. Collectively its members are strategically significant to the NHS nationally and they are dedicated to excellence in clinical research, education and patient care. Equality and diversity are highlighted as a priority in their policy.2
We aimed to describe the differences in mean bonus pay gap for Consultants across the Shelford Group looking specifically at the intersection of gender and ethnicity.
Methods
Freedom of Information requests were sent to the 10 Shelford Hospitals (first sent 01/20 with two reminders sent every three months if no response (maximum of two reminders). Data was requested on the mean bonus pay gap for male vs female Consultants, white vs Black Asian Minority Ethnic (BAME) Consultants and white male vs BAME female Consultants for the financial year 2018/2019. Where mean bonus pay data was provided, the mean bonus pay gap was calculated using standard government guidance.3 Data were analysed using simple descriptives.
Results
Of the 10 Shelford Hospitals, eight provided data. No data were provided by Imperial College and Sheffield Teaching Hospitals NHS Trusts. Two NHS Trusts (Manchester University Foundation Trust and University College London Hospitals Foundation Trust) reported they do not routinely collect data for ethnicity and therefore only provided data related to gender.
The average mean bonus pay gap by gender was 27% (range 3-48%) in favour of male Consultants. The average mean bonus pay gap for white and BAME Consultants was 17% (range 7-31%) in favour of white Consultants. The average mean bonus pay gap between white male and BAME male Consultants was 18% (range 7-34%) in favour of white male Consultants. The average mean bonus pay gap between white male and BAME female Consultants was 41% (range 18-60%) in favour of white male Consultants.
Discussion
This data agrees with national data showing a mean bonus pay gap associated with gender in favour of male Consultants. This is the first data to show that there is also a significant mean bonus pay gap associated with ethnicity. Importantly, there may be a superimposing effect of gender and ethnicity, with female Consultants from an ethnic minority background receiving the lowest bonus pay for all Consultant groups analysed in financial year 2018/2019.
Analyses are limited by incomplete return of data from two hospitals and no return of data from a further two hospitals. in addition, Shelford hospitals may not be truly representative of all hospitals in England.
Conclusion
There may be a superimposing intersectional effect of gender and ethnicity associated with the awarding of Clinical Excellence Awards within the Shelford Hospitals. Further investigation on reasons for this and whether this is a widespread issue within the NHS is urgently needed.
Acknowledgments: Esther Jewson for advice on wording of the Freedom of Information Request and Adejoke Oluyase for analysis of data.
1 Department of Health and Social Care. Mend the gap: the independent review into gender pay gaps in medicine in England. 15 December2020.
https://assets.publishing.service.gov.uk/government/uploads/system/uploa....
2 The Shelford Group. The Shelford Group. https://shelfordgroup.org (Accessed 24.11.20)
3 Gov.UK. Gender pay gap reporting: make your calculations. https//www.gov.uk/guidance/gender-pay-gap-reporting-make-your-calculations (Accessed 24.11.20)
Competing interests: SB self identifies as a female British Pakistani and works clinically at both King’s College Foundation Trust and Guys and St Thomas' NHS Foundation Trust.