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At the heart of general practice since 1960

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We asked 10 women GPs to list the top 10 things that would make their working lives better. The answers were strikingly concordant. But are male GP leaders prepared to make changes? Emma Wilkinson reports

Over the past decade the proportion of GPs who are female has risen from around a quarter to more than to 40 per cent.

Of newly certified GPs, more than two-thirds are female. If current trends continue, wo-men will make up the majority of GPs in not much more than a decade.

This rise in no small part reflects the ‘family friendly' reputation of the profession.

One of the oft-quoted maxims about general practice is that it is a good career for women because it has, supposedly, far greater flexibility than hospital posts.

Juggling act

But comments from a panel of 10 female GPs suggest that while this is broadly true, practices are not always the paragons of equality and family friendliness. The reality of juggling family commitments with a career in general practice appears to be very different from the ideal women hope for when they start out.

Seven out of the panel of 10 women cite more flexible working as a feature that would improve their working lives.

And although they apologise for the predictability of their responses, the vast majority also ask for more help with maternity leave and support for childcare.

Another frequent response is that these women GPs want more recognition from colleagues. In particular recognition that just because they may work part-time this does not mean they are any less committed to the practice – or ‘second rate' as Bristol GP Dr Domin-ique Thompson puts it.

As well as making all pay and benefits pro rata, she says there needs to be a ‘cultural shift' so that it is acceptable that a woman might ‘move from full- to part-time and back again during her career, as and when her other life demands require it'.

Long-term view

Another of our respondents, who asked not to be named, told us that practices need to look to the long-term. ‘Children are not dependents forever,' she says. ‘Women will want to expand their roles when the children are older.'

Other demands for recognition include that surgery times be flexible, so that a GP could do early surgeries, sometimes lunchtimes, and sometimes late sessions, depending on the other demands in their life.

So are these desires recognised by GPs' political leaders?

Despite the lack of female representation in the corridors of power at the BMA and, to a lesser extent, the RCGP, the answer is broadly yes.

Although GPC chair Dr Hamish Meldrum could only manage seven suggestions, his arguments for improved childcare arrangements, maternity pay that actually covers the costs, and increased flexibility in working hours did coincide almost exactly with the majority view of our panel of women.

Practical agenda

Dr Clarissa Fabre, honorary secretary of the Medical Women's Federation, praises Dr Meldrum for producing ‘a practical agenda which would bring substantial benefit'.

She says the GPC, having recognised the problems, must now prioritise agreements on maternity leave and locality-based childcare.

‘We need a national agreement on maternity leave, so that practices are nor disadvantaged when a partner has a baby and there is no discrepancy between practices,' she says.

‘Also locality-based childcare which is tax-efficient, when widespread practice-based commissioning becomes a reality.'

However, Dr Fabre is less impressed with RCGP chair Dr Mayur Lakhani's ideas for what would improve the working lives of women GPs.

Peer support, mentoring and control of workload, she says, apply equally to male GPs and did not specifically address the issues facing women in the profession.

To be fair to Dr Lakhani, one of the women in our panel says she ‘does not feel the major issues these days have much to do with the gender of the GP at all'.

Nevertheless, the mere fact most of the 10 women on our panel requested their views be anonymous in case they were seen as too outspoken indicates there are issues that specifically affect women GPs that need to be addressed.

General practice may be more flexible compared with working as a hospital doctor, but there still apears to be room for female GPs to get better support with juggling the demands of family life with a challenging career.

Dr Hamish

meldrum's 7 suggestions

1 Improved childcare arrangements

2 Maternity pay that actually covers the costs

3 Sort out the unfair pension arrangements, especially on widowers' pensions

4 Improved returner arrangements after career breaks

5 Increased flexibility in working hours, both during the day and over the

course of the year, to take account of school holidays

6 Encourage representative organisations such as

LMCs, PECs, the BMA to

be more family-friendly in terms of when they hold meetings

7 Above all, don't just assume what women want, ask them

Dr Hamish Meldrum is GPC chair

Dr Mayur

lakhani's

10 changes

1 Peer support groups

2 Faster and better access to financial and pension planning

3 Hotline for difficult patients

4 Managed solutions for flexible and financially attractive portfolio careers and structured portfolio working options

5 Advocacy service

6 Workforce policies that value female GPs, eg competitive income, childcare facilities

7 Control and say over workload

8 More autonomy and control over role in a practice and workload

9 Easier and better access to structured CPD, protected time for learning

10 Named personal mentor

Dr Mayur Lakhani is RCGP chair

Top 10 changes to make women GPs' working lives better

Chosen by our panel of 10 women GPs

1 More flexible working

2 Better maternity and childcare support

3 Recognition of family commitments among

colleagues

4 Fair deal for part-time workers (workload, responsibilities, pay and benefits)

5 Female representation on national committees

6 More role models

7 Feeling valued – female GPs are an asset

8 Training and career development which fits in working hours

9 Protected time for meetings (practice and committee)

10 Improved safety in consultations and home visits

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