A major independent review finds huge pay discrepancies remain, reports Nicola Merrifield
Female GPs are earning around 15% less than male GPs who work the same hours. That is the stark finding for GPs from a Government-commissioned review into the gender pay gap in medicine.
The 370-page report, published in full in December, looks at payroll data for around 16,000 GPs in England and also reveals pay gaps exist for female and male GPs in the same roles, for both salaried and partner positions.
The problem is not restricted to GPs. Health secretary Matt Hancock’s foreword notes there is a pay gap across medicine that is ‘out of line with other professions and significantly wider than for other NHS staff groups’.
The review confirms women account for the majority of the GP workforce, at 55%, but Mr Hancock states the medical profession has ‘inadvertently created a glass ceiling for women’ over decades due to retaining ‘a male dominated culture and reward package’.
The reasons behind the GP pay gap are manifold. As in many other professions, women are more likely to work less than full time due to childcare or caring responsibilities – and, as a consequence, are less likely to take higher-earning partnership roles.
‘For a predominantly female workforce, why are more of us not partners?,’ asks Dr Helena McKeown, who is BMA representative body chair and contributed to the review.
Dorset GP Dr McKeown says while general practice is more family friendly than hospital work, more still needs to be done to create flexibility in partnerships.
‘We need to encourage applications from women by offering partnership job shares and also accept more four-session partnerships. Some practices don’t want partners unless they can commit to six or seven sessions,’ she says.
The absence of such flexibility means female GPs are often found in salaried roles, which tend to be paid less than partnerships.
But even when doing the same roles, female GPs earn less than their male counterparts – on average around 22% less in salaried positions and 8% less as partners (see charts, below). The review does note that the pay gap is ‘close to zero among GP registrars and locum GPs’.
GPs can attract additional pay if they take on extra duties such as GP training or medical student training. But Dr McKeown says the size of the gender pay gap among salaried GPs indicates that there are also cultural issues at play.
The report’s findings back this up, suggesting the discrepancy cannot be explained by female salaried GPs being younger and therefore less experienced: ‘For salaried GPs… most of the gender pay gap attributable to men and women being paid differently is due to different rates of pay for a given age.’
Dr McKeown highlights one possible factor: ‘Men are generally more likely to ask for pay rises then women.’
She also believes outdated attitudes are playing a part. ‘I’ve heard a senior male GP partner say during a meeting: “All the salaried doctors who are women leave at 5pm to get the children”. It was explained to the partner by a male colleague that their practice had both men and women who leave at 5pm for childcare responsibilities if that’s in their contract.’
The report makes a total of 47 recommendations across seven themes, including retaining and promoting more women in senior roles, and eliminating the ‘pay and career penalty’ for doctors working less than full time.
Professor Dame Jane Dacre, professor of medical education at University College London, who chaired the review, calls for a systemwide effort, warning: ‘Although the pay gap has narrowed over time, progress is slow and women will continue to face disadvantages unless action is taken.’