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Poor remuneration, fear of failure and our current voting system are all holding female GPs back

Over recent years much has been written about the need for a medico-political leadership that increasingly reflects the escalating diversity of our profession. This is true in many senses, not least in terms of ethnic background and gender – and it is the latter issue that has spurred an important motion to this year’s conference of local medical committees.

We all know that the medicine is becoming more and more feminised as women continue to leave medical schools across the countries in numbers that now outstrip their male counterparts. This is not an achievement to be ignored as it was not too long ago that the imbalance between men and women appeared to be an unbridgeable chasm.

Still held back

But despite this advancement there remains a troubling situation: that while women are certainly now able to get a first foot on the career ladder, their progress up is still not assured. Not enough women seem to be able or willing to get involved in the medico-political progress, despite the efforts of many bodies such as the BMA and others.

In talking to female colleagues at Wessex LMCs we agreed that there were differences in the drivers and barriers to women at different points in their careers, and that we needed to develop a dual approach – broadly aimed at ST3s and recently qualified GPs, with another aimed at 40-something GPs. Registrars and newly-qualified GPs have a great capacity to learn about contracts and medical politics, while women later on in their career often find they have more flexibility and experience. The main hurdle, certainly for the older group, is the lure of well-paid roles as appraisers, on CCGs or in academia. For example one of my female LMC colleagues wanted to be involved but also wanted to be paid for her contributions.

Never the less, the make-up of our constituent LMCs are changing and we need to encourage progress. One female colleague of mine said she found canvassing for herself ‘embarrassing’ and ‘irritating for those at the receiving end’. None of my male colleagues displayed such reticence. Doctors are used to over-achieving and coming top and many of us are very self-critical and reflect badly on ourselves if we come second or third.

Voters need more choices

The voting system might be another one of the reasons that committees fail to represent members well. Regional GPC elections are by more likely to be won by first past the post, but the Single Transferable Vote seems a more obvious choice when voting for GPC reps from the Conference of LMCs or the Annual Representative Meeting of the BMA.  Plurality of choice is far more likely to result in a positive electoral win. By having two or three individuals, it allows for a second or third preference.

We should encourage plenty of female candidates onto the ballot paper and keep voting for the women until all one’s votes are used up. If an obvious big name is rightly voted to negotiator, then all their surplus votes will pass to the next candidate and are therefore never ‘wasted’. The more women that stand, the more likely our best supported candidates will be elected and be able to show the way to the others.  

One of my colleagues describes what we need is a ‘step-ladder image’ of women helping each other up to the top by being present in sufficient numbers to permit this, rather than being in competition with each other if there are ‘too many names’ on ballot paper.  

Allow yourself to be taken along to the LMC by a colleague or trainer, stick up your hand to come to conference next year – childcare can be provided for the under-fives. Encourage women you know to stand in regional elections and bye-elections and if they don’t win first time remember to tell them what went well. Remind other GPs to vote – often the turnout in regional elections is less than 20%.  Once at the GPC, the committee will arrange a ‘mentor’ for you, responsible for making sure you manage to find your way around the way everything works. This means in a short time the electorate will not think of ‘the woman candidate’ as a yes /no but as several of us.

This year our minimum aspiration is to restore where we were before July 2012, with at least one women on the negotiators committee, but it’s realistic to believe we could and should have more visibility and participation at every level.

Dr Helena McKeown is a GP in Salisbury and sits on BMA and RCGP Councils.She is also vice-chair of Wiltshire LMC.

Motion 63 at the 2013 LMCs conference, to be proposed by DERBYSHIRE, will put that Conference:

‘(i) is concerned that women are underrepresented in both membership and leadership roles on GPC

(ii) calls for an investigation into ways of making GPC fully representative of the profession as a whole.’