Harassment, exclusion and innuendo: women frozen out by 'sexist BMA culture'

Senior women GPs have exposed a culture of 'institutional sexism' within the BMA's GP committee - reporting belittling, crude and sexist comments, being frozen out of meetings or ignored and facing sexual harassment.

Leading female GPC members warn that a generation of leaders is being excluded because of the demoralising impact of the culture they believe overshadows the committee.

One senior woman on the 77-strong GPC is said to feel unable to attend events away from home without a family member to accompany her after being propositioned by a male colleague. Another doctor said a male colleague had sent her a naked photograph of himself, unsolicited.

GPC sessional subcommittee chair Dr Zoe Norris, who along with UK LMCs conference deputy chair Dr Katie Bramall-Stainer has written today for GPonline about the impact of sexism, said: 'I have never experienced the level of sexism and discrimination in my entire career that I have in the GPC.'

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Senior women on the GPC have been asked by male colleagues 'what their husband thinks of them being away for so long', and several have reported being called 'naughty girl' or other belittling names - including at the UK LMCs conference last month. In one case, a female GPC member overheard two 'senior LMC people on GPC braying loudly their guesstimated bra size of a key committee member'.

Female GPC members have spoken out too about being excluded from meetings or conversations related to policy areas on which they had been appointed to lead - making it difficult to carry out basic work.

Institutional sexism

The findings come as a government report on the gender pay gap in medicine reveals that male GPs are paid 33% more than their female counterparts - twice the gap across medicine as a whole.

Another senior GPC member, who asked not to be named, told GPonline she felt that sexism was 'absolutely institutionalised' within the organisation.

Several doctors spoke of being almost paralysed with shock, left unable to speak because they could hardly believe the comments directed at them at times.

Dr Norris said her experiences had 'taken a significant toll on my mental health and wellbeing'. Former GPC member Dr Stephanie deGiorgio said she had simply stopped talking in meetings at one point because the treatment she received had destroyed her confidence.

Dr Norris and Dr Bramall-Stainer call in their GPonline article for 'a wholesale culture shift away from drinking and dinners, taps on the shoulder to take on roles, under-the-breath comments, factions and back-stabbing'.

Diversity in medical politics

They write: 'We have to make sure those who represent the profession, reflect the profession; and embrace diversity by offering all GPs the same opportunities. Most importantly, there must be a genuine objective process for challenging and addressing such behaviours.'

According to a list of voting members of the GPC updated in December 2018, women are outnumbered by two to one on the committee - despite official NHS data for the same month showing that 54% of the GP workforce is female. The GPC has 77 voting members, of whom 25 are women.

Dr Amy Small, a GP in East Lothian and former GPC member told GPonline: ‘I think if we get representation right in the GPC, then the role models are there for women to follow. You look to the leadership to inspire and for role models you can work with - and the GPC still falls short on that, big time. There is a lot more they could do in terms of mentorship. Women need more people around who they could go to and say: "How do I do this?".'

Dr Sarah Matthews, Coventry LMC medical secretary and Medical Women's Federation representative on the GPC, said that BMA committees were 'unable to be representative of the workforce in a number of ways'. She said: 'We are not representative of the numbers of salaried colleagues, or locums, and because we under-represent those groups we are by default not representative of women - because those groups have more women in them. The issue to address is representation, and if we get that right we will be more able to deal with sexism.'

Dr deGiorgio said she had been recruited to the GPC for a specific role and then repeatedly undermined. At one point she was patted on the knee and called a ‘naughty girl’ by a senior GPC colleague in front of staff from national media outlets - an incident for which she received an apology.

Undermined by GPC colleagues

She reported that ideas shared by female GPC colleagues via the email listserver used by BMA leaders to communicate privately were ‘frequently ignored’ and sometimes later ‘posted by others who got credit for them’.

One senior GPC member said the sexist culture began right from the way that female chairs at conferences were referred to as 'madam'. 'It's meant to be respectful, but it automatically singles you out as being different because of your gender,' she said.

She had faced 'horrific problems' along with a fellow female GPC member trying to integrate with a committee in which they both held senior roles - reporting being 'repeatedly excluded from meetings'.

The GPC member added that a male colleague had been allowed to ignore measures meant to promote inclusion, despite complaints. Asked how the culture could be changed, she said: 'I think it is about the people at the top showing that leadership and demonstrating it every single day.'

But she added: 'When there is discussion about these issues, the top tier of people don’t join in - I think they are afraid. They think it is politically safer to stay out of it.'

Sexist treatment

Dr Matthews said she had not personally experienced sexist treatment. 'I don’t know if that's because I am older, or a partner or because I am low-threat - I'm not looking to take one of the big jobs.

'But it seems to me that those women who have taken on bigger roles have become more exposed to this, and that is a real concern. Other women who come into the committee will look at that and say: "I don’t want to do that". That is a real worry - that the committee will become more dysfunctional and unrepresentative.'

Dr Matthews said there had been 'big efforts in recent years to make systems more robust' - pointing to the 'Living our values' programme rolled out to BMA committees, to raise awareness of the union's core values and expectations of staff in terms of behaviour.

The BMA code of conduct says that 'bullying and harassment, including sexual harassment, will not be tolerated, and cases will be taken extremely seriously'. It warns that doctors are expected to 'display the same duty of care towards one another as they would towards patients and in the workplace'.

But Dr Matthews said she had heard colleagues express a fear of reporting incidents. 'There is a feeling that for those who are accused in those processes, the outcome is still a quiet word in a back room, where they are told to pull their socks up.

'If people repeatedly fall foul, what is the sanction? I am not aware of anyone who has been told to leave the committee or told not to stand again. And I think there are some serial offenders.'

GPC executive committee member Dr Farah Jameel said it 'was unacceptable that individuals may have failed to live up to [the] high standards' set by the BMA or 'not treated others with the respect they deserve'. She highlighted 'robust complaints procedures' to support colleagues treated inappropriately.

Dr Norris said she had avoided 'naming and shaming' colleagues over sexism because of fears over how she would be treated, and about how she would be perceived.

Dr Matthews said she was surprised, but not shocked, at the extreme nature of some issues reported by colleagues, adding: 'I think there is a wider landscape this is situated in. I don’t think the wider healthcare environment is great and just the GPC is messed up - I suspect the wider landscape is a bit messed up too.'

Dr Jameel said: 'The BMA strives to be respectful, professional and inclusive at all levels of the organisation, and expects all members, representatives and staff to uphold these values. Although the BMA has not been provided with specific details of the allegations and comments made to GPonline, we nevertheless maintain that it is unacceptable that individuals may have failed to live up to these high standards and not treated others with the respect they deserve.

'There are robust complaints procedures in place to both support anyone in the BMA who feels they have not been treated appropriately, and to ensure that action is taken against those who are found to have fallen short in their behaviour.

'It is imperative that all doctors, staff and representatives feel respected and welcome within the BMA, regardless of gender, age, sexuality or race. The BMA will continue to promote a culture of inclusivity and seek to banish all forms of discrimination for good. At GPC, we recognise that we must always be striving to improve our representation which is why we recently set up a group within GPC to look at this issue.

'Personally, as a female GP, it is deeply upsetting for me when I hear about concerns of this nature from my colleagues, and it is a priority for me that more is done to foster inclusivity and respect in GPC, the wider BMA and medicine as a whole.'

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