Viewpoint: NHS must take bold steps to end gender inequality within medicine

Professor Dame Jane Dacre, who is leading the government-backed review on the gender pay gap in medicine, says it is time to act on gender inequality and ensure women have access to senior positions within the profession.

International Women’s Day is important to me every year but is especially pertinent for me in 2020 with the government due to publish the independent report on the gender pay gap in medicine in England, which I am leading.

A gender pay gap is the difference in average hourly earnings of men and women as a percentage of men’s earnings. It is different from equal pay, which is equal pay for equal work.

Overall the NHS has a gender pay gap of 23%, despite employing far more women than men. In medicine, the gap is high for a single professional group, and is 15.3% for GPs.

In my forthcoming report we will be proposing some bold proposals for how this gap can be reduced. We have known about the difficulties the female medical workforce experiences for some time, with reports dating back more than ten years – now is the time for action.

However, on International Women’s Day, I like to reflect on how far we have come, not just how much more progress still needs to be made.

Women's progress in medicine

In the UK, over 50% of medical school entrants are women.

Women make up a similar proportion in many countries around the world. I am now the president of the Medical Protection Society (MPS) which has over 155,000 female members around the world, which is more than half of our membership – and a figure that is on the rise.

But of course it wasn’t always easy for women to enter the profession. Medical schools were not open to women and they had to pass their exams incognito before being able to officially register. This was easier when all the exams were written!

Some of the earliest members of the MPS are a case in point.

Dame Mary Ann Dacomb Scharlieb DBE was MPS’s first woman member. Joining in November 1899, she was a gynaecologist and a surgeon and worked at the New Hospital for Women - known today as Elizabeth Garret Anderson Hospital, along with Dr Garret Anderson herself.

Elizabeth Garret Anderson’s daughter, Dr Louisa Garrett Anderson, was also one of MPS’s earliest members having joined in 1903. She is not only notable for her medical work - she along with others established the Endell Street Military Hospital in Covent Garden - but also because of her suffragette activities which led her to be imprisoned. Her name and statue can be found along with other women’s suffrage supporters, including her aunt Dame Millicent Fawcett, in London’s Parliament Square.

Dr Mary Hannah Frances Ivens CBE FRCOG joined MPS in 1907 and she was notable for being the first woman appointed to a hospital consultant post in Liverpool. She served as the president of the Medical Women’s Federation from 1924 to 1926 and was chief medical officer at the Scottish Women’s Hospital at Royaumont, in France. Like some of her contemporaries, she was active in the suffragette movement. 

Structural barriers to overcome

Although it wasn’t until the turn of the century that women were seen entering the medical and dental profession officially – and being able to study, register and be remunerated for their work – healthcare began at home and within communities, and caring for the sick had long been the responsibility of women.

Nowadays, although almost half of healthcare workers are women, we still have structural barriers to overcome in order to improve the access of women to senior positions.

For the women coming into medicine now, we owe it to them and their future commitment to the NHS to ensure they are treated and paid fairly.

  • Professor Dacre is a consultant physician and rheumatologist in London and president of the MPS. She is a former president of the Royal College of Physicians and is currently leading the government-backed Gender Pay Gap in Medicine Review.

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