Gender, Pay and the NHS

Gender, pay and the NHS

There has been recent interest in the gender pay gap now that employers of more than 250 staff have a legal duty to publish an annual report. So we at the Bristol Care Workers Network thought we should have a look at the situation at the two local NHS Trusts. They are both major employers in the city with around a combined workforce of about 20,000.

We were staggered to discover the scale of the problem. At the North Bristol Trust (NBT)the gender pay gap is 19% and at UH Bristol it is a whopping 22.24%. We are talking here about the mean average. Some, mainly the highest paid, prefer to look at the median average. The smaller gap making more attractive to talk about.Strangely the inequality seen in median pay was reversed in this calculation. The gap was now bigger in North Bristol at 4.9% and lower at UH Bristol at 0.94%.

In the NHS most staff are paid under an agreement called ‘Agenda for Change’. This should ‘provide a clear process of paying employees equally for the same or equivalent work’. Medical, dental and senior managers are outside of this deal. It would appear that staff pay in these areas are the driving forces behind gender pay inequalities.

We can’t hide our surprise to find, from these reports, that at UH Bristol doctors received bonuses that added up to to over £3,000,000. Yes, that is that 3 million. So while NHS staff are being balloted on a below inflation pay offer, those at the top of the medical profession, are taking even more home in bonuses than a cleaner or Porter will get for a full years work. North Bristol’s figures don’t allow us to come with a total bonus bill but rest assured that doctors at this trust are also doing very well. The average male consultant at NBT will have received a bonus of over £15,000. Female consultants consistently receive lower bonus payouts. Nice work for those who can get it.

The bonus system is over rewarding male doctors. It is not possible to gleam from the reports why this is. Certainly more males are consultants and maybe the jobs with the best possibility of high bonuses are filled by male doctors?

The other reason for the shocking gender pay gap is the stacking of senior management roles with males. At UH Bristol all pay bands have more women in them except for one. Yes you guessed it. The one that pays the most. Band 9 staff, who are payed between £80,00 and 100,000, are 80% male. We imagine the author of the Trust’s Gender Pay Gap report is paid at this band or higher. No wonder they want distract our attention and talk about median values. Masking the pay inequality and the reasons behind it.

So was does this all matter? We know that doctors earn more than nurses, who in turn earn more than cleaners. The current division of labour divides us and rewards us differently. But the questions still remains, why are senior males doctors picking up more in bonuses than their female colleagues? Why are senior management jobs going to the men? A NHS mainly staffed by women is failing to see many women reach the top. There can be no excuses for this.

While we are critically examine the gap in the NHS. Let’s also ask a similar question of the biggest trade unions in the NHS. Our hard earned subscriptions allow Unison to have a median gender pay gap of 15.8%, the RCN comes in at 13.7% and Unite’s median gender pay gap is mind-boggling 29.6 percent.

Also, the Gender Pay Gap is indicative of other forms of inequality. The reports are not asked to examine pay equality in terms of class or ethnicity. What the report lacks we will have to fill in the gaps ourselves. The UH Bristol Chief Executive earns more than 19 cleaners. Interestingly, at North Bristol they have a female Chief Executive but she can not command pay like her male counterpart at UH Bristol. So she only receives pay equal to that of about 14 cleaners. What more we add?

Remember, employers with more than 250 staff now have to publish information about their gender pay gaps. The Government recently set up the Gender Pay Gap Service; an online database of all large employers and their gender pay gaps. If your employer employs more than 250 people then you can find out what the gender pay gap is here.

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