As an overseas doctor working part-time in the National Health Service, my mother suffered a 'triple whammy'. Being a woman, qualifying outside the UK and working part-time could not have put her any lower down on the career ladder. All three obstacles were huge barriers to any real hope of career progress. This meant taking a job in the less competitive end of the job market, which was a job that nobody else could possibly want: working part-time in a large community hospital as a non-training doctor. I saw life at the very top end of inequality. It meant being witness to a perpetual career treadmill of someone doing the work of a junior doctor; with no hope of becoming a consultant.
A few days ago, a final offer for the Junior Doctors Contract came after an equality impact assessment was carried out by the government. Under the new contract, the pattern of pay distribution depends on working patterns, but it was the sheer gall of both the wording and the dismissive attitude toward female doctors that made me question not just how little the government value doctors but if it values women doctors at all. The impact assessment had the temerity to state 'Whilst this (the contract) may disadvantage lone parents (who are disproportionately female) due to the increased cost of paid childcare in the evenings and weekend, in some cases this may actually benefit other women, for example where individuals have partners, it may be easier to make informal, unpaid childcare arrangements in the evenings and weekends than it is during the week due to the increased availability of partners and wider family networks at weekends and in the evenings.' That has to be one of the longest patronising statements that I've ever seen. Here's the punchline. 'Any indirect adverse effect on women is a proportionate means of achieving a legitimate aim'. Reaching for the sick bowl?
The document had clearly been phrased after legal scrutiny but missed key ingredients that also needed to be considered. It had skilfully failed to disprove that the reason for any indirect discrimination was because any available option that reversed this would have been more costly. In other words, there should also have been no reasonable, less discriminatory alternative.
With this bombshell, we have really taken a huge step backwards in time with our treatment of women and it's got little to do with the colour of the tie worn by men holding political office. The Representation of the People Act that gave the vote to some women over the age of 30 was passed under a Liberal Prime Minister and the Equal Franchise Act that finally gave the vote to all women over the age of 21 was passed under a Conservative government. Yet never before has the UK been subject to such regressive reform against women than the current junior contract.
In 2009, the British Medical Association published The Pay Gap for Women in Medicine and Academic Medicine, finding that only 60% of the gender pay gap could be explained because women in a similar job to men were younger, had fewer years of experience, were more likely to have had career breaks and were less likely to hold high profile administrative or research posts. Even after comparing with another doctor having a similar background and in a similar job, significant gender differences were found at all levels of training.
The free text responses from anonymous feedback makes for disturbing reading that may leave you close to tears. Here are a few.
"Am about to go on maternity leave, with inevitable consequences on research projects during this time; it will take 1-2 years minimum post leave to re-build group."
"They had very stereotypical views about women with young children. A female colleague who was childless was promoted over my head despite much lower experience, but I applied for promotion through an appeal process and got it."
"How many male consultants do the supermarket shopping..."
"Unable to attend meetings and sit in committees due to childcare difficulties"
Many women are literally backed into a corner and compelled to change to part-time employment. Even then, it remains a slippery slope of inequality. Again, some further responses from the survey.
"I had to wait 8 years for a part-time consultant post"
"Being part-time, still regarded as inferior to full-time male colleagues"
Others echoed the challenges faced by others.
"You need to have 110% commitment to progress. I have made many personal lifestyle sacrifices"
"Hate to say it but I still think you have to work twice as hard to get anywhere especially if you are of an ethnic minority and female"
Seeing my own mother's career suffer, this was no surprise at all to me. The worst is still to come.
"People make judgements on first impressions and you have to work hard to show them otherwise"
"The old boy network"
"Alpha male culture"
Lastly:
"It is still a man's world - especially at the top."
With another set of strikes by junior doctors looming large, the public should know that female doctors are likely to be severely disadvantaged by the government's Machiavellian approach to imposing a contract that will prove to be their downfall.
There is one message that Jeremy Hunt needs to hear loud and clear. After the next election on Thursday 7 May 2020, don't say we didn't tell you so.