Prime Ministers used to be unashamedly sexist – but at least you knew where they stood. As the women’s suffrage movement gained momentum, incumbent William Gladstone denounced the women’s vote as a violation of their feminity which would: “trespass upon their delicacy, their purity, their refinement, the elevation of their whole nature”.
Today, thanks to the fearlessness and grit of the suffragettes, Prime Ministers have been forced to confront the electoral clout of the ‘Mumsnet vote’ and – it seems – will say anything to curry favour with women. Take David Cameron. In the run up to last year’s election, he vowed to force all large firms to reveal whether they paid men more than women. Pledging to “end the gender pay gap in a generation”, this valiant champion of female emancipation would go on to declaim that there is “no true opportunity without equality”.
That didn’t last long. Earlier this year, election win secured, Cameron’s new contract for junior doctors exposed his commitment to gender equality as so much manifesto hot air. The government didn’t even try to hide the discrimination at the heart of the new contract. Instead, the Department of Health’s Equality Impact Assessment conceded that the contract would discriminate against female doctors, yet claimed that, “any adverse effect on women is a proportionate means of achieving a legitimate end”. It seemed that when not intrinsic to electoral success, women were mere collateral damage.
Once upon a time in Britain, all doctors were men. Elizabeth Garrett Anderson, whose birthday we celebrated this week, fought tooth and nail against prejudice, discrimination and weasel words like the ones above to become the first ever female doctor in Britain. She is my inspiration, my strength and idol. How she’d be turning in her grave.
The sorry truth about Cameron’s contract is that it is set to make medicine more male, overturning generations of fighting for gender equality within the profession. The contract will cause a massive redistribution of pay from female to male doctors. This may make it financially impossible for many women to remain in medicine. Why? Because currently there are small annual pay rises in NHS that help mitigate against the way in which the pro-rata pay of full-time doctors outstrips that of their part-time colleagues. Cameron is intent on abolishing these ‘annual increments’ across all public services, the NHS included. But since 80% of part-time doctors are female, it is women who will disproportionately suffer. Heidi Alexander MP, Labour’s Shadow Health Secretary, said the equality assessment had led to “many women rightly questioning whether they’ve woken up in a different century”.
Even before Cameron’s contractual changes bite, the gender pay gap in medicine is profound. Women have practised medicine for over 100 years and yet, according to the Office for National Statistics, female doctors still earn 29% less than their male counterparts.1 When voting begins this week in the ‘other’ referendum – the junior doctor one – Cameron is hoping we will accept his new contract. The last thing he wants is more strikes. But under his contract, as doctors progress through their training, they will see ever-widening gender pay gaps in medicine. Now how – as a female doctor and mother of a son and a daughter – could I possibly justify that to Elizabeth Garrett Anderson? Cameron may be happy to watch his children grow up in a society that treats women as essentially the same as men, just that little bit cheaper, but I am not. And nor, I believe, are my colleagues.
For the first four years I worked as a doctor, my childcare costs outstripped my income such that I was a net financial drain on my family. Each year I worked in the NHS, I cost my family around £5000. My job is my love and privilege, but the mortgage repayments have at times made it very hard to justify. And that – perhaps more than anything – should be making this government think twice. We are in the midst of a junior doctor recruitment and retention crisis. 60% of doctors are female. Even if David Cameron doesn’t care a jot about gender equality, perhaps the imperative of actually staffing the NHS frontline might cause him to think twice about imposing a retrograde, regressive contract that treats women as second class doctors – and is set to force many of us out of the profession we love so dearly but cannot afford to sustain?