The gender pay gap in England’s NHS

Little progress since last year

The deadline has now passed for the second report on pay equality for UK employers with more than 250 employees. The “gender pay gap” is the overall difference in earnings between men and women.

We now have two years' data to compare, so have things changed in NHS organisations? Are they closing the gap? Overall, the short answer is no, though some individual organisations seem to have improved.

Scroll down this piece to see the differences between the two years' data and which organisations have changed, for better or worse.

Employers with equality Employers where women earn more than men Employers where men earn more than women 2017-18 185 (91%) 8 (4%) 10 (5%) 2018-19 191 (94%) 5 (2%) 7 (3%) 2018-19 5 10 15 20 25 Women earn more than men Men earnmore than women Number of NHS organisations EQUALITY Difference in median hourly pay (%) -10% 10% 20% 30% 40% 50% -20% 2017-18 2018-19 -30 -15 15 30 45 -30 -15 0 15 30 Pay gap switch from favouring men to women Larger gap, still favouring women Reduced gap, still favouring women Gap reduced to equality No change Reduced gap, still favouring men Larger gap, favouring men Pay gap switch from favouring women to men Pay gap switch from favouring men to women Larger gap, still favouring women Reduced gap, still favouring women Gap reduced to equality No change Reduced gap, still favouring men Larger gap, favouring men Pay gap switch from favouring women to men Change from 2017-18 to 2018-19 Number of employers with this type of change EQUALITY 1 4 2 4 6 78 104 4 1 4 2 4 6 78 104 4 Percentage difference in median hourlypay between men and women

The reporting organisations

Each circle in this graphic represents one of the 203 English NHS organisations that reported in both years. Hover over the circles to identify them.

Only English organisations are covered here, because without a functioning executive, Northern Ireland is yet to enact the reporting requirement. Welsh and Scottish NHS organisations report separately.

The first year

In 2017-18, the first year that the data reports were required, the vast majority of NHS organisations reported a gap in the median hourly basic pay in favour of men, although a few reported no gap or one favouring women.

Overall, taking a simple average of the median pay gaps across all NHS organisations, women earned 90.6p in basic pay for every £1 men earned.

A disappointing result

The 2018-19 data show that the proportion of these organisations with a basic pay gap favouring men has risen to 94%. The change is not statistically significant but, given an expectation that gender differences in pay should be reducing, this is disappointing in policy terms.

Overall, taking a simple average of the median pay gaps, women earned 90.3p in basic pay for every £1 men earned.

The disparity

At a more disaggregated level, this year’s data for England’s NHS look similar to last year’s. Gaps in basic pay in NHS organisations now range from 40% in favour of men (at Queen Victoria Hospital NHS Foundation Trust in Sussex) to 30% in favour of women (Liverpool Community Health NHS Trust).

The Queen Victoria Hospital attributed that gap to the number of male consultants (54, compared with 18 female Consultants). At Liverpool Community Health, that pattern is reversed.

Charting the changes

Delving a bit deeper, 104 of the 203 organisations reported a worsening of the pay gap between 2017-18 and 2018-19, and another four declared a switch from a pay gap favouring women to one favouring men.

A mixed picture

While most organisations reported a worsening pay gap, some show that positive changes are possible. Northern Devon Healthcare NHS Trust made the biggest progress, reducing its gap in basic pay from over 21% to just under 5% in men’s favour.

Why is there still a pay gap?

Several other analyses show that one of the main causes is men continuing to dominate consultant grades, with larger gaps in specialties dominated by men, such as urology and surgery. This may change as employers appoint more female consultants and as current female doctors move into more senior roles. But there is still a long way to go to reach equality, especially considering the lack of progress between the first two years of reporting.

Further details are available in a data briefing, Gender pay gap in England’s NHS: little progress since last year by John Appleby, published on The BMJ on 22 May 2019.

© 2019 BMJ Publishing Group Ltd.

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