“The New NHS Contract Is Harmful To Female Doctors And Women”

Junior doctor Georgie Fozard writes on how the government's proposals for the new NHS contract are a threat to female doctors - and women.

This week thousands of junior doctors in England took to the streets to protest against a new contract the Conservative government has threatened to impose upon them. I was one of these doctors, and as I stood outside Downing Street with my home-made placard, yelling at the top of my lungs, it struck me how many of these doctors were women, and how angry they were.

Media coverage has focused so far on the way the contract attacks out-of-hours pay, and might affect patient safety. These are huge issues, and will hit almost all junior doctors hard. Many of us face pay cuts of around 30% for doing even longer hours and we’re predictably livid. But what has been less commented on is the way the contract will be particularly harsh for female doctors, and how it will affect women in general.

Moving into the world of medicine as a junior doctor was a welcome breath of fresh air after years of dodging the sweaty paws of inebriated rugby players at university club-nights. Finally, I felt valued for my knowledge and my ability to perform at work and could challenge male opinions without unleashing a hostile ‘you’re weird’ or a ‘cheeky’ slap on the bottom.

The NHS has always been a great place to work as a woman - this isn’t surprising, since around 77% of the workforce are female. For a long time the NHS has led the way with fair maternity leave arrangements and a flexible approach to working part-time.

Presently, if you’re a junior doctor in a specialty training post your salary will increase by a small amount each year, even if you take time out to have kids or work part-time to care for them. This is called ‘pay progression’ and is important as it means that those who’s working lives are complicated by having a family aren’t penalised for making this choice.

Now the government say they want to scrap this. A few men I have spoken to on the topic, have said ‘fair enough – why should women’s pay go up each year if they haven’t spent every day actually working?’. Of course, that argument makes sense if you imagine that experience only equates to hours spent actually being in work, but I’d like to think we can be a little more sophisticated than that.

The problem with scrapping pay progression is that it financially penalises people for doing anything but full-time training in their specialty, bringing a value judgement into what is described as having ‘worth’. This is a problem for those who wish to take time out to do research, or gain extra skills. With its priority money-making, the government doesn’t want responsibility for all the ways a mother brings value to society. It also treats having babies as a selfish distraction and forces women to take pay-freezes just for doing what nature intended.

Starting a family is a massive commitment emotionally and financially and when I’m ready I’d like to know that my employer will support me in that journey. For me and the 60% of doctors under the age of 30 who are female, this can no longer be a foregone conclusion.

Under the new contract, once you start having babies, your pay will be frozen and won’t progress until you’re back in work full time, like a man. In my current job, I work with psychiatrically unwell children, and have seen first hand the way early maternal bonding is vital for their future mental health.

A contract that financially disincentivises women to take their maternity leave or work part-time will have huge repercussions for future generations. I worry that young female doctors, many of whom will make fantastic mums, will be put off having kids. If they do choose to have a family, how will they afford childcare? Only those with high-earning partners will be able to stay – a further blow to female independence. Women will leave the profession in droves.

But if you're not a doctor you're probably wondering: how will these changes affect you? Well, to anyone who has ever used the NHS, or ever will do, this contract is harmful. In the short term, your doctors will be more tired and downtrodden, so more likely to make silly mistakes.

In the longer term, doctors will leave, and there will be a worsening recruitment crisis, which will further exacerbate funding problems as expensive locums are hired to fill gaps. It’s widely argued that this is the first step towards steering the NHS to collapse, so it can be quickly privatised. Do you know how expensive private healthcare will be?

But there are other broader implications for women like you. If a government is prepared to impose a contract that discriminates against women and mothers, what hope is there for the private sector? Government should be encouraging a societal shift towards everyone (men, women and business) accepting joint responsibility for the care of children. If not literally, then at least financially. Leaving all the costs with women in the relentless pursuit of efficiency denies our biology!

I fear that this contract sends the wrong message to employers in other sectors and will set the campaign for gender pay equality back years.

As doctors, we’ll fight it - for all women, for all patients - and we need your support!

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