Women are acceptable collateral damage in the junior contract dispute

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Staff writer

The Department of Health has released the revised junior doctor contract due to be imposed this summer. Alongside it is an equality analysis that has deemed that ‘Any indirect adverse effect on women is a proportionate means of achieving a legitimate aim’ in specific reference to maternity leave and those with responsibilites as carers. These concerns had been raised early on in the discussion of the contract and even the government’s equality analysis can only claim woman which comprise the majority of the medical workforce are acceptable collateral damage for ‘legitimate aims’.

The legitimate aims that apparently justify these ends are the ‘key objectives’ at the top of the 39 page document. These aims are anything but legitimate; a lot of them have already been torn apart throughout this dispute by doctors but continue to be parrotted by the department of health.

One such aim, ‘to enable employers to roster Doctors when needed across seven days including evenings and weekends more affordably to support the delivery of a 7 Day NHS for patients in accordance with the clinical standards developed by the Seven Days a Week Forum’ is in direct conflict with Jeremy Hunt’s claim that the new contract is cost neutral.

However, another key aim which is the main cause of the inequality impact is, ‘to end time-served automatic annual pay progression (“AAPP”) and establish a pay model based on the level of responsibility of the role being performed’. The reason this disproportionately affects women is that this is the group of people most likely to take time out of work for maternity or caring purposes. Some might say that surely people should only be paid based on their level of responsibility, and this is true. However, how do we gauge someone’s responsibility? Stage of training is one admittedly, but this is a fundamentally blunt instrument that does not reflect the real level of experience people have. Responsibility is fundamentally about making decisions and this is achieved by spending time in hospitals learning. AAPP respects this and ensures that we value people that choose to change specialty, adding much more experience to their roles than would otherwise be suggested by their titles.

AAPP is a rare concept now in the modern workplace but it used to be an almost universal perk in most jobs. This would ensure employees would remain loyal to an institution rather than simply moving from place to place. With a health service failing to fill cover throughout; abolishing any pull factors is only going to increase the brain drain of doctors to other countries offering better conditions.

Even if these aims were in any way acceptable aims, the fundamental issue is that women are being purposely sidelined in order to achieve them. That 50% of the population that continue to suffer an average wage gap in full time work of 13.9%.

It was only 46 years ago that the equal pay act was established to ensure that women were paid the same as men for equivalent jobs. However the pay gap remains as women tend to be found in lower skilled labour posts, as well as the lack of women in higher senior positions. One must ask that if Jeremy Hunt was a woman, would she be happy to impose this contract?

Whilst women are paid numerically the same as men in equal positions in medicine, there are other issues that matter such as work-life balance. Indeed, women are overrepresented in specialties such as General Practice which facilitates this. Nonetheless, as rising levels of women enter the senior rungs of the profession across all specialties, this is likely to change as they hit a critical mass that ensures women’s needs are met.

It is strange that in a society where many of us value having children, we seem to make people choose between having a family or being able to work. Society is not set up in a way that allows working women to be continue, where taking time from the career ladder is seen is a failing no matter what the cause. We still live in a world where our identities are meant to be purely based on our jobs rather than what we do outside of it.

Fundamentally we live in a society that does not value the acts of caring. In days past where housewives took up a huge labour burden cooking, cleaning and raising children, skills taken for granted and completely unpaid for. This is reflected in wider society with these skills often treated as low grade labour that does not warrant good pay. As is seen in the wages of cleaning staff, carers and not least of all, nurses.

This contract sets a worrying precedent that women’s rights can be wilfully ignored for a political agenda. It also underscores the point that caring for others in society is not a valuable pursuit, a particularly worrying point when we consider that we are doctors, a professional built on caring for the sick. And it is also for this reason that we cannot treat this as a woman’s issue. Discrimination damages us all, and it is only through solidarity that we can hope to succeed.

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