Five years ago I retired from the NHS. My three days a week at Bournemouth were replaced by two consultants working between them ten and half days a week. I would like to think that this meant that I was practically irreplaceable, but in fact the hospital took the opportunity to expand and improve the service. I refrain from making the sexist point that it took two women to replace me, especially since back in the 1980s I got into trouble by raising alarm bells over the fact that the number of women going to medical school had massively increased. My point then was that the average woman worked for seven years after qualifying whereas the average man worked for 35 years after qualifying. No doubt the truth was that women would in future not work for a few years before marrying and retreating into a life of domesticity and the occasional family planning clinic.
So I was interested to see a new paper in the Journal of the Royal Society of Medicine (101:27-33) entitled 'Gender and variation in activity rates of hospital consultants'. The authors have surveyed the number of 'Finished Consultant Episodes' (FCE) attributed to various doctors in the NHS. The surprising finding was that male consultants were responsible for at least 20% more FCEs than female consultants in equivalent posts with equivalent case mixes. Other variables like age, specialty and hospital were taken into consideration. Indeed male doctors tend to have the more complicated casemix, and when workload is adjusted for this, the excess activity for males approaches 100%.
Similar results have been found in both the USA and Canada, but in these systems more work brings more pay, so that there is an element of choice in how much activity is undertaken. In the UK everyone is paid the same. Well, not quite. There is a system of discretionary points and merit awards which are supposed to reward those who work especially hard or are in other ways meritorious. And sure enough, doctors in receipt of those awards do work harder. However, protests have been made that fewer women than expected get these rewards and instructions have come from government to remedy this imbalance. It seems from this survey that the distribution of these awards is indeed fair.
Another finding of this survey is that doctors who have a private practice in addition to their NHS practice, actually work harder for the NHS than those doctors who don't have a private practice. This again contrasts with what the government has been telling us, that doctors who sneak off to Harley Street are neglecting their NHS patients.
Entry into Medical School in the UK is 60% female. Is this wise?