Woman doing the bulk of the work in NHS Scotland but men taking home most of the pay

For too many decades now women have had to drag employers to the steps of the courts [and sometimes in to the well of the courts] just to get paid what the law requires - equal pay with men for work of equal value.  I am unable to recall a single example during those decades of exploitation by men of where any employer gladly, willingly and with a joyous smile, ensured that not only henceforth would women get the same pay as men but that their pay packet would be wedged thick with back-pay from all those years of being discriminated against because of their gender.

In NHS Scotland, blossoming under the fragrant leadership of Cabinet Secretary for Health Jeanne Freeman, the equal pay gap between women and men is heading in the wrong direction.

In 2015, when most of Scotland's 22 Boards got around to publishing pay gap data, the aggregate for all of NHS Scotland was 18.85% - men earning more than women by hourly pay average.  In 2017, a check-up on NHS pay gaps found that instead of panic setting in at 2015 and all hell breaking loose about how the 18.85% gap needed to be closed under the barn-storming leadership of Shona Robison, the gap had grown to 19.99%.  Sadly and 2 years on, the 2019 pay gap reports published by most of Scotland's Boards - a few didn't think it important enough to publish reports by the legal deadline of 30th April - showed that the change of leadership from Shona Robison to Jeanne Freeman found the gap had again increased - from 19.99% to 20.77%

For those trying to get an insight into how this can have happened I would commend a read of some of the equal pay gap reports published by Boards.  One in particular which I found highly informative is from NHS Grampian's 2019 pay gap report.  The following is a screen shot from that report and shows the core data sets which make up the pay gap at NHS Grampian.

In another part of the same report, the position taken by the Board on the NHS Grampian pay gap is summarised as 'negligible'.

The underlying problem in NHS Scotland on why the pay gap is so large and why it is not being reduced is in the occupational segregation which props up the current model of working in the NHS.  

At December 2018, the NHS Scotland workforce [140,710 whole time equivalents] relied on women to the extent that 77.3% [equivalent to 108,907 FT jobs] of the work carried out across the NHS was done by women.  Of that overall figure, 40.1% [43,681 equivalents] work part time.  

Men accounted for just 31,803 [equivalents] or 22.6% of the entire NHS workforce.  Of them, just 3,615 worked part-time.

From research first published in April 2018, the NHS vertical pay axis and distribution of women and men up and down that axis was revealed for the first time.

62.06% of the cohort of women employed across NHS Scotland are paid up to £25,806. For men, the proportion of their cohort paid up to £25,806 is 49.16% - a substantial 13% points to the detriment of women.  Put simply, in the NHS women are almost 5 times more likely to be in low paid work than men.

Curiously, Scottish government as an employer has a much less discriminatory pay culture than NHS Scotland.  The table below shows the equivalent spread of women and men along the vertical axis of pay within government.

All of this leaves Jeanne Freeman, Cabinet Secretary for Health in a rather awkward spot.

She presides over an increasing equal pay gap in NHS Scotland.

She presides over structural occupational segregation in NHS Scotland.

None of the NHS Boards [which have pay gaps of over 5% and which discriminate against women] who report to her have published plans for closing the pay gaps.

None of the NHS Boards who report to her have published plans for eliminating the occupational segregation which discriminates against women.

Jeanne Freeman - will she condone the continuing 
exploitation  of and discrimination against women 
within and across NHS Scotland

Her choices are stark.  Condone the continuing exploitation of and discrimination against women within and across NHS Scotland ?

Or intervene and demand NHS Boards draw up clear action plans which will deliver gender equality in the pay and employment structures and cultures of NHS Scotland - and deliver that in the lifetimes of the women on which NHS Scotland has been built ?