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08 April 2020

To really value our healthcare workers, we need to close the gender pay gap

Anne Laure Humbert

ANNE LAURE HUMBERT: Women, who make up the majority of healthcare workers, still face a significant pay gap in the sector

Nurse corona ward

Over the last month or so we’ve seen governments, companies and individuals working flat out to adjust to the new reality of the Covid-19 crisis. Part of the UK government’s response to ease the burden on business was to suspend gender pay gap reporting for this year. Whilst understandable, this is symbolically unfortunate, given we are this year set to celebrate the 50th anniversary of the Equal Pay Act (1970). It is also disappointing in light of one group of workers who deserve greater attention in these debates: healthcare workers, and most particularly nurses, 90 per cent of whom are women.

The gender pay gap is defined as the percentage difference between gross hourly earnings of working women and working men. According to Eurostat, in 2017 the gender pay gap in the UK amounted to 21 per cent, above the EU-28 average of 16 per cent. This is a significant gap, and one that only increases as people age. Indeed, the gender pension gap for those aged 65+ averaged 30 per cent in the EU-28, and 34 per cent specifically in the UK, in 2018.

Even though gender pay reporting only provides a partial picture, it nevertheless represents an important tool to eradicate pay differences. It mirrors efforts and recommendations at EU level to achieve greater pay transparency, as recently featured in the new European Commission’s Gender Equality Strategy 2020-25.

The gender pay gap is characterised by various factors, some of which are structural and some of which are potentially discriminating on the basis of sex. Structural factors can be differences in working hours or segregation patterns (eg women’s under-representation in more senior positions or in certain sectors), shaped, to a large extent, by gendered social norms and stereotypes. Once the effects of these structural factors have been taken into account what remains unexplained can be understood as discrimination. In examining the gender pay gap, it is important to consider how these two components play out and to quantify them using statistical decomposition methods.

The current way of measuring the gender pay gap is also problematic because it relies on hourly pay. However, differences in pay are most prominent when measured weekly, monthly or annually due to differences in working patterns, for example women are much more likely than men to work on a part-time basis. Furthermore, measuring pay is more meaningful to the reality of people’s lives when measured at the weekly or monthly level, since this is the aggregate that allows them to pay bills and meet other financial commitments.

Our research at the Centre for Diversity Policy Research and Practice at Oxford Brookes University, in collaboration with the Royal College of Nursing, examined gender and pay in the health sector. The findings show that women earn, on average, 30 per cent less across all health professions (nurses, doctors, managers and allied health professionals) per week, or 16 per cent less on an hourly basis. Pay for nurses is 81 per cent of that of the healthcare average. The low variation (evidence by a relatively small standard deviation) also suggests that more skills and experience do not translate into higher pay for nurses. In 2018, gross weekly pay for men in nursing was on average £617 compared to £512 for women, representing a 17 per cent weekly gender pay gap.

Decomposing this weekly gender pay gap in the health sector (£351.45) shows that working hours play a significant role, as the gap would close by £137.73 weekly if women worked the same number of hours as men. The decomposition also shows that a significant part of the gap is unexplained by any of the structural factors examined, and suggests that discrimination alone accounts for £93.49 of the pay gap.  

A decomposition of the nursing gender weekly pay gap (£107.72) shows that if women and men worked the same hours, the pay gap would be reduced by £102.60 per week, accounting for the majority (95 per cent) of it. However, unlike the figures for all health professionals, there is no evidence of potential discrimination on the basis of sex. It is the gendered treatment of nursing –– the way it is devalued as a feminised profession –– that is suppressing wages, rather than gender inequality in the workforce. Nurses are paid equally… badly.

We are so heavily reliant on health professionals in this time of crisis –– but the lack of progress since the Equal Pay Act (1970) and the suspension of gender pay gap reporting feel somewhat at odds with how we value them. It is more important than ever in the post Covid-19 world we aim to conduct more appropriate analysis of the gender pay gap (including decomposition methods); use a wider range of measures (extending the measure from hourly to weekly or monthly); revisit existing job evaluation frameworks and dispensations across the health sector and in relation to other professions; and create monitoring tools that enable greater transparency.

Dr Anne Laure Humbert is the Director of the Centre for Diversity Policy Research and Practice at Oxford Brookes University, as well as a Visiting Researcher at the Global Institute for Women's Leadership, King's College London.