Retrospective observational study of ethnicity-gender pay gaps among hospital and community health service doctors in England

Abstract

ObjectivesTo identify differences in average basic pay between groups of National Health Service (NHS) doctors cross-classified by ethnicity and gender. Analyse the extent to which characteristics (grade, specialty, age, hours, etc.) can explain these differences.DesignRetrospective observational study using repeated cross-section design.SettingHospital and Community Health Service (HCHS) in England.ParticipantsAll HCHS doctors in England employed by the NHS between 2016 and 2020 appearing in the Digital Electronic Staff Record dataset (average N=99 953 per year).Main outcome measuresHours-adjusted full-time equivalent pay gaps; given as raw data and further adjusted for demographic, job, and workplace characteristics (such as grade, specialty, age, whether British nationality, region) using multivariable regression and statistical decomposition techniques.ResultsPay gaps relative to white men vary with the ethnicity-gender combination. Indian men slightly out-earn white men and Bangladeshi women have a 40% pay gap. In most cases, pay gaps can largely be explained by characteristics that can be measured, especially grade, with the extent varying by specific ethnicity-gender group. However, a portion of pay gaps cannot be explained by characteristics that can be measured.ConclusionsThis study presents new evidence on ethnicity-gender pay gaps among NHS doctors in England using high quality administrative and payroll data. The findings indicate all ethnicity-gender groups earn less than white men on average, except for Indian men. In some cases, these differences cannot be explained giving rise to discussions about the role of discrimination.

Trends and determinants of clinical staff retention in the English NHS: a double retrospective cohort study

“…However, when considering senior doctors, female staff constitute approximately 40% of the total. This stark contrast highlights the gender disparities within these healthcare professions 15–17…”

Foreign Healthcare Professionals in Germany: A Questionnaire Survey Evaluating Discrimination Experiences and Equal Treatment at Two Large University Hospitals

“…Earlier studies [ 19 , 20 , 21 , 22 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 ] reported that international nurses felt distressed, confused, and humiliated by the discrimination they experienced while working. Participants reported incidents of discrimination including ‘patients displaying racist behaviour’, ‘refusal of care by international or Black nurses’ and ‘staff undermining the work of their international colleagues or drawing unfair conclusions about morale, motivation or character’ [ 26 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 ].…”

Retention of ethnic minority staff is critical to resolving the NHS workforce crisis

“…Pay and pensions are clearly important too, although increasing pay is unlikely to be enough to encourage staff to stay if working conditions are not improved 16. It is also clear that staff from ethnic minority groups and international staff are more likely than their white British colleagues to experience many of the predictors of attrition, such as low pay and poor career progression, and have also been disproportionately affected by the pandemic 171819…”