“Hi,” I said. “My name is Beth. I’m one of the ward doctors. How are you feeling?”
“A bit sore, I suppose,” he said. “It’s better than it was before I went to surgery!”
“Excellent. I need to take a blood test from you, if that’s all right.” I checked out his forearms. Drainpipes. Fab. “I’m sorry to have interrupted,” I said, making an apologetic face at his family. “It won’t take but a minute.”
“Oh, that’s OK. Hop off,” he told the little boy who had been sitting on his legs. “Look, the lady doctor is going to take blood from Daddy, isn’t that exciting?”
It was quite the coolest thing this particular little boy had seen in his whole life.
And then there was me, getting my tourniquet and needle and blood bottles ready while quietly launching a hissy fit inside my own head. It was 2013. There were women in the Armed Forces, women in the House of Lords and the Senate, women in the Old Bailey and on the Supreme Court, women in our newspapers and on our police forces and fire brigades and in our research laboratories and on our library shelves, women running marathons and shooting guns. There are women in our pulpits if not yet in Lambeth Palace (and we’re working on that one). There is a woman on the British throne and a woman in charge of the US State Department. Elizabeth Blackwell became registered with the GMC in January 1859. Surely, more than a century and a half later, we can stop attaching the ridiculous prefix of “lady” to a job done by millions of women around the world.
For as long as we identify “women doctors” as an exotic subspecies distinct from “doctors”, so shall gender disparity continue to exist and so shall articles such as that written by Professor J. Meirion Thomas in the Daily Mail this week continue to be thought worthy of press time and attention.
Professor Thomas’s thesis is that (1) By 2017, women who practice medicine in the UK will outnumber men who practice medicine in the UK (in 2012, the ratio, based on practicing doctors registered with the GMC, was 57/43 in favour of the men), (2) Because she will also be a wife and a mother, a woman is more likely than a man to work part time, and (3) The confluence of (1) and (2) is destroying the NHS. In approving tones, he quotes the former health minister Anna Soubry, who told the House of Commons in June last year that “women doctors” are a drain on resources. Professor Thomas himself is appalled that over half of all “qualified” male applicants to medical school are rejected.
My reflex when presented with such a thesis is to say, plaintively, that I wish that men wouldn’t presume that professional women are going to go off and have babies. There was a time when I could be heard to joke that I was considering putting “Childfree Lesbian” as one of my primary qualifications. Professor Thomas’s article is far from the first recently to claim that women are going to be the downfall of the NHS. I loathed the idea that at a job interview, men would look at my two X chromosomes and their first thought, before they considered my skills or my experience or how well I might fit into their team, would be, “Well, that one’s going to take maternity leave.” It is an attitude that I loathed then and despair of still, but it is merely a symptom of a larger problem, and to pretend otherwise is a betrayal not only of the Sisterhood but of the thousands of people, women and men, who devote less than full time hours to their primary employment for myriad reasons that include but are far from limited to childcare provision. I choose not to have children and I choose to work full time. I am a single white non-disabled person with no carer or dependent responsibilities and with a proverbial Munro of student debt that needs conquered. It is my joy and my privilege to have made those choices.
And it is my view that people who choose differently or who are compelled by their circumstances to have no such choice are as valuable members of my profession.
Even people who work part time in the NHS because they choose to use the rest of their time to work in their lucrative private practices, as the professor does. Tell me, Professor, if your concern is, as you claim, that the taxpayer should get a proper return on its half million pound investment into a doctor’s medical education, what return exactly is the taxpayer getting during the hours you spend squandering your talents on an institution inaccessible to most of them?
Professor Thomas believes that part-time working is hanging us over the precipice of a disaster in primary care. It’s a disaster, he says, because this is why GPs no longer have the cradle-to-grave relationship with patients that their forebears did and, he says, because this is why out-of-hours provision is in the mess that it is. The loss of the cradle-to-grave relationship has many and complex reasons, the greatest of which might be that we live now in a larger and more mobile society. And although I do not deny that out-of-hours reform in primary care is needed, if it is the fault of a part time female GP, and I don’t think it is, that someone pitched up in ED at 5am on Boxing Day with cold and flu symptoms then it is also the fault of a full time male GP, because if I can be confident in one thing it is that neither of them were at work in their own practice at 5am on Boxing Day. GPs, whether full time or less than, are not on call 24/7/365. I suppose some people dream, mistily, of a time when they were. I ask, and forgive me if I do it with a touch of bite, if this career actually wants to aspire to the rates of suicide, divorce, drug and alcohol dependence, and burnout that it was once infamous for.
(Why do I insist on calling it the correct “less than full time” rather than the colloquial “part-time”? Simply because I wonder whether those who read the article in the Daily Mail this week are aware that there are weeks when a so-called part-time doctor might easily clock in excess of 38 hours. In few other jobs would this be considered part-time.)
And so having given due consideration to Professor Thomas’s thesis, I invite him to consider the following:
(1) that women have the capacity to be every little bit as smart and competent as a man,
(2) that whether individuals of either gender reach that capacity has less to do with raw hours/week of service than it has to do with other factors, such as availability and quality of training and engagement with process,
(3) that not all women work less than full time,
(4) that men work less than full time,
(5) that the process involved in less than full time working is more complex and better planned than not turning up to work on Tuesday afternoons,
(6) and is not the same thing as opting out of evenings, weekends, public holidays, or nights,
(7) that people who choose to work less than full time generally have valid reasons,
(8) that those reasons are none of his business,
(9) that engaged and fully present doctors who work less than full time hours are better doctors than full time doctors who are apathetic towards their jobs and leave bang on 5pm, and
(10) that he is not in fact a feminist.
For remember this: I am not a better or a worse doctor than my less than full time colleagues merely because I work full time. I do not give more or less of myself during my working hours. I am no more or less committed. I am no more or less likely (hint: in this job we are all less likely) to actually leave work on time. I have no greater or fewer training requirements, exam requirements, or CPD requirements. I get neither more nor less screwed by the on-call rota and I do not, proportionally, provide more or less out-of-hours services than those who have chosen, for whatever reason, to not do it on a full time basis.
And for as long as doctors continue to show up for work early and stay late, educate themselves, work as effective clinicians, and make the care of their patients their first concern, it is my view that Professor Thomas has no say in who chooses to work when.