What is the ethnicity pay gap among NHS doctors?

The Secretary of State recently commissioned the president of the Royal College of Physicians, Jane Dacre, to examine the gender pay gap among doctors in the NHS, but is it time we examined the ethnic pay gap, too?

Although race and sex are both “protected characteristics” listed by the Equality Act 2010, there is no requirement for organisations to report pay gaps by ethnicity (or indeed any of the other seven protected characteristics).

The NHS is one of the largest employers in the world and the single largest employer in the UK with around 1.6 million directly employed staff, and 1.2 million in England. In England, a higher proportion of NHS staff identify as belonging to a minority ethnic group compared with the population as a whole (20% in December 2017 versus 15% based on the 2011 census). For NHS doctors (excluding general practitioners), however, the proportion of black and minority ethnic (BME) staff varies from 37% for foundation year 1 doctors to 60% for specialty doctors (see chart).

So how does the pay of NHS doctors vary by ethnic group? Basic pay data – extracted from the NHS Electronic Staff Record – for December 2017 for doctors in England directly employed by the NHS, coupled with doctors’ self-identified ethnicity category, show differences in median basic pay between white and BME doctors. 

For nearly all grades and types of doctors, the gap in median basic pay is small, ranging from close to zero for foundation year 2 doctors to 1%, favouring BME associate specialist doctors (see chart).

Although the lack of a significant pay gap for most doctor grades is encouraging, a larger gap exists among consultants: the median basic pay for white consultants is 4.9% higher than for BME consultants. This is equivalent to additional basic pay in December 2017 of £387 (€430; $490) – or, scaled up, around £4,644 a year – for white consultants.

A more detailed breakdown shows that median basic pay for white consultants is higher than for all other ethnic groups – varying from around 3.5% higher than black/black British consultants, to over 6% higher than mixed or dual heritage consultants (see chart).

It is one thing to identify pay gaps between staff, another to explain them. As with the gender pay gap (and as the Office for National Statistics and other analyses have shown), the ethnic pay gap among consultants will be driven by several factors. Part of the explanation may be differences in the age profile of white and BME consultants.

As the next chart shows, white consultants tend to be older, and if age is taken as a proxy for experience, and experience is positively linked to remuneration, then we would expect to see some difference in pay.

However, there will be other explanations too – some warranted, others not so much. These, as with the gender pay gap, are worth investigating further.

*This article first appeared in the BMJ on 5 September and is reproduced here with permission.