The gender pay gap in the English NHS: how does it vary across age groups?

With it already known that the gender pay gap in the health service favours men, John Appleby and Laura Schlepper take a closer look at how this gap varies by age.

Blog post

Published: 12/07/2018

We know from our previous work on the overall gender pay gap in the NHS that women’s basic median pay (per full-time equivalent) was 8.6% lower than men’s. But how does this gap vary by age?

As the Office of National Statistics have pointed out, one of the main characteristics that influences someone’s pay is their age – with the assumption that age is a proxy for experience and on-the-job training. So, one explanation for the overall pay gap across NHS staff might well be that there is a higher proportion of men in older age groups than women, and that men’s higher earnings reflect this age distribution.

But in fact, the proportion of men and women in each age group is very similar in the NHS, and their median age (group) is the same – 40 to 44 years old.

So it may be that from the point of view of a proxy for experience (and hence higher pay) for the NHS, age explains relatively little of the overall pay gap. However, when we look at the gender pay gap within each age group, there are some big differences.

A one-sided story

As the next chart shows, while at younger ages there is a pay gap that favours women, this reverses between the ages of 30 and 34, and continues to grow across older age groups. The gender pay gap for women and men aged between 55 and 59 is 29.1% in favour of men. For those over 65, that gap has extended to 31.5%.

Another way of looking at this is the median basic pay for men and women at different ages. As the next chart shows, while women earn more than men in younger age groups (£1,677 versus £1,488), men’s median pay grows faster in older age groups. It overtakes women’s median pay between the ages of 30 and 34, and reaches a peak between the ages of 50 and 54 (£2,833). For this age group, men’s pay is 90% more than men aged under 25.

But for women, pay grows more slowly from 30 to 34, and peaks (£2,342) at a younger age (40 to 44) – at which point it is only 40% higher than the median pay for women aged under 25.

The impact of having children

What this data also reveals is that age (and gender) may well influence pay – not necessarily as a proxy for experience, but due to the negative impact on pay of having children. The average age for first time mothers is 28.8 years (and for all births, 30.4 years).

Evidence on the gender pay gap suggests that having children has a big impact on pay gaps. Using Danish pay data between 1980 and 2013, researchers at the National Bureau for Economic Research have shown that the arrival of children creates a gender pay gap of around 20% in the long run, and that in 2013 this ‘child penalty’ accounted for 80% of the pay inequality in Denmark between men and women.

While this explanation applies to total earnings – where the choice of part-time work by women with children will influence the earnings gap – and our NHS data uses basic pay for full-time equivalent posts, their research found the pay gap was in part driven by wage rates (not just reduced working hours through part-time work). It was also associated with workplace promotions and how family friendly (or unfriendly) the employer might be.

And while there is evidence that age – linked to experience and having children – is part of the explanation for gender pay gaps (in both the NHS and other sectors too), we know that other factors also influence differences in pay between men and women.

As part of our investigation into the gender pay gap in the NHS – which includes this analysis on how it varies by ethnicity – we will be looking in more detail at the interaction of other factors (such as occupation) and their impact on pay over the coming months.

Suggested citation

Appleby J and Schlepper L (2018) "The gender pay gap in the English NHS: how does it vary across age groups?", Nuffield Trust comment.


Appears in

  • 16/02/2018
  • 16/02/2018