The gender pay gap in the English NHS: how does it vary by ethnicity?

While we already know there is an overall gender pay gap in favour of men in the English NHS, research shows that pay gap inequalities between men and women are also shaped by ethnic inequality. Laura Schlepper and John Appleby look at its impact within the NHS.

Blog post

Published: 12/07/2018

Our recent work on the overall gender pay gap in the NHS revealed that women’s basic median pay (per full-time equivalent) was 8.6% lower than men’s. We also found that this headline figure does not tell us the whole story, and that the pay gap varies by occupation, pay band and age.

Research by the Fawcett Society has shown that the pay gap between men and women in Britain is also shaped by ethnic inequality. So does the gender pay gap exist within different ethnic groups in the NHS?

A telling picture

Based on 1.2 million staff records – over 95% of which included information on ethnic origin (see the notes for how ethnicities are categorised) – we found that the gap does exist and is again in favour of men for most ethnic groups, with women from different ethnic groups facing different pay gaps when compared to men of the same ethnicity (see chart).

Asian/Asian British and Chinese women experience the largest gender pay gap at 21.3% and 20.9% respectively, followed by those of Mixed Ethnicity (13.5%), White women (6.1%) and women of Any Other Ethnic background (2.1%).

Only for Black/Black British staff is the gender pay gap in favour of women (2.2%).

The combined impact of gender and ethnicity

The now-departed health secretary Jeremy Hunt recently announced a review into the gender pay gap of doctors (to be led by Professor Jane Dacre). With our initial analysis above showing that women face different pay inequalities compared to men of the same ethnicity, it shows the importance of exploring the combined impact of gender and ethnicity on pay and position in the workforce. We need to gain a deeper understanding of pay inequalities and ensure that the gender pay gap closes for women of all ethnic backgrounds.

It also highlights which inequalities to target. For example, policies directed at minimising the overall gender pay gap across all staff may do little to correct gender pay inequalities on other levels (such as within ethnic groups).

It is likely that the many complex factors that shape gender pay differences – such as occupational segregation, age, maternity and childcare, as well as cultural norms and direct discrimination – exert varying degrees of influence when it comes to different ethnic groups.

Further work needed

More work is needed to untangle the root causes of these gender pay gaps. Effective policies will not only seek to address factors and barriers common to all women (such as the number in lower grade jobs with lower pay), but target inequalities faced by women belonging to specific groups, based on characteristics such as ethnicity, age and profession.

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

Suggested citation

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


Appears in

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  • 16/02/2018