Medical women: internet resource
July 2006
Childcare access
The government has produced a 10-year strategy, Choice for parents, the best start for children, which aims to deliver a sustainable framework of childcare provision in the UK (see reference 37).
In 2006 the BMA adopted a policy calling on ‘all NHS trusts and PCTs to provide comprehensive nursery care (24 hour where necessary for shift workers) for all NHS staff, including academic staff, which must be equally accessible to all' (see reference 38).
The 2005 report of the BMA 1995 cohort study - read more here - found that approximately 30 per cent of doctors cited childcare as an important factor in decisions on part-time working (see reference 21). A third of those needing childcare had experienced problems in making suitable arrangements, including lack of workplace facilities, and poor flexible childcare provision.
The NHS launched its childcare strategy in 2000 (see reference 39), which sets targets for the provision of additional nurseries for employees and ensuring that every NHS employee has access to at least one childcare coordinator. More information can be found on the DH website , which includes a childcare toolkit for human resources professionals, links to childcare news, and a database of coordinators.
The implementation of this strategy has seen some improvements in childcare provision, but more needs to be done to ensure that childcare provision meets the demands of doctors’ working patterns. For example, while childcare coordinator roles have been established in 97 per cent of trusts, a survey in 2005 of childcare in the NHS showed that 44 per cent of trusts do not provide any nursery facilities for staff (see reference 40). It should also be noted that these coordinator positions are under threat because funding for them is no longer ring-fenced. Given the fact that the NHS is a round-the-clock service, thought should also be given to the provision of out-of-hours childcare.
The BMA has conducted research into childcare provision, which has reinforced the fact that this is still inadequate at all levels of medicine.
There are increasing numbers of medical students with children as the mature student entry grows. These students are not properly supported by medical schools. A survey, conducted jointly by the BMA’s medical students committee (MSC) and the MWF, of medical schools in the UK found that of those that responded, none had any formal policy for supporting pregnant students. Childcare is a huge financial burden, which can cause considerable hardship for students. Many students are not aware that funding is available to help with these costs, or how to access it. A 2006 welfare survey of medical students conducted by the BMA, found that only 13 per cent of students were aware of support provided by their medical school for students with children or dependents (see reference 41).
Similarly, the childcare provision for GPs needs to be improved. A 2005 BMA survey of local medical committees throughout the UK found that 65 per cent of those that responded said that the childcare needs of local GPs had not been met. The BMA’s health policy and economic research unit is currently preparing an A to Z web resource which will contain information for parents and carers about childcare facilities and the assistance that is available to the medical profession. This resource will be available on the BMA website before the end of 2006.
Case study
One GP practice in East London has had a workplace nursery for the last 12 years. This benefit is not taxable and the business retains managerial control. The nursery places are funded by adjusting the employee’s final salary. The scheme is based on a similar arrangement devised by HSBC Bank. Contractually, if the child leaves the nursery, the employee’s salary cannot be increased to reflect that, but in practice this has not been a problem. With the development of practise-based commissioning and the banding together of GP practices, this idea could become more widespread and would be a great advance in providing affordable, tax-free childcare, close to the workplace.