Gender inequality: call to focus on listening

A ‘listening-up’ culture in the NHS and the medical professional is key to tackling gender inequality, the first joint MWF (Medical Women’s Federation) and BMA conference heard last week.

Location: UK
Published: Wednesday 6 November 2019
Megan Reitz portait

A ‘listening-up’ culture in the NHS and the medical profession is key to tackling gender inequality, the first joint MWF (Medical Women’s Federation) and BMA conference heard last week.

‘We spend a vast amount of resources to get women to speak up when more work needs to be done in the listening and inviting,’ Ashridge Hult International Business School professor of leadership and dialogue Megan Reitz told the conference.

‘Listening up is a bit of a deaf spot. We need to look at ourselves in the mirror: how do we perpetuate the cultural habits here?’

Prof Reitz was speaking after MWF president Henrietta Bowden-Jones called for a ‘zero-tolerance’ to gender bias. ‘Gender inequalities are prevalent across many parts of medicine and it is vital that we understand what all of those challenges are,’ she said.

The gender pay gap between the total hourly earnings of male and female hospital doctors is 17 per cent, according to the interim findings of a review by former Royal College of Physicians president Jane Dacre.

BMA council chair Chaand Nagpaul said the association was committed to being a ‘learning organisation and welcomed its closer working relationship with the federation'.

‘Who better to learn from than the MWF,’ he added. ‘We need a gender-equality vision of hope and to embed equality as a positive, attractive attribute. It matters because it is morally right.’


Cultural change

The conference comes weeks after Dr Nagpaul made a series of pledges to tackle sex discrimination in the BMA itself.

They follow the findings of an independent investigation into allegations of sexism and sexual harassment by Daphne Romney QC. This found that some female doctors and staff there felt ‘undervalued, ignored and patronised because they are women’ and pointed to a lingering ‘old boys' club’ culture.

Dr Nagpaul said there was ‘no place for sexist behaviour and misogyny’ in the BMA and pledged to take ‘any necessary action’ to end it.

‘We are taking the report extremely seriously and will take forward each one of the recommendations with a timeline to achieve key cultural change,' he said.

BMA representative body chair Helena McKeown apologised for the way women had been treated by the association.


Biased algorithms

The conference also heard about the risks of building bias into computer ‘algorithms’ and how NHSX, a new Government agency was helping to mitigate them.

NHSX head of digital health and AI Indra Joshi said that racial and other bias could be ‘built into’ computer programmes. It aimed to help tackle this with its code of conduct for ‘data-driven technology’.

This includes principles around ‘doing no harm’ and ‘transparency’ around the expected effect a new technology would have.

Women working in the technological world also faced discrimination in the internet community despite producing better-quality programmes than their male counterparts, Dr Joshi added. ‘My call to action is: go out and campaign. You don’t have to prove yourself better, you have to just get stuck in.’

BMA council member Hannah Barham-Brown said doctors had an important role in ‘calling out’ bad behaviour. ‘We have a way to go in making this mainstream.'

She called for a recommendation in the Romney report for quotas on BMA committees to improve gender balance to be implemented. ‘Sometimes organisations have an over-reliance on individuals. We need to think organisationally,' she said.


Protected characteristics

Dr Barham-Brown also pointed to the need for an ‘intersectionality’ approach to tackling gender bias which accounts for the multiple categories of protected characteristics into which women fall. ‘If we don’t, we can miss out the most vulnerable,’ she added.

Cranfield School of Management director of gender, leadership and inclusion Doyin Atewologun said doctors’ different identities could interplay in different ways over the course of their careers.

‘Historical, cultural contexts influence experience,’ she added. ‘It was when I moved to the UK [from Nigeria] that I realised I was black,’ Dr Atewologun told the conference. ‘Through a series of experiences I learned how privileged I was socio-economically in Nigeria.’

The conference also heard from female doctors with experiences of discrimination, owing to their gender and other aspects of their identities. MWF vice-president Chloe Orkin talked of the time she was ‘trolled’ on social media for her own post on research she presented at a conference was picked up widely by other media.

Palliative care consultant Sabrina Bajwah told of her successful campaign to reform the way clinical excellence awards were allotted in her trust to female doctors who had taken maternity leave.

Countess of Chester Hospital clinical fellow Chelcie Jewitt told of her campaign ‘Everyday Sexism in the NHS’, which she set up after being belittled by a consultant after a series of night shifts.

Following the publication of the Romney report, the BMA is providing training for members and staff and set up a confidential helpline, a network of ‘listening champions’ and is creating a BMA women’s network.

Hannah Barham-Brown video cover
Conference: overcoming gender bias in medicine