Patricia is a management adviser, trainer and facilitator in general practice. She is a Fellow of the Chartered Institute of Personnel and Development and was a practice manager/partner for 11 years
T 01279 777371
On the breakfast news on TV the other morning, two female managers were being interviewed on the question of employing women with young children. The interview had been prompted by a recently published report, which found that women with children under the age of 11 experience more discrimination, and find it harder to gain employment, than other members of society. The interviewer asked both managers what their reactions were to this report.
The first manager adamantly declared that she would not employ a woman of childbearing age unless they were postmenopausal or had had a hysterectomy. The interviewer asked her if this was not rather discriminatory, but the manager retorted that, call it what you like, she was entitled to exercise her discretion to take on whoever she thought was best for the job, and no-one could challenge her freewill to make this choice.
She went on to outline various reasons why parenting young children and working do not go hand-in-hand, and she felt that mothers of young children should choose between a family or a job, and not mix the two together.
The second manager's response was quite different. She put greater importance on building the right team, irrespective of personal circumstances, and she tried to accommodate flexible working, as well as home working, wherever possible. She would rather appoint the right person, in her judgement, and allow them time off for maternity leave, knowing that they would return to continue in a job they enjoyed and which suited them. She felt this attitude engendered a committed and motivated response from her employees.
As you can no doubt imagine, there then followed a heated debate, with examples given of those who have to work – such as single parents, divorced parents and those who cannot afford not to work – counterbalanced with cases where mothers with young children had caused great disruption at work because of difficulties with childcare, particularly in the school holidays, as well as time needed to care for sick children, inflexibility of working hours, endless time off on maternity leave, etc.
Where do you stand on all this? You might indeed be one of those mothers yourself with young children, juggling with competing demands and feelings of guilt. I should know, I was one of those mums and it was hard!
For me, it was a question of maintaining my sanity (at the risk of losing it, of course!) and pursuing my career. I worked part-time from home while the children were little and started a full-time job outside the home when they were aged 10 and eight, with the help of an au pair in the early days, and childminders as time went on. Looking back on it now, I am not sure how I did it!
Now that my two children are responsible, independent and happy adults, I don't think they are scarred and, indeed, they always seemed proud to have a mum with an interesting job. And going out to work when I did was right for me. I feel strongly that no-one should be bullied into doing something that isn't right for them, be it staying at home fulltime to look after the family (which is an important job in itself) or going out to work.
There is a great deal of legislation that is supposed to protect different groups of society to ensure that they have a fair deal, including sex discrimination legislation, which has gone a long way in protecting the rights of women in the workplace.
However, clearly it has not achieved everything it should have done, and this is one of the reasons why the government has introduced more legislation from 6 April this year, making it a duty of public organisations, such as primary care trusts (PCTs), as well as those who are contracted by them – such as GPs – to promote equality between women and men and eliminate unlawful sex discrimination and harassment.
The Gender Equality Duty is a provision of the Gender Equality Act of 2006, which amended the Sex Discrimination Act of 1975. The Duty not only covers employment practices, but also covers policymaking and the services provided by public organisations. The legislation is intended to ensure that women and men are provided with the services that meet their needs more closely. The Equal Opportunities Commission gives the following example, which is relevant to general practice:
"Men are less likely than women to visit their GP, which means that they often seek treatment late in an illness. This is bad for their health and wellbeing, and costs the NHS more in the long run. For example, although women are more susceptible to lung cancer, more men die from the disease because they seek help late."(1)
Another example, relevant to public transport services, is given:
"Women use public transport in different ways and for different reasons than men. They are more likely to need to access healthcare, childcare and food shopping, as well as going to work. Unfortunately, transport services and town planning rarely recognise this, as routes are often aimed at commuters. They don't always provide easy access to transport for those carrying children or pushchairs, or recognise that women have a greater fear of travelling at night."(1)
Under the legislation, PCTs have a specific duty to prepare and publish a gender-equality scheme, gather information on how policies affect gender equality, consult with stakeholders, implement actions set out in its scheme within three years, and report against the scheme every year. They were required to publish their schemes by 30 April.
There is a general duty to all functions of every public authority, including each general practice, notwithstanding that the legal liability for gender duty remains with the contracting authority. This means PCTs are obliged to ensure that GPs meet their responsibilities.
Services – consider the differences
Every practice will now have to think about policies developed and services delivered with the different needs of men and women in mind. You need to ask the following types of questions:
Clearly, most general practices are places where there is easy access by both men and women to services. However, will there be a case for ensuring that the different requirements and needs of both sexes are being properly served? Will lack of childcare be an issue for women or men accessing a GP or a nurse? Will it put them off attending? Will practices have to research the different needs of men and women to assess that these are being met? Will this highlight the need for some services to be more effectively provided for one sex only or segregated in some way?
In terms of service provision, it is envisaged that PCTs will provide guidance to practices regarding their policies and how they expect them to be implemented, since the PCTs themselves have an overall responsibility for the service provision provided by their contractors, the GP surgeries. PCTs have to ensure that GPs understand the gender-equality requirements and how these will impact on practices and their patients.
With regards to employment policies, some gender issues that GP surgeries need to think about are:
This may prove a more difficult area to justify for GP surgeries, which traditionally employ far more female nurses, administrators and managers. You will no doubt argue that your advertisements and recruitment processes are not discriminatory to men, and it is just the way it is that general practice employs more women (or is it more about the pay in general practice attracting mostly women?)
The question regarding flexibility is more tricky, as is the question of the return rate from maternity leave. The way things currently stand, employers are under an obligation to consider a request for flexible working but not necessarily to meet it, although more and more claimants are linking refusals to agree flexible working with claims under sex discrimination. One has to wonder if employees in the future may throw noncompliance of this legislation in among other claims of unfairness, should they leave their employment with a grudge and claim discrimination.
As a start, practices should ensure that they have employment policies covering equal opportunities, antidiscrimination, bullying and harassment, as well as equal opportunities and antiharassment service provision policies.
Partnership and other considerations
The legislation also has an impact on how partners behave towards one another. For example, how male and female partners are treated to ensure equality in recruitment to the partnership, as well as working arrangements, such as treatment during and following a maternity leave. It is expected that the General Medical Council (GMC) will provide further guidance on these issues.
According to the gender equality legislation, you also now need to ensure fair employment policies affecting transsexual men and women (should you employ any). This involves protecting them against harassment, protecting their dignity and privacy, supporting them undergoing gender reassignment, and being cautious about requesting identification information that may reveal their original sex.
Now I can really hear you groaning. Is this political correctness gone mad? No, it's just another little something for practice managers to have to do, because you are clearly sitting around twiddling your thumbs too much …