• Structural barriers are the main reason for pay disparities
• Government commits to tackle the gap by dismantling barriers, making senior roles more accessible to women, improving pay transparency and promoting cultural change

The Health and Social Care Secretary has today committed to tackle the gender pay gap among doctors by making the NHS a more equal place to work, as an independent report finds structural barriers are the main reason for pay disparities.

The final report, the first review of its kind, found the gender pay gap between men and women in medicine is highest for hospital doctors, with female doctors earning 18.9% less an hour when adjusted for contracted hours. The report also found the disparity in medicine is considerably higher than other professions – the gap being 2% for accountants and 8% for teachers.

The government will establish an Implementation Panel to help address the structural barriers outlined in the report, look at driving forward the review’s recommendations, with members including gender pay experts and representatives from across the health service.

The report outlines a range of recommendations to make senior roles more accessible to women and help close the gap, to the benefit of the workforce as a whole. These include:

• reducing pay points within pay scales, so it takes less time for people to reach the top, and encourage greater pay transparency in general practice
• promoting flexible working, with jobs advertised as flexible unless there is a strong justification not to, helping to improve work–life balance and make the NHS the best place to work
• restructuring part-time training to focus on competency rather than time served, reducing disproportionate long-term career penalties for women who are more likely to go part time

Minister for Care Helen Whately said:

Now more than ever, our NHS needs talented doctors providing top-quality care for patients and I thank Professor Dame Jane Dacre for her vital work. Making workplaces better for women is something I am passionate about. All too often women continue to face barriers that make it harder to succeed at work.

We will all lose out if talented women feel unable to continue working in healthcare – promising carers ended early and vital expertise and experience lost at a time when we need it more than ever.

I’m redoubling my efforts to work with the profession to remove the barriers stopping people from achieving their full potential. I want the NHS to be a truly diverse and inclusive employer.

Professor Dame Jane Dacre, Chair of The Independent Review into Gender Pay Gaps in Medicine in England said:

The causes of the gender pay gap in medicine are complex and wide ranging and will require a system-wide effort to tackle. This pioneering review has uncovered the underlying causes and made recommendations for government, employers and the profession to address the pay gap.

I’m glad that the Health Secretary has committed to addressing this important issue, which will help keep more talented women working in the NHS.

The report sets out in full for the first time the causes of the pay gap, citing inflexible career and pay structures in medicine as creating barriers, especially for women with caring commitments, which leads to pay penalties for lower levels of experience and less favourable career paths.

The report also finds that although the pay gap has narrowed over time, progress is slow and women will continue to face disadvantages unless action is taken.

In addition, the report highlights the need for further research into the ethnicity pay gap in the NHS, looking at both the medical workforce and those on the Agenda for Change contract.

To better understand this, the Minister for Care Helen Whately will host a roundtable to hear from staff, stakeholders and BAME representatives from the NHS, complementing the NHS’s ongoing work through the NHS Workforce Race Equality Standard to close the gaps in experiences between black, Asian and minority ethnic and white staff.

All of this work supports measures set out in the NHS People Plan, to improve recruitment and retention, including ensuring equal opportunity and access to flexible working for both men and women.

The Gender Pay Gap in Medicine Review is the largest examination of gender pay data ever conducted in the public sector. The review was commissioned by the Department of Health and Social Care in April 2018 to determine the extent of the gap, its causes, and what needs to be done to tackle it.

Professor Dame Jane Dacre, former President of the Royal College of Physicians, was invited to chair the gender pay gap review, with the research undertaken by Professor Carol Woodhams, an expert in gender pay, alongside a team of analysts and researchers from the University of Surrey.

The evidence presented in the report outlines the main causes of the gender pay gap in medicine. These include:

• periods of part-time working to have children or to undertake caring responsibilities have long-term implications for women’s career and pay trajectories, reducing their experience and slowing down or stalling their progress to senior positions
• medical structures make it difficult for women to combine motherhood with a career in medicine. It takes women in medicine up to 35 years to close the gender pay gap after having children, compared with around 15 years for graduates in other professions in the UK
• married women doctors earn nearly 30% less than married men doctors, and this gap increased to over 32% for those with current or former NHS doctor partners, with women more likely to undertake childcare or make sacrifices to accommodate their partner’s career
• male doctors are more likely to be older, have more experience and hold more senior positions. Two thirds of doctors in training grades are women but within consultant grades this drops to under half

Professor Carol Woodhams said:

The gender pay gap in medicine is large in comparison to other professions. The good news is that by making changes to some of the structural pillars that support typical medical careers, over time this will be reduced. Our report provides a road map to achieve this.

The review team conducted in-depth analysis of anonymised pay data, evidence obtained from interviews conducted with medics at various career stages, and an online survey sent to 40,000 doctors.

The review’s methodology will provide a valuable resource for other sectors looking to address their gender pay gaps.

Mend the Gap: The Independent Review into Gender Pay Gaps in Medicine in England

Passengers arriving into England from today (15 December 2020) will be able to choose to pay for a private test and potentially shorten their self-isolation as the government’s testing strategy for international arrivals goes live.

Transport Secretary Grant Shapps has announced that passengers arriving from locations not featured on the government’s travel corridor list can, from today, take a private test 5 full days after leaving the non-exempt place in order to release themselves from self-isolation on receipt of a negative result.

Available as an option for all passengers arriving into England by plane, ferry or train who have been in a ‘non-exempt’ location in the past 10 days, the move will ensure that passengers who receive a negative result on or after day 5 can immediately finish self-isolation, but must continue following the current domestic rules in their local area.

The move will give passengers the confidence to book international trips in the knowledge that they can return home and isolate for a shorter period if they receive a negative result.

With those opting into the scheme having to book and pay for a COVID-19 test from a private provider on the GOV.UK list, the government is ensuring NHS Test and Trace testing capacity is protected.

Transport Secretary Grant Shapps said:

I’m determined that, when people travel here from abroad, everyone remains safe. The introduction of this day 5 Test to Release scheme is a helpful step in the right direction. It means less time in quarantine, but only in return for a negative COVID test. Good news for those travelling and good news for the wider public too.

International arrivals must wait for 5 full days since leaving a location not on the government’s travel corridor list before taking a test from a private provider. This is because a test after 5 days of self-isolation provides materially better results than having one on arrival, as it allows time for the virus – should it be present – to incubate, helping reduce the risk of a false negative result.

Ensuring that passengers can travel safely has been one of the priorities of the Global Taskforce. It has brought together a host of experts across all modes to kick-start international travel.

Collinson CEO, David Evans said:

Test to Release is a good scheme that we are proud to be delivering to ensure we can support the aviation sector to open up travel in a safe way.

The new testing strategy being rolled out today will be a critical way of achieving this, while also continuing to safeguard public health in the UK. United Kingdom Accreditation Service (UKAS) accreditation will also become mandatory for all providers offering commercial COVID-19 testing services in England on 1 January 2021.

COVID-19 has profoundly changed the nature of international travel. Travellers should make sure they check the latest travel advice from the Foreign, Commonwealth and Development Office.

Mr Speaker, we now conduct a huge proportion of our lives online.

People in the UK spend an average of 4 hours 2 minutes on the internet every day. And of course we know that for children, it’s even longer.

Of course, that technology has improved our lives in countless ways.

But as members across the House know, too many people are still exposed to the worst elements of the web: illegal content; racist and misogynistic abuse; and dangerous disinformation.

Those interactions may be virtual, but they are causing real harm.

Over three-quarters of UK adults express concerns about logging on, while a declining number of parents believe the benefits of their children being online outweigh the risks.

Mr Speaker, trust in tech is falling. That’s bad for the public, and it’s bad for the tech companies.

So today the government is taking decisive action to protect people online. Through our full response to the Online Harms White Paper, we are proposing groundbreaking regulations that will make tech companies legally responsible for the online safety of their users.

That world-leading regime will rebuild public trust, and restore public confidence in the tech that has not only powered us through the pandemic, but will of course power us into the recovery.

Now, I know this legislation is highly anticipated on both sides of the House.

I want to reassure Members that when drafting our proposals, I sought to strike a very important balance:

…between shielding people from harm, particularly children…

…while also ensuring a proportionate regime that preserves one of the cornerstones of democracy – freedom of expression.

And I’m confident that our response strikes this balance.

Under our proposals, online companies will face a new and binding “duty of care” to their users, overseen by Ofcom.

And, if those platforms fail in that duty of care, they will face steep fines of up to £18 million, or 10 percent of annual global turnover. Now I know that a number of people, including Ian Russell, the father of Molly Russell, expressed concerns about this point. I do want to reassure him and member’s of this House that the maximum fine will be the higher of those two numbers.

And platforms will no longer be allowed to mark their own homework.

To hold them to their responsibilities, I can also announce to the House that major platforms will be required to publish annual transparency reports to track their progress. This could include the number of reports of harmful content received and the action taken as a result.

Mr Speaker, this will be a robust regime requiring those at the top to take responsibility. I can therefore confirm that we will legislate to introduce criminal sanctions for senior managers with Parliament taking the final decision as to whether to introduce that.

And of course, we hope not to use these powers, and for tech companies to engineer the harm out of their platforms from the very outset. But have no doubt, they remain an option – and we will use them if we need to.

Together, those measures make this the toughest and most comprehensive online safety regime in the world. And they will have a clear and immediate effect.

…A 13-year-old should no longer be able to access pornographic images on Twitter…

…YouTube will not be allowed to recommend videos promoting terrorist ideologies…

…And anti-semitic hate crime will need to be removed without delay.

Those are just a few examples – but I know that the House will take a keen interest in the details of this legislation. So let me lay out a few key areas of action.

Our first focus is on illegal content, including child sexual abuse, terrorism and posts that incite violence and hatred.

Sadly, many members here today have themselves been the target of online abuse – some of which will have been illegal, such as threats of violence or hate speech. Unfortunately, that is particularly true for female members of this House.

This isn’t only a problem suffered by people in the public eye. Close to half of adults in the UK say they have been exposed to hateful content online in the past year.

Under these new laws, all in-scope companies will need to take swift and effective action to remove criminal posts. If it’s illegal offline, it’s illegal online.

Users will be better able to report this abhorrent content, and can expect to receive more support from platforms.

Crucially, this duty of care will apply even when communications are end-to-end encrypted. Encryption cannot serve as a protection blanket for criminals.

And given the severity of certain threats, Ofcom will also be given powers to require companies to use technology to proactively identify and remove illegal content involving child sexual abuse or terrorism, as a power of last resort.

Of course, not all harmful content is illegal.

Every day, people are exposed to posts, images and videos that don’t break any laws, but they still cause a significant amount of harm. We of course all know that cyberbullying can ruin a child’s life.

But I want to address one particularly horrific form of legal content first.

Sadly, too many members here today will be aware of cases where children are drawn into watching videos that encourage self harm. Some find themselves bombarded with that content, ultimately sometimes ending in tragedy.

It is unforgivable that this sort of content should be circulating unchecked on social media. And given the severity of its consequences, I believe there is a strong case for making it illegal.

So I can today announce that the government has asked the Law Commission to examine how the criminal law will address the encouragement or assistance of self harm.

This is an incredibly sensitive area, and we need to take careful steps to make sure we don’t inadvertently punish vulnerable people.

But we need to act now to prevent future tragedies.

And I know many members are particularly concerned about the effect online harm has on children. We have reserved our strongest and toughest protections for them.

All companies will need to seriously consider the risks their platforms may pose to children, and take action.

They will no longer be able to abdicate responsibility by claiming that children do not use their services when that is manifestly untrue, and we all know examples of that.

And we also expect them to prevent children from accessing services that pose the highest risk of harm, including online pornography.

Cutting-edge age assurance or verification technologies will be a vital part of keeping children safe online.

At the same time, we are going further than any other country to tackle other categories of “legal but harmful” content accessed by adults.

Major platforms will face additional obligations to enforce their own terms and conditions against things such as dangerous vaccine misinformation and cyberbullying.

Where they fall short, they will face the legal consequences.

Now I do know that some members are worried these regulations might impose undue burdens on smaller, low-risk companies. I can reassure them that we have included exemptions for such companies; as a result, fewer than 3% of UK businesses will fall within scope.

I also know that in this House we have always ardently championed freedom of expression. Robust and free debate are what give our democracy its historic strength.

So let me be clear Mr Speaker. The purpose of this proposed regime is not to stop adults from accessing content they disagree with. It is not our job to protect people from being offended, and I won’t allow this legislation to become a weapon against free debate.

Therefore, we won’t prevent adults from accessing or posting legal content.

Companies will not be able to arbitrarily remove controversial viewpoints, and users will be able to seek redress if they feel content has been removed unfairly.

Nor will I allow this legislation to stifle media freedoms or become a charter to impose our world view and suppress others.

I can confirm that news publishers’ own content on their sites is not in scope, nor are the comments of users on that content.

This legislation Mr Speaker is targeted exactly where it needs to be, and tightly focused on delivering on our core manifesto pledge: to empower adult users to stay safe online, while ensuring children are protected.

So Mr Speaker, we have engaged extensively to get to this point, and this process is by no means over. We want all parliamentarians to feed in to this significant piece of work, and will continue to listen to their concerns as we go through pre-legislative scrutiny and beyond.

However, I am confident that today’s measures mark a significant step in the continual evolution of our approach to our life online – and it’s fitting that this country should be a step that our country takes.
The World Wide Web was of course invented by a Brit.

And now the UK is setting a safety standard for the rest of the world to follow.

I commend this statement to the House.