Dr. Karen Morton on Women's Health and how it's fuelling the Gender Pay Gap
We're thrilled to have Dr. Karen Morton, Consultant gynaecologist and obstetrician at the Royal Surrey County Hospital, Guildford, and Founder of Dr. Morton's - the Medical Helpline. guest blogging for us this month. Dr. Morton has worked in the NHS for over 30 years and her major interests are maternal medicine and labour ward management together with paediatric and adolescent gynaecology. Cucumber is intrigued by the strong link she draws between the knock on effect of women's health and pay inequality.

women pilot

Nobody can deny the fact that there are relatively few women in the boardroom or flying jumbo jets. They are, of course, over-represented in hospitality and the caring professions such as nursing. That might be because of gender stereotyping right from the word go with pink for girls and blue for boys, and Barbie for girls and Action Man for boys. Even if we have to accept that (which I don’t!) there is no earthly reason why a woman doing the same job as a man should be paid a different salary. We know it happens. Whether that is at the BBC or perhaps even more shockingly, at No.10.

mum at work

Now on almost a daily basis we hear more gender pay gap statistics, as companies which employ more than 250 people comply with their statutory obligation (by April 2018) to publish the average hourly pay rate for men and for women, together with their average annual bonuses. Easyjet pay an average of 50% lower to women than to men and Phase 8, a staggering 65%. The companies say that they have more men in higher paid jobs; but one would have to ask why????

It is a fact that much of this is women’s own fault. Women begin to undersell themselves from the moment they think about starting a family, and then, when returning to work they skulk back into the workplace as if they have been on some sort of holiday, rather than doing the thing most vital to the health of the Nation which is to grow, deliver, and nurture a baby. Indeed there is no reason whatsoever why a woman should not apply for promotion whilst on maternity leave; but it is almost unheard of. Maybe it’s those sleepless nights due to crying babies needing to be fed, and the night sweats which accompany the menopaus and the hormonal situation which accompanies breast feeding.

mum struggling with workload

One in five women suffer from postnatal depression and do need some extra support at this time, and a proactive supportive approach to this would be both appreciated, and would make sound financial business sense.

Women take one third more time off work than men due to sickness. There is a natural inclination to attribute this to ‘pulling a sicky’ when in fact it is a child who is ill and needing looking after. In fact Timeware (UK) survey, July 2015, showed that this is only the case 20% of the time. Actual illness or a health matter account for 45% of sick absence, with 17% being attributed to ‘relationship issues’ and the remaining 11% being due to attending job interviews.

There is no reason to imagine that women are less resilient to illness than men. On the contrary, from having better survival rates when delivered prematurely, through to lower incidence of heart attacks in 50s and 60s, I believe that women are the tougher sex. But they do have different physiological functions which have a monthly effect on most women’s lives, and however emancipated men may be over childcare, it will always be the women who carry and deliver the babies. So menstrual and hormonal issues, pregnancy complications and a whole plethora of other female genitourinary problems do demand a certain amount of medical attention.

people in the street

The government commissioned a research review of the data available to assess the effects of menopause transition on women’s economic participation in the UK. Published in July 2017, the group based at the University of Leicester reviewed 105 papers on the subject, and it would have to be said that the conclusions were pretty much predictable. What I did find interesting is the data showing that there is no significant reduction in actual numbers of women in the workforce at the time of menopause. The researchers divided the economic impact into what they call the Extensive margin cost meaning loss of income for the employee and family, loss of health benefit of being at work and training costs of replacement, and the Intensive margin cost which refers to a reduction of hours, negative feelings about treatment on the job, and loss of career opportunities. The study looked at the impact of the HRT scares in the USA such that many women discontinued HRT and that had a visible impact on the workforce. There is very little UK data.

The study talks a lot about hot flushes, insomnia, migraine and depression, but interestingly doesn’t mention sex nor family breakdown once. I think this is remiss, particularly as the report uses terms such as biopsychocultural which might imply looking at as many aspects of a woman’s life as possible. It mentions them arriving late at work as an Intensive margin cost, but doesn’t speculate as to why that might be.

The bottom line, of course, is that if you are not top notch you can’t work at your best (I was pleased to see the ‘presenteeism’) and this cost employers and the country money.

At Dr Morton’s – the medical helpline© we believe that ready access to a gynaecologist will empower women at home and in the work place to take control of their health. We encourage employers to be proactive about their employee’s health, including aspects of mental health, so as to show that they care, and to reduce the cost of absenteeism and indeed presenteeism; in other words the effect of people at work who really should not be, or whose performance is hampered by a health problem. Nowhere is there a better example of this than menopausal problems. Sleepless nights due to drenching sweats and low confidence due to hot flushes and anxiety. Remedies do not always involve medication and wonderful fabrics like those used by Cucumber clothing can dramatically improve sleep without the need for HRT. The NICE guidelines are clear that HRT can be safely used (unless there are specific medical contraindications) as a long-term treatment. It is a source of disappointment that women still tell me that their GP (only some I am sure) has told her she has been on it long enough and they won’t prescribe any more. There is no science behind that decision. This is a matter of informed choice.

woman jumping

So, all you bosses out there, please look to your female employees’ health as being the key to their progress in a competitive career. Help them smash that glass ceiling! Healthy women make for happy families and successful businesses.

lady at work



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