Women: Representation and Empowerment

Lord Kakkar Excerpts

Monday 7th March 2016 Lords Chamber

[Lord Kakkar (CB)]

My Lords, it is a distinct pleasure and privilege to follow the maiden speech of the right reverend Prelate the Bishop of Gloucester. It was historic and excellent in every way. I was struck by her career prior to ordination and the fact that she had worked in the National Health Service as a speech and language therapist—a vital role. I understand that during that period of her life she developed a concern for and deep commitment to ensuring that people’s voices were heard. I have no doubt, following her remarkable maiden speech, that in the years to come the people of Gloucester and, more broadly, our fellow citizens in this great country will have their voices heard very well and effectively through the contributions of the right reverend Prelate in your Lordships’ House.

I also congratulate the Minister on having secured this important debate. I will confine my contribution to the transformation of the healthcare workforce and the vital role played in it by women, both in our own country and globally. In so doing, I declare my interest as chairman of University College London Partners, as well as my other interests in the register, and my fellowships of the Royal College of Surgeons and the Royal College of Physicians.

There can be no doubt that one of the greatest achievements of society in the last 150 years is the convergence of men and women in the workplace, and there can be no more important and dramatic demonstration of that convergence than in the area of healthcare. If we look back to 1866, the then two senior royal colleges—the Royal College of Surgeons and the Royal College of Physicians—were some four decades away from admitting women members. Today, the president of the Royal College of Surgeons, Clare Marx, and the president of the Royal College of Physicians, Jane Dacre, are women at the pinnacle of the medical establishment.

However, it is not only the senior leadership of the profession that reflects greater gender diversity: since the 1990s some 50% to 60% of those entering medical school have been women, and in 2014 the number of female general practitioners on the medical register overtook male GPs for the first time. That is vital because general practice—family community care—is the very foundation of the delivery of healthcare through the NHS. These are important advances.

Globally, some 75% of the entire healthcare workforce is made up of women. Governments both here and abroad have to understand how most effectively to engage with that diverse workforce if we are to meet the challenges of increasing demand for health and social care. What assessment have Her Majesty’s Government made of the changing global and national demographic in terms of driving increased demand, changes in the composition of the workforce, and how a workforce that delivers healthcare effectively can be achieved?

Beyond looking at workforce composition in terms of the skills of healthcare professionals, labour economists also identify more broadly a very important difference in the priorities and preferences of men and women in the workforce. A Harvard economist, Claudia Goldin, has looked at pharmacists in this context. In 1970, some 10% of US pharmacists were women, who earned only 60% of the earnings of their male counterparts. As a result of the reorganisation of this very important area of healthcare delivery, some 60% of US pharmacists are now women and they earn approximately 92% of the earnings of their male counterparts.

This transformation has been achieved by consolidation but also by the application of information technology to ensure broader participation by different elements of the pharmacy workforce, allowing continuity of care and not focusing on long hours and the stress associated with certain roles, but ensuring that teams can come together using technology to allow the different elements that wish to make different contributions to work effectively for patient safety. What assessment have Her Majesty’s Government made of the future adoption of information and digital technology in the provision of healthcare to ensure that both male and female members of the healthcare workforce can be most effectively engaged to deliver effective and safe care in our NHS?

Finally, a very interesting report published in 2015 by the Center for Talent Innovation, entitled Harnessing the Power of the Purse, identified that in many communities and societies 59% of women make healthcare decisions for other people. That is not only mothers, because 43% are working women without children. It is a striking statistic that women have such a profound impact on taking decisions such as the vaccination of members of their families and communities, undergoing preventive screening and attending medical clinics for health advice. However, only 38% of the women who admitted to having the role of taking healthcare decisions for others felt that they were sufficiently informed and educated to take those decisions in a meaningful way. Clearly, there is a greater need to ensure education for the whole population and—in a context where women might be considered the chief health officer in their families and communities—that the information is provided in a meaningful and effective way to allow them to take these decisions.

Given the increasing need in the NHS to look at public health and preventive medicine strategies, what assessment have Her Majesty’s Government made of the opportunity to target women undertaking the role of chief health officer in their own families and communities, so that they can be better informed and educated to achieve our national goal?