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Supply, demand and gender

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THE two professions aren't directly comparable. Nevertheless, a news item in The Daily Telegraph last week about a shortage of family doctors seems relevant in the context of debate in the veterinary profession about increased student numbers and what has come to be called ‘feminisation’ of the professions. Under the headline ‘Feminisation of GPs has led to a shortage that could fuel demands for higher wages’, the newspaper reported that the Migration Advisory Committee (MAC) had rejected a request from the Department of Health to place GPs on the Government's shortage occupation list, which would have made it easier to recruit more doctors from countries outside the EU.1

The news story was based on a report that had just been published by the MAC.2 In reaching its decision, the committee considered, among other things, evidence from the Centre for Workforce Intelligence, which helps the Department of Health with workforce planning. According to the MAC, this noted that ‘the gender balance in general practice has shifted due to a significant increase in the number of women GPs. This so-called feminisation of the GP workforce necessitates an increase in the number of trainees in order to maintain the current full-time workforce, as women are more likely to work part-time, at least for some periods of their career’. However, looking at the situation overall, the MAC concluded that there was no shortage of medical students who might work in general practice; instead, it suggested, any shortage of GPs could be potentially overcome by changing the incentive structure for GPs, to encourage more take up on GP training programmes.

The Royal College of General Practitioners has expressed disappointment at the MAC's decision and its ‘lack of action’ to help rectify the problem of ‘a chronic shortage’ of GPs by ‘unlocking the potential of skilled medical professionals in the many countries that have similar health systems to our own.’ It also drew attention to the need to ‘tackle the 3Rs – recruitment, retention and “returners” – making it easier for trained GPs who have taken a career break to return to frontline care’.

Given all the upheaval in the NHS, it is unlikely that feminisation will be the only factor contributing to a shortage of family doctors. However, setting that aside, and despite the very different career structures available to doctors and vets, the debate is of interest, not least in demonstrating that predicting and meeting future workforce requirements is fraught with difficulty, and that it is not just in the veterinary sphere that this is an issue of uncertainty and concern. Veterinary surgeons used to be on the Government's shortage occupation list, but were removed a few years ago (VR, October 29, 2011, vol 169, p 454). Since then, much of the debate in the veterinary field in the UK has focused on the potentially negative impact of rising numbers of veterinary graduates on future employment as a result of increased competition for jobs (see, for example, VR, November 2, 2013, vol 173, pp 406, 416-417). However, paradoxically, although the number of new graduates has increased fairly substantially in recent years, practices report difficulties in filling vacancies. It would seem important to find out what, exactly, is going on here, and to determine what might be done about it in terms of ‘recruitment, retention and returners’.

The impact of a gender shift towards a majority of women members has also been the subject of much debate in the veterinary profession, for example, at the BVA Congress last November (VR, December 13, 2014, vol 175, pp 578-579) and more recently at the SPVS/VPMA congress in January (see p 244 of this issue). So far, discussion seems to have focused on the relative dearth of women in senior positions, and the steps that might be taken to address this, rather than on the number of graduates that might be needed to meet future workforce requirements; however, in light of what is apparently happening in the medical profession, that may yet change. No one so far has suggested that feminisation of the veterinary profession could fuel demand for higher wages, though it would be nice to think that it might. Instead, the suggestion has been that salaries are more likely to go down. Surveys by the Society of Practising Veterinary Surgeons have indicated that female vets are often paid less than their male counterparts, and this is an issue that needs to be addressed.

It would be wrong to draw too many parallels between what is happening in the medical and veterinary fields, not least because of different demands and because GP services in the NHS, unlike the services provided by veterinary practices, are publicly funded. However, one thing that is common to both is that matching supply to future demand is a complex process subject to many other factors apart from student numbers and gender. The impact of demographic change is one of the issues being considered in the joint RCVS/BVA Vet Futures project (vetfutures.org.uk) which is currently looking at the forces acting on the profession with a view to developing a strategy for the future.

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