Having worked in the Australian health system for more than 30 years we both looked forward to “Keeping Australia Alive” series on the ABC.
Health care in Australia is complex with its governance and provision being managed by eight state and territory governments, multiple for profit and not for profit organisations and in cities with millions of people through to some of the remotest places on earth.
Understanding, recognising and celebrating the people who work in these systems is essential if they are to flourish.
We expected the series to at the very least show the health workforce as it really is – hard working, ethnically diverse and predominantly female.
In Episode 1 the ‘workers’ in the background doing ward rounds, getting handovers, talking and caring for patients and supporting families were predominantly nurses and midwives who were evidently female.
And yet those who talked to camera and got a by-line that identified their name and role were doctors who were, as you might have guessed, men.
Image: Keeping Australia Alive, ABC
So, we decided to watch each episode with an analysis template examining gender and discipline mixes.
The gender and discipline inequity was glaring in Episode 1 – women worked busily in the background while every single health professional that spoke to camera was male.
Even the midwife was male – good for him, but given that 99% of midwives are female and the rest of the episode was an all male affair, a female midwife was surely not too much to ask for.
Sadly, this situation continued in all but one other episode.
While we recognise and accept that doctors are a critical component of
the health system, they are not the only ones ‘Keeping Australia Alive’.
Image: Keeping Australia Alive, ABC
According to the Australian Health Practitioner Regulation Authority, 76%
of the health workforce are women.
This is especially notable in the disciplines of nursing and midwifery (where
it is in the order of 90% women) but also in the allied health professions and
now in medicine where more than 50% of those entering medical school are now women(1)(2)(3)(4)(5)(6)
Sadly, with Episode 1 the die was cast.
The proportion of women health professionals who were interviewed to
camera and proffered with a by-line ranged from 14% women in Episodes 1, 3 and
7, 29% in Episodes 4, 5 and 6 and reaching more than half (57%) only in Episode
2 (see Figure 3).
Nurses and midwives make up the largest proportion of the health
workforce, but the proportion of nurses and midwives who were interviewed to
camera and proffered with a by-line ranged from 0% in two episodes, 14% in one
episode, 29% in three episodes and 43% in one episode.
Overall, 23% of the health professionals who were interviewed to camera
and given a by-line were women and 18% were nurses or midwives.
So, where were the women? Where were the women doctors, nurses,
midwives, allied health professionals and managers?
Women play senior and junior roles in every aspect of health care –
where were they?
Maybe they were too busy doing the work to be interviewed or maybe the
producers of the show were displaying an unconscious bias that should be named
Not for a moment do we contend that the significant gender imbalance of
the programme was intentional.
Years of habit, inculcation and exclusion can lead even the best of us
to miss what is in plain sight – a system overwhelmingly staffed and run by
women who are barely recognised and for most of the programme, largely ignored.
Gender equity across Australia in all walks of life and work has a long
way to go and judging by the Keeping Australia Alive series, the ABC is no
All health care professionals are essential but how is it that an
esteemed broadcaster like the ABC and a program clearly with considerable
resources could get the numbers so wrong?
What message does this send to the young women in our community
considering a health care profession?
What message does it send to the thousands of women and men considering
a career in the important and necessary disciplines of nursing and midwifery?
We think it says – yes, you are important … but not important enough to
give you a name … to give you a title, a by-line, … to highlight your critical
role in the Australian health care system.
We love the ABC, which makes writing this analysis all the more painful.
But calling everyone on gender equity is, for us, essential.
And it’s just as essential for the ABC to look at the objective data on
this and other programmes and not fall into the trap of perpetuating gender
myths that have no place in 21st Century Australia.