This tyranny of work and status

The stereotype dictates that motherhood is the work of a lifetime, while fatherhood is the work of a minute

At first glance, Professor Carol Black seems like a pull-the-ladder-up-behind-me sort of gal. Only the second woman to preside over the Royal College of Physicians in its 500-year-history, she appears to believe that her own stunning success in the medical profession ought to be the exception for woman, and not the rule.

Prof Black made headlines yesterday when she told The Independent's health correspondent, Jeremy Laurance, that the increasing dominance of women in the medical profession was threatening its status. She referred to the growth in the number of newly qualified female doctors, which meant that they already dominated the lower end of the profession, and predicted that women doctors would outnumber men in less than a decade. This, she suggested, would lead to inevitable decline.

"We are feminising medicine," she declared. "It has been a profession dominated by white males. What are we going to have to do to ensure it retains its influence? Years ago, teaching was a male-dominated profession - and look what happened to teaching. I don't think they feel they are a powerful profession any more."

This seems an outrageous assertion to make. Even if one accepts that it was the influx of women, rather than a broader and more complex mix of cause and effect, that led to a sense the teaching profession has lost influence, the casual assertion that this always must be the consequence of increased female input is even more shocking.

Yet it is easier to be shocked by Prof Black's theories than it is to refute them. It is impossible, for example, to name a profession in Britain that is female-dominated and high-status. Even the younger industries, which we like to see as being much more female-friendly - the media, public relations, and advertising - tend to have more men at the top of the hierarchy and more woman at its base.

The pay gap at all levels - from film star and commodities broker to care assistant and catering worker - confirms that a smaller monetary value is still placed on women's work. There is not much evidence to suggest that woman's work is cherished more highly under any other measure of status either. Looked at in this light, Prof Black's assertions can be viewed as a pragmatic prediction rather than as a derogatory slur.

Prof Black's concerns, examined in context, as simply a strategic extrapolation of the debate we're all used to having, the debate that asks us to decide what's to be done about work-life balance. Prof Black's argument is simply that as the profession becomes more and more female-dominated, there will be fewer people willing to make their profession their whole life and existence.

She is concerned not just that this will cause a shift away from specialisms that are less flexible - such as cardiology - but also that it will cause a falling-off in the take-up of other influential roles. She asks who will be willing to do the work - such as serving on government committees and regulatory bodies - that ensures doctors will continue to wield influence.

In part, Prof Black sees an answer in "extra support with child care, flexible rotas and mentoring", although she maintains that part of medicine would continue to require a 24-hour "commitment". Women, she is certain, will prove simply not to have the single-minded focus needed to secure the top jobs.

What Prof Black fails to address, however, is whether single-minded focus really is necessary at absolutely all times throughout an entire career. She herself appears to believe so. She married in the 1970s, when she was a young doctor, and quickly realised that she was not willing to give up her work. The marriage failed, and Prof Black dedicated herself to medicine, embarking on a second marriage in 2002. She has no children and believes that younger women are less prepared to make the sacrifices she made.

Clearly, Prof Black is sceptical about whether women can combine career success with family commitment, even though she must be aware that people do manage this very often. But she appears to assume that "family commitment" continues from the moment a child is conceived to the moment of its mother's death, at a similar all-encompassing intensity.

Instead, while one's children don't attain a reliable level of day-to-day independence until they are 12 or so, they need far from constant attention once they are at school at five. A woman with three quite closely spaced children will have to be flexible over illness and school holidays for about 15 years of a working life of at least 40 years - and since Prof Black herself is 64, one must assume longer.

Combining career and motherhood is difficult, especially in the early years, and the Government's moves towards longer maternity and paternity leave, and towards opportunities for more flexible work when families are started, is of crucial importance, culturally as well as practically. But it is only a phase in a family's life, this period of intense nurture, hard as it may be to accommodate.

In among all the debate about what is best for a baby, what sort of role a woman ought to have, and whether women can "have it all", what is seldom emphasised is that childhood is quite short, and there is plenty of time for female doctors to serve on committees before their children are born or when they are older, or while they are babes in arms if that is their choice.

Certainly woman do need help at the time when their children are small. (Although doctors, who are well paid, are able to purchase this help more easily than others). But it is a testament to the fact that men are assumed, as a matter of course, to have all the time in the world to invest in keeping the status of their profession high, whether they have a family or not, that it is not expected that this help should come from fathers.

Which is really the crux of the matter. The cliché is that God-like male consultants or surgeons have time not only for select committees and the NHS, but for private practice and for sport and leisure as well. Maybe they do, maybe they don't. But no part of the cliché ever states that they have time to be parents as well as men. The stereotype that Prof Black is herself in thrall to dictates that motherhood is the work of a lifetime, while fatherhood is the work of a minute.

Interestingly, and not coincidentally, the idea that work and careers are things we must feed all of our time to has grown more rapacious in the years since feminism started to change society. As women have won the same career opportunities as men, the bar has been raised, not lowered, on flexibility of commitment.

Neither men nor women gain from this tyranny of work and status - and certainly children don't, for as any estranged father will tell you the expectation that women should be primary carers is as powerful as ever.

This dual mechanism of exclusion works amazingly well at keeping the perceived needs of men and women pitted against each other when really they have become more convergent. Prof Black is wrong to believe that the fall in status that can perhaps be ascribed to areas that become dominated by women is due to a lack of commitment on their part. It is due instead to a lack of commitment on the part of all of us, to share work meaningfully, share parenting properly, and give both the equal status they are due.

d.orr@independent.co.uk