Little pay difference between private and public healthcare

A study from Statistics Sweden, published in May 2002, finds that pay in the Swedish private healthcare sector is generally around same level as in the public healthcare sector (though the situation varies between different occupational groups). This seems to contradict a general view that private sector healthcare pay is higher. The study also examines gender wage differentials.

The widespread ongoing discussion around pay and working conditions in the Swedish healthcare sector (SE9905163F) has up until now often been based on a general assumption that workers in the private sector are much better paid than workers in the public sector. However, this view has been challenged by a study of pay and conditions in the healthcare and social welfare sector presented by Statistics Sweden (Statistiska Centralbyrån) in May 2002, entitled 'Enjoying the fruits of one's labour - facts about working conditions and wages for women and men in health and social work' (Lön för mödan- fakta om arbetsvillkor och löner för kvinnor och män inom vård och omsorg, Lena Johansson and Christina Österberg). There are currently about 700,000 employees in this sector, representing 20% of all employees in the Swedish labour market. About 35% of all female employees and 5% of all male employees work in the sector and almost all (98%) are represented in the survey.

The healthcare and social welfare sector workforce is made up as follows: 90% work directly for municipalities and country councils; 2% work in enterprises owned by county councils; and 8% work in the private sector.

Wage differences

The study examines questions such as: are there any evident differences in pay between public and private activities? How large is the wage gap between men and women? And what kinds of work problems are present in the healthcare and social welfare sector?

The survey - covering the year 2000 - divides healthcare and social welfare workers into 'minor' and 'major' occupational groups (both blue- and white-collar), with the latter containing about 80% of all workers. Childminders, assistant nurses, dental nurses, medical orderlies, specialised nurses and dieticians are examples of 'minor' groups, while 'major' groups are above all various categories of doctors and nurses. In all, 22 occupational groups were studied.

The research found that the 'minor' groups on the whole are greatly dominated by female workers, with only a few exceptions - eg hospital technicians, engineers, supervisors and janitors. Overall, the proportion of men is small in most 'minor' groups in health and social work. Within these groups, wage differentials between women and men are not particularly large, nor is the wage dispersion. However, a couple of the minor professional groups containing highly qualified and senior management jobs (within administrations, for example) have a large proportion of male employees. Such groups with relatively high wage levels also have large wage differentials between women and men, to the advantage of the latter. The wage dispersion was also relatively wider, with female employees at the bottom.

The 'major' group of 'health specialists' (doctors, dentists, veterinarians and others with a university degree) makes up a little more than 4% of all employment in the health and social welfare sector, and these workers are mainly found (80%) in municipalities and county councils. Of this group, 55% are male. The average monthly salary for female local government employees in the group is SEK 35,800 (in 2000), which is 16% lower than the average salary for men in the sector, at about SEK 41,500. Compared with pay in the private sector, the salary for the workers in this group employed in the public sector was 13% higher for women and 4% higher for men than for the corresponding workers in the private sector.

The 'major' group of nurses (90% of whom are 90%) shows a slightly different picture. The average female wage in the public sector was 5% lower than for nurses in the private sector. On the other hand, midwives and nurses in the public sector, with special skills, received 3% higher pay than the corresponding workers in the private sector.

The survey made no comparisons between the private and the public sector in the social welfare sector, as this work is mainly carried out by the public sector.

Work-related problems

As for working conditions and work-related health problems the survey found that large groups within the healthcare and social welfare sectors do not work standard hours. Flexi-time and relatively freely arranged working hours are less usual than in all other sectors. Back trouble and other musculo-skeletal problems are more common among these workers than others, because of much heavy lifting and awkward working positions. It has become more common for the sector's employees to be exposed to violence and threats of violence, and at a higher rate than in other sectors.

Commentary

The study from Statistics Sweden shows, among other findings, that there are no significant differences in wages and salaries between the private healthcare sector and the public healthcare sector in Sweden. Also, there are no significant differences in wage between male and female workers in a large number of groups, such as assistant nurses, where women often dominate. Among doctors the difference is larger - female doctors' pay in the public sector is 16% lower than male doctors' pay in the same sector.

Comparing salaries in the private sector and the public sector, the survey findings point in both directions. Doctors' wages in the public sector tend to be higher and nurses' wages are just about the same in both sectors.

The researchers, Lena Johansson and Christina Österberg, are very cautious in judging the results of the survey, especially regarding possible wage differences between the private and the public sector. No clear pattern can be seen as the differences vary within different groups in both sectors, they conclude. This is possibly true. However, the mere fact that there do not seem to be too many differences, on the whole, between the wages in the private and public healthcare sector is interesting enough - at least in the light of the widespread public view that healthcare jobs in the private sector are more lucrative than those in the public sector. (Annika Berg, Arbetslivsinstitutet)