Private Sector Surgery Faces Stark Gender Gap as Women Remain Critically Underrepresented

New research published by the Royal College of Surgeons of England has exposed a striking gender imbalance in private sector surgery, with women making up just 6.2% of surgeons across the UK’s five largest private hospital groups. This figure stands in stark contrast to the NHS, where 16.9% of consultant surgeons are women—already considered underrepresented itself.

The research, authored by Kate Hulse, a Clinical Research Fellow, and Caitlin Brennan, a Trauma and Orthopaedic Registrar, examined consultant surgeon listings across Circle Health Group, HCA Healthcare UK, Nuffield Health, Ramsay Health Care, and Spire Healthcare. Of 7,934 surgeons identified in the private sector, only 488 were women. The findings, published in The Bulletin of the Royal College of Surgeons of England, paint a concerning picture of a profession struggling with diversity even as women now comprise the majority of UK medical students.

The disparity extends across almost every surgical specialty, with female representation in private practice remaining substantially lower than NHS levels recorded as far back as 2012. In some cases, the gender imbalance becomes almost absurd: orthopaedic departments at Circle and Nuffield list more surgeons named David than they do female orthopaedic consultants altogether—18 and 22 Davids compared to 15 and 18 female consultants respectively.

Structural Barriers and Workplace Culture

The research raises serious concerns about access to surgical careers in the independent sector for women and suggests that longstanding structural barriers continue to determine who can enter and succeed in private practice. Professor Felicity Meyer, a consultant vascular surgeon and Chair of Women in Surgery at RCS England, emphasised that this is not merely a fairness issue. “The independent sector now delivers a growing share of surgical care, yet women remain strikingly underrepresented within its surgical workforce,” she stated. “This is not just an issue of fairness, but one that affects the resilience, safety and sustainability of the profession as a whole and ultimately impacts patient safety.”

The private hospital sector now delivers an increasing proportion of NHS services through contracts, meaning the gender disparity has direct implications for patient care. Research into orthopaedic surgery specifically found that whilst 78% of female surgeons work exclusively in the NHS, 63% of male surgeons work in private practice, suggesting differential access and career opportunities between genders.

Barriers facing women in surgery extend from early perceptions about workplace culture and compatibility with personal life, to practical challenges around flexibility, visibility, and progression into leadership positions. Women consultant surgeons have typically been in practice for a median of 10.4 years since specialist registration, compared to 13.7 years for men, yet remain underrepresented despite early career advantages: female applications to surgical training posts have actually declined relative to male applications, rising from a ratio of 1.71:1 in 2021 to 1.95:1 in 2024—a widening gap despite women outnumbering men in UK medical schools.

The Wider Context

Whilst women now comprise 55% of UK medical students and, for the first time, outnumber male doctors with a licence to practise, no surgical specialty has more than 29% female consultants. In some specialties, such as Trauma and Orthopaedic Surgery, female representation among consultants remains below 9%. On average, for every female consultant surgeon, there are currently five male colleagues, highlighting the scale of underrepresentation across the profession.

The research reveals that women represent just 4% of arthroplasty (joint replacement) surgeons in the National Joint Registry, the lowest proportion among all surgical specialties. Regional variation also exists, with Northern Ireland recording the highest proportion of female arthroplasty surgeons at 8%, whilst Wales, the Isle of Man, and the Channel Islands recorded none at all.

Calls for Action

Following publication of the research, RCS England has written to the five largest independent hospital groups, calling on them to take “clear and credible action” to ensure their surgical workforce reflects the diversity and talent of the profession. Specific recommendations include publishing transparent, organisation-level gender data across all surgical roles; setting targets to increase women’s representation; investing in programmes that support women entering surgery; guaranteeing fair access to leadership and progression opportunities; and enforcing robust policies that ensure safe, inclusive workplaces free from discrimination and harassment.

The findings carry significant weight given the growing role of the private sector in delivering surgical care across the UK, including work commissioned by the NHS. If the gap widens further, it risks limiting access to diverse surgical talent at precisely the moment when the profession faces workforce pressures and demand for surgery continues to grow.

Key Takeaways

• Women represent just 6.2% of surgeons in private healthcare, compared with 16.9% in the NHS
• Female representation in private practice remains below NHS levels recorded in 2012 across most surgical specialties
• Some private hospital orthopaedic departments have more surgeons named David than female consultants
• The gender disparity reflects structural barriers affecting career access, progression, and workplace culture
• RCS England has called on private hospital groups to publish transparent data and set targets for improving diversity

What This Means for Kent Residents

For patients across Kent and Medway, this disparity matters. Kent’s growing private healthcare sector—including facilities operated by the major providers studied in this research—plays an increasingly important role in delivering care alongside NHS services. Limited diversity in surgical teams can affect patient outcomes, as research consistently shows that diverse teams deliver safer, more innovative care.

If you’re seeking surgical treatment in Kent, whether through the NHS or private providers, it’s worth asking healthcare facilities about their commitment to equal opportunities and workplace culture. Patients registered with Kent GPs can access comprehensive NHS surgical services through Kent and Medway NHS Trust and other NHS facilities, where the gender balance, whilst still improving, is considerably better than in the private sector. For those considering private healthcare options, RCS England’s recommendations suggest asking providers about their diversity data and commitment to supporting women in their surgical teams.