New contracts, old problems :
the unforeseen impact of indirect discrimination on NHS doctors.

  • Katrina Easterling

Student thesis: Doctoral Thesis


My Thesis, comprising my Context Statement and Published Works, presents my contribution to practice, scholarship and knowledge as an experienced Human Resource Management practitioner-academic. This study has integrated further my professional and academic selves (sic) and enhanced my academic identity, by conceptualising my learning and experiences into a critically reflective narrative for my professional doctorate. I have contributed to knowledge through this study and my contribution to six co-authored government publications by the Review Body on Doctors’ and Dentists’ Remuneration. I am at the centre of this Employee Relations case study which focuses on a contemporary phenomenon within the real-life context of the NHS. Its purpose is to understand why SAS doctors were dissatisfied with aspects of their new contract that had taken several years to negotiate. My aim was to explain why many doctors were dissatisfied, and what problem(s) the new contract had failed to resolve. Utilising a strategy of action research, this study undertakes an interpretivist exploration of the complex phenomena, through the collection and analysis of qualitative data and document analysis; its findings highlight the existence of competing perspectives and multiple realities amongst the parties. My critical and reflective analysis reveals the hidden effect of power relations on HRM practices and its indirect effect on the employment relationship. The study concludes that power inequalities in the form of indirect discrimination exist around the variables of gender and race for this population; they are probably institutionalised and, in this study, are reinforced by the HRM process of career progression. Organisational change in the NHS to modernise the contract has not led to all the predicted gains for SAS doctors, but has maintained managers’ control over a key discourse. My work contributes to practice through the identification of indirect discrimination in the career pathway for SAS doctors in the NHS. As a consequence, remedial actions were taken by the General Medical Council, Department of Health and others; but this emancipatory case study raises general awareness of the unforeseen impact caused by any HRM process that may have a disproportionate adverse effect on workers with a protected characteristic.
Date of Award22 Aug 2018
Original languageEnglish
Awarding Institution
  • University of Winchester
SupervisorPrudence Marriott (Supervisor) & Adam Palmer (Supervisor)


  • Critical HRM
  • Discrimination
  • Employee Relations
  • Employee Voice
  • HRM Practices
  • Power Relations

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