With national contracts in place for pay, it might be safe to assume that the NHS would report a smaller than average gender pay gap. In fact, at 25 percent, the disparity between male and female earnings in the NHS is almost half as big again as the ONS average of 17.4 percent. But it’s not a matter of unequal pay. As with many industries, it’s the domination of senior and better paid roles by men that creates the pay gap.