UK healthcare workers are less likely to receive an honour than sportspeople, politicians, and those working in the arts, media or business, finds a study in the Christmas issue of The BMJ.
The proportion of women receiving higher order awards was also significantly lower than men, the findings show.
The UK honours system recognises people who have "committed themselves to helping and serving Britain."
Nominations are suggested by the general public and awards are bestowed by the monarch for achievements in public life, including community services, arts and media, health, sport, education, science and technology, business, and civil or political services.
In recent years, the system has been accused of bias towards certain people, particularly celebrities, prompting calls for a review to ensure that it "rewards genuine public service."
The NHS is a genuine public service and is persistently voted among the best in the world. So researchers set out to compare the proportion of healthcare workers awarded New Year Honours from 2009 to 2018 with workers in other industries, and to determine whether there are any gender or regional differences in honours awarded.
There were a total of 10,989 New Year Honours bestowed from 2009 to 2018 of which 47% were awarded to women.
There were 832 awards (7.6%) for services to healthcare. There was no significant difference between the rate of receiving an honour for services to healthcare compared with services to science and technology industries.
However, in relation to the sizes of their workforces, the rate of receiving an honour for services to sport was 22 times higher than healthcare, and for services to the arts and media was almost six times higher.
The rate of receiving an honour for services to business and the economy was four times higher than healthcare, and for civil and political services was nearly three times higher.
One third of awards were issued to people living in London and counties in the Southeast of England, corresponding to an average of 23 honours per 100,000 people and 20 honours per 100,000 people, respectively.
East England received the lowest number of honours (12 per 100,000 people) followed by Yorkshire and the Midlands. People in other regions of the UK fared better, with an average of 19 honours per 100,000 in Scotland, 18 per 100,000 in Wales, and 38 per 100,000 in Northern Ireland.
Compared with healthcare, the rate of receiving a higher order award (knighthoods, damehoods, Companions of Honour and Commanders of the Order of the British Empire) for civil and political services was significantly higher, while the rate for services to sport was significantly lower.
Only one-third of the higher order awards were received by women.
The researchers point to some study limitations that may have influenced their results, but say, in relation to the size of its workforce, a career in healthcare is not as "honourable" as careers in certain other industries.
The NHS is persistently voted among the best healthcare systems in the world, they add. "This is possible because of the extraordinary contributions being made by ordinary people working in healthcare--the very reason the honours system is alleged to exist.
"This needs to be reflected in the New Year Honours and may increase morale in the struggling NHS," they conclude.
Type of evidence: Observational
Subjects: Recipients of New Year Honours