To wish I could be marching with the juniordoctors today

[nocoolnamesleft]

Today, thousands of "junior doctors" are marching in London. A junior doctor is every doctor from the moment of qualification, to the moment they turn into a consultant or GP. They are the work horses of the NHS, the backbone of the system.

My own life has twice been saved by junior doctors.

And I, as a paediatric consultant, could not deliver the service I do without them.

Jeremy Hunt wants to impose (not negotiate) a contract which would, by extending the "normal working week":

• remove safeguards on hours limits - unsafe!
  
• penalise most those who already work the most weekends/nights
  
• make it even harder to recruit to those specialities
  
• cause juniors to flee the country
  
• disproportionately hit women (hits maternity leave, working pattern, ability to work less than full time)
  

We already cannot recruit enough junior doctors to train in A&E, paediatrics, obstetrics, and GP. This will make it worse.

If you want there to be doctors to treat you, and your families, please support our junior doctors.

The new contract would see them go back to working the way I did in the earliest years. It was not safe then. It will not be safe.

[nocoolnamesleft]

//www.theguardian.com/society/live/2015/oct/17/junior-doctors-protest-against-contract-proposals-live

[WorraLiberty]

Errm I don't know

You haven't told us why you can't go on the march?

[BathshebaDarkstone]

I didn't know about the march until reading this. Logistics and keeping 2 DC entertained would have made it very difficult, also wrangling a 4 year old, but I certainly would have tried my damnedest to be there.

[LunchpackOfNotreDame]

Contracts change. Not all work contracts are sustainable so terms and conditions get renegotiated.

[Follyfoot]

i'm genuinely curious, how can Jeremy Hunt remove safeguards on hours limits? Surely he cant personally overturn EWTD can he?

[Follyfoot]

Agree about contracts changing too, the current junior doctor contract isnt fit for purpose, and hasn't been since 2000 when it was introduced.

[nocoolnamesleft]

Why am I not there?

Because I live at the far end of the country, and despite working full time am mobility impaired. I am not physically capable of standing that long and walking that far straight after 5 hours on a train, so couldn't travel today. I was stuck at work last night until I missed the only evening train (for which I had in fact booked tickets, and indeed a hotel room...).
But I wish I could be.

We already cannot recruit enough doctors for paediatrics. This is in part because they already work incredibly unsocial hours. At the moment, we are short 20% of our junior doctors, and cannot recruit them. The new contract would have the biggest financial impact on doctors like ours, that already work so many weekends. I know a number of trainees who would end up no longer able to afford their child care, as their salary would drop by about 20%, but their childcare costs rocket. These guys are in many tens of thousands of pounds of debt already, from uni, and fork out many more thousands of their own money for exams and courses.

But that isn't the biggest problem. The biggest problem is that the safeguards limiting any individual week to 72 hours of work would go. I don't want to see them working the 100+ hours per week that we did. It wasn't safe. In those days, we had all fallen asleep whilst examining patients. We had all reached the point that we were so tired that we literally couldn't spell our own names right in the notes. Where you feel nauseated and shaking, verging on hallucinating, because you have had no sleep in 72 hours. It was not safe. Nationally, it killed people. Which is why the hours safeguards were brought in. Which Hunt wants to scrap.

As a doctor, that worries me. As a patient, it scares the living crao out of me.

[LunchpackOfNotreDame]

Are the recruitment issues anything to do with the lack of graduates being turned out? How about increase places on medical courses? Plenty of kids want to do medicine but not enough places

[780539gjg]

The contract has "become unsustainable" because the Tories have deliberately underfunded the NHS. It's a matter of political priorities: for Hunt et al the NHS is not a priority.

[780539gjg]

Plenty of grads but massive attrition due to the nature of the job: people leave the profession or go abroad

[LunchpackOfNotreDame]

I think It is a priority for them but they see it needs to go in a different direction in order to keep it going

[780539gjg]

They do not want it to continue being a public body: they want to privatise it essentially. They are good at making it seem as though the NHS cannot continue in its current form, but as I said this is a matter of priorities and ideology.

[Follyfoot]

There is no rule saying junior doctors are allowed to work for 72 hours in any one week, so he cant be getting rid of that...

[780539gjg]

It doesn't have to go in a different direction to keep functioning, but it does have to change if the Tories want to reduce the size of the state. This is the nub of it and it's fraudulent of them to pretend otherwise

[780539gjg]

He wants to make Drs opt out of the EWTD

[PetShopGirl]

Genuine question - I was talking to several doctors the other day of the 'older' generation (early sixties, couple of years from full retirement) and they were saying that they disagreed with the way the contract works currently. Their view was that when they were junior doctors, you worked on one team, under one consultant, for longer hours, and that resulted in far better continuity of patient care and more experience and depth of training for the doctors. I have no personal insight (other than admittedly fragmented care when I have been in hospital myself), I wondered what your take on this is? As I said, genuine question, I honestly have no agenda - I was just interested and a bit surprised by their lack of support for their juniors.

[ihavenonameonhere]

Makes me laugh when people say doctors are leaving to go to Australia but also saying save the nhs.

Do they realise that Aus is partly privatised? We could offer those conditions if we did that.

[Follyfoot]

Do you mean he wants to force them to sign an opt out (as lots of doctors already do by choice) or do you mean he wants to get the UK to abandon EWTD for doctors?

[780539gjg]

He wants to force them to opt-out.

petshop that system worked reasonably well 20-30 years ago, but medical care has changed beyond all recognition in that time. Patients in hospital are much sicker, decisions are much more complicated. Also there is less trust of Drs and more scrutiny of decisions. All this leads to guidelines, reviews, pressure which means that if you work 48 hrs solid, you are more likely to kill someone and the authorities are more likely to notice!

[780539gjg]

I think ewtd was well accepted by most except surgeons.

[LunchpackOfNotreDame]

How about other professionals to whom the ewtd doesn't apply such as police officers?

"Sorry sarge I've hit my 48 hours for the week got to let this one go"

Or in doctor speak

"one two three four, ah fuck it 48 hours are up let's declare this one dead shall we? I make that pub o'clock"

[Follyfoot]

No doctors works 48 hours solid though do they? EWTD and New Deal both prevent that.