MumsnetGuestPosts (MNHQ) Tue 01-Mar-16 15:50:50

Guest post: "It is my duty as a doctor to strike"

Junior doctors have been left with no choice but to strike says Dr Rachel Clarke, but on those days some will be offering basic life support training sessions for local groups

Rachel Clarke

Junior doctor

Posted on: Tue 01-Mar-16 15:50:50

(162 comments )

Lead photo

"For all the frustration next week's strike will provoke for patients, the alternative is much worse."

Next week, for two of seven days, your hospitals and general practices will be emptied of their junior doctors. We'll still be there covering the emergencies, but non-urgent care will carry on without us. I'll wake up, I have no doubt, feeling queasy with guilt, and will drag a heavy heart to the picket line.

No one wins in an industrial dispute that's become as toxic as it is tiresome, but for the public – who are by far the biggest losers – patience must be wearing exceedingly thin.

I'm haunted by the fear that you must listen to both sides, government and doctors, insisting they prioritise patient safety above everything, while feeling thoroughly sick and tired with the whole lot of us.

When helping is ingrained in what you do, leaving those for whom you care feels wretched. And yet – yet again – I'll be on strike next week. Like 98% of junior doctors, I feel the government has left me no choice. Because for all the heartache and frustration next week's strike will provoke for patients, the alternative is so much worse.

David Cameron would have you believe this dispute is about nothing more noble than our pay packets. He has a vision, he will tell you, of a "truly seven-day NHS" – which only the avarice of junior doctors stands in the way of. But this is not a pay dispute. None of us chose medicine to get rich quick, and none of us are asking for more money.

This is a matter of putting patients first. As someone who already works one weekend in four on the frontline of the NHS, I'm pretty certain the strength of my desire for better weekend services vastly outstrips my Prime Minister's. I desperately want the CT and MRI scanners my patients need up and running on Saturdays and Sundays. I desperately want their biopsies processed, their lab results calculated, as swiftly at the weekend as any other day.

If we are forced to work more thinly across seven days, what you will get in a "truly 7-day NHS" is a workforce too demoralised, too overworked and too exhausted to do a decent job for you. We have nothing left to give, and burned out doctors are a threat to safety.


What I want for my patients, in essence, is the small army of NHS staff who provide care five days a week, on duty for seven.

But – and this is the crux of the matter – what I will never do is pretend that you can have a "seven-day NHS" without funding it. David Cameron claims he cares about patient safety at weekends, yet he's pledged not one single extra pound towards an improved weekend hospital service. Instead, his government's cheapskate solution is to stretch an already broken workforce of juniors so that we provide seven days care for the price of five. That's not a pledge, it's a scam.

What you need, to put weekends on a par with weekdays, is a whole new raft of staff, safely delivering new weekend services. Jeremy Hunt's own Department of Health has estimated – in figures leaked to the Guardian newspaper – that a seven-day NHS requires 11,000 more staff, 4000 of which are doctors. Yet right now, across the UK, thousands of NHS nursing and doctor posts lie vacant. BBC Freedom of Information requests have just revealed that the NHS currently has 6000 too few doctors. The gaps in our rotas already endanger our patients. If we are forced to work more thinly across seven days, what you will get in a "truly seven-day NHS" is a workforce of junior doctors who are too demoralised, too overworked and too exhausted to do a decent job for you. We have nothing left to give as it is, and burned out doctors are a threat to patient safety.

My duty as a doctor is therefore to strike. But as a mother of two young children, as well as junior doctor, I don't want my strike days to be spent in vain. Next week, on 9th-10th March, for any Mumsnetters who'd like them, junior doctors are ready and waiting to provide local basic life support training sessions aimed at mothers with babies and young children in particular. Our #littlelifesavers sessions will teach you with the skills to handle an emergency with your child, such as choking or stopping breathing. Every #littlelifesavers group of doctors will include a qualified advanced life support instructor. Please email littlelifesavers999@gmail.com if you'd like us to set up a local session with you. We'll try our very hardest to make this happen.

Photo: William Perugini / Shutterstock.com

By Rachel Clarke

Twitter: @doctor_oxford

Millieveasey Fri 04-Mar-16 12:23:23

Totally support you! Keep up the good fight. This new contract also makes it a lot harder for women in medicine, more difficult to flexibly train for both men and women with families or other life commitments. The checks on safe numbers of rotad hours are i believe at the discretion of the hospital under the new contract so hours will be less regulated thus less safe. If someone is looking after my little ones health I want them healthy, happy well rested and well paid not demoralized taken advantage of over worked and burnt out.

Carole178 Thu 03-Mar-16 22:23:07

I fully support the strike,I retired from NHS having spent 40 years and seen the work that junior Drs do, they frequently work longer hours than rota as you can't walk out if dealing with emergencies, the NHS works 7 days anyway, this government is hellbent on killing off NHS it's being sold off .

tuesday123 Thu 03-Mar-16 17:40:10

pausing I agree. I think a lot of failings occur because of staff shortages and this will only get worse. First doctors then the rest. Already nursing bursaries have been affected, I hate to think what the impact is going to be on nursing recruitment.

It is interesting that your friend was working in a private healthcare setting. I wonder whether things would have been investigated more in the NHS.

If there are already a shortage of doctors and nurses it seems ludicrous to make the job less appealing when they struggle with recruitment already.

I appreciate money doesn't grow on trees (although it appears to at the governments convenience).

lavenderdoilly Thu 03-Mar-16 15:15:51

Your friend did a good thing and I'm sorry it didn't have a sweeping result. I'm not pinning all my hopes on whistle blowers but I know that when an individual does it , this takes great personal courage - especially in your friend's case. She may have felt it was in vain but it will not have gone unnoticed. Her ex employer will need to have refreshed its whistle blowing policies. Let's hope that has some benefit longer term.

PausingFlatly Thu 03-Mar-16 14:50:09

It was actually even harder than normal, lavender, as she was on a visa which meant she could be deported if she crossed her employer. She came from a country many people were fleeing as refugees, and anyone with healthcare qualifications was using those to get out rather than the more difficult route of an asylum application.

So if it had gone wrong, she could have been deported to a country where she was at risk of death (and some of her family did die).

I had started discussing with CQC (I think it was), when friend discovered a patient's family had reported to the police.

She was delighted that the police asked to interview her and her colleagues, as it provided cover for information they'd wanted to give anyway. And they expected now things would be sorted out.

But a few months later came the news there was to be no prosecution: management just blamed the patient/bad luck/these things happen. And the police weren't investigating care in general, but a particular death. The decision was it didn't cross the threshold for whatever they could have prosecuted for. Which in turn made it harder to make a case to CQC, because now the organisation been "cleared".

My friend said things improved slightly at the organisation immediately after the police investigation, but she left for another employer when her visa status changed. So I don't know state of play now.

I'm not hopeful, as it was people in charge didn't change.sad

So I suspect my friend's courage was all for nothing. CQC and the police had information, but that wasn't enough to enforce change. And the organisation could put on a show for inspections.

Sorry, that's off topic. But this is why I'm less optimistic than you about whistleblowing - there's no guarantee it will be effective. I would still do it, but that's easy for me to say because I'm the go-between with nothing to lose.

YoungGirlGrowingOld Thu 03-Mar-16 14:14:12

Hear hear lavender and pausing

DH is more pushy now and refuses to carry out practices that his hospital tries to implement for people who are at risk of breaching NICE guidelines over delays in treatment. But why do the hospitals try to hoodwink the DoH? It seems the tail wags the dog in some hospitals.

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lavenderdoilly Thu 03-Mar-16 13:54:27

Well done to your whistle blower friend, Pausing. That takes real courage. Whatever we might disagree about, I am grateful for them standing up for better care at personal risk.

tuesday123 Thu 03-Mar-16 13:51:22

No, but they're bright enough(and young enough!) to probably retrain to do these jobs. Yes they're not going to be world class athletes (probably why they earn £££s), yes they might not become successful artists or musicians (again earn £££s) but I suspect they could switch to teaching, management, finance fairly easily or onto many graduate training schemes. After all graduate training schemes are for any graduates and given that medical students have all got excellent grades what's stopping them from not jumping ship.
I understand that you're experience has not always been positive but I personally like to focus on all the good things done through the NHS that I've seen personally and hear about.

PausingFlatly Thu 03-Mar-16 13:48:02

lavender , I completely agree with you that doctors aren't gods who need special protection above all others.

That's why I don't ignore other HCPS, don't expect them to put up with it, and do support them when they strike. I've also helped a HCP friend whistleblow on her (private) employer about poor care.

I'd actually be making a weird exception for Junior Doctors if I didn't support them in things that affect recruitment, safety and fair working conditions.

lavenderdoilly Thu 03-Mar-16 13:38:37

A doctor cannot drop into the job of a sewage engineer or a power station worker. Doctors are highly skilled and trained specialists but they are not gods who need our special protection above all others. I haven't had a pay rise for years because of public sector pay restraint. It wasn't much better when I was in the private sector. I value the work that doctors do. I rely on it. But they chose this vocation and they remain with fantastic career prospects.

tuesday123 Thu 03-Mar-16 12:51:18

As I see it, it probably is about pay somewhat but as they are highly skilled, trained for many years and very intelligent they can go off and do other things or work abroad. If they go, what are we left with? An NHS crumbling further. Whoever is left will be stretched even further and as a result poorer care. The everyone will whinge how catastrophes are allowed to happen when it all goes back to staffing levels. Quite simply, no one else can do their jobs. But doctors can do most of ours. (In fact, talking about taxi drivers, I got in a cab once where the driver had been a doctor - I don't know if he ever worked in this country but he seemed to have a level of medical knowledge for me to believe him).

lavenderdoilly Thu 03-Mar-16 12:44:02

Pausing, everyone is concerned about this but it is disengenuous of the JDs to try and turn a pay dispute into a battle for the nhs. As pp have said there are many people who do vital work for shit pay with few career prospects. These people are ignored and expected to put up with it. If I am going to go to the barricades, I will not do it for JDs.

tuesday123 Thu 03-Mar-16 12:37:29

pausing flatly agree with your posts and well said!

PausingFlatly Thu 03-Mar-16 12:36:05

BTW, despite the discussion above having got heavily onto pay, my concerns remain the unsafe hours and the impact on supply of doctors.

lavenderdoilly Thu 03-Mar-16 12:29:18

OP, your duty as a doctor is to do no harm. Will you do harm to any patients by going on strike? If the answer to that is, yes, then the rest is a matter for your conscience. Life saver courses for parents are great and I welcome them. Hope you have struck the right balance there.

PausingFlatly Thu 03-Mar-16 12:25:31

There we go. So they'll generously introduce a couple and claim to have reinvented the wheel in fit of vision and generosity.

You know this from the army.

The story fed to the public in press releases (especially in headlines) is always reyther different from what people on the ground know is happening.

TheFairyCaravan Thu 03-Mar-16 12:16:54

Nursing bursaries have been scrapped actually.

PausingFlatly Thu 03-Mar-16 12:12:53

Do I think when new contracts are rolled out for nurses, the government will attempt to announce they are getting a pay rise?

Hell yes.

They always do.

It'll be something like, "Nurses are getting an average pay rise of BLAH," meaning three heads of regional nursing get a stonking pay rise, and the other 100,000 get squit. Obviously we didn't average across the cohort, but who's going to ask about icky statistics.

Or "Nursing bursary values have been increased," no one's to mention pay.

Or "All nurses are getting a minimum pay rise of BLAH" but actually we downgraded 50% of posts to being healthcare assistants not nurses, and they're getting zilch or an actual cut.

YoungGirlGrowingOld Thu 03-Mar-16 12:03:20

You are absolutely right Fairy - the consultants' contract is next. Unlikely to be so favorable as the one that will now be imposed on JD's. It will impact on our disposable income as a family and no doubt leave us worse off but I still think it's the right thing to do because unlike the JD's I am not entirely self-interested.

PausingFlatly Thu 03-Mar-16 12:01:51

confused Would corporals love an 11% rise in basic pay, while losing the same in, say various deployment allowances, or relocation allowances, etc?

So that they were taking home the same or less?

TheFairyCaravan Thu 03-Mar-16 11:36:39

If you read what I posted Pausing I said they would love an 11% rise on their basic pay.

I know that they are having their pay protected for 3 years.

Do you all think that when this contract is rolled out for nurses and AHPs they'll all get an 11% rise on their basic pay, because I don't.

writingonthewall Thu 03-Mar-16 11:17:59

thefairycaravan do you realise that most doctors will see a pay cut of around 25% and that those who do the most antisocial hours will be hit hardest?

PausingFlatly Thu 03-Mar-16 11:12:07

But doctors won't be seeing an increase of 11%.

That's the point.

The government have published a figure of 11%, while playing exactly the same sort of game as dropping the RAF trades down the pay scales. Neat, eh?

About 25% of junior doctors would actually get paid less under the new scheme (there's transitional protection for those already in post, so actually it's the newbies who'll get hit).

And by upping the basic but dropping overtime rates, what this contract will do is make it cheaper for management to schedule excessive hours than at the moment.

PausingFlatly Thu 03-Mar-16 10:59:16

Should have made clear, we should do our best to change the structures that make things worse (eg the decimation of council housing stock, the roll back of employment rights). I'm not suggesting we accept the detrimental structures and just hand round tissues.

TheFairyCaravan Thu 03-Mar-16 10:58:40

I do care what's happening in the NHS. DS2 is a student nurse, I am a disabled woman who relies on it.

However, there are people in this country who are being treated horrendously by this Govt and not one person gives a shit. There are corporals in the army who won't get a pay rise until/if they get promoted to staff sergeant. That's years away, their current pay is only protected for 3 years, so they're looking at pay cuts. Whole trades in the RAF have been dropped down pay scales. They are losing money, they don't get overtime pay, they don't get extra money for Christmas Day, they don't have the right to strike. They would bloody love 11% on their basic pay and their hours limited.

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