Would you support a junior doctor strike?

[NC3435]

NC for this. To be clear, during the last strike, non training grade doctors were in hospitals etc as were consultants. Emergency work continued and A+E was functioning. The background to the dispute is that JDs want pay restoration to the levels in 2008/09 and the BMA has been attempting to engage with the government for a while without any acknowledgement. There is a staffing and retention crisis with more and more doctors leaving the country every year. Those of us still around are pretty burnt out from the last 2 years and things are getting worse - this includes patient care.

@fissty you seem to think that what we do is so easy - perhaps you should do it? Your argument that you have been a rota coordinator so know what it’s like to work with barely any support and increasingly unwell patients is a joke. Yes our working hours are on a rota but hardly anyone leaves at 5 pm and I have definitely not put in a claim when I’ve had to stay late because of an emergency. Perhaps as a senior registrar my view is slightly different on claiming for staying late. Most rota coordinators I’ve had the displeasure of working with have no idea what goes on on the shop floor. You keep trying to convince people that we are infinitely better off than most people when that is not the argument - there will always be someone “better off”. If your argument that we work normal hours and earn good wages is correct then why is there a staffing crisis compared to even a decade ago when I graduated?

I presume you are a consultant, so it's embarrassing to see the "in my day" arguments advanced.

As a PRHO I put in chest drains, did pleural taps unsupervised (so many I actually got the medical students to do part of the procedure under my supervision), everything except CVCs - which I then got competent in in my first year as an SHO. I had a job with resident 24/48 hr on call - but there was at least mostly the chance to grab some sleep in an on call room. I used to do 7 consecutive 13hr night shifts, where you were expected to stay for the PTWR afterwards as well. I was on call with my firm unless I swapped. My first job as a registrar I did my first ever outpatient procedure after reading up about it, and was just left to get on with many of the procedures. The job has changed,not always for the better- but it has changed, whether or not you agree with it. PRHOs 20 years before me were on a 1 in 2/1 in 3 resident oncall. As a houseman I recall my boss saying to me how they used to get free breakfast, and thinking that I was glad that we got a break overnight (the registrar used to be able to sleep overnight, and I can remember the one time I woke them up in my 6/12 PRHO job. By the time I became a med reg myself, oncall rooms had gone. I found myself often the only person on call who could do procedures, as the SHos had less experience than I did at their stage of training - and rightly so, we don't just slap in CVCs on the ward any more.

Nope..not a rota coordinator although I retain oversight of a number of rotas and frequently have to referee rota disputes/issues/leave requests outside of 6 weeks etc

And again; not talking about registrars (as I’ve said above my regs are not striking - (they’ve messaged me to assure me they aren’t). I’m talking about F1s and F2s.

And no I didn’t ask them if they were they messaged me of their own volition. The IMGs were never going to go out on strike (one of them actually said to the juniors they need to check their privilege). I have three deanery (2 about to CCT so they aren’t going out either) and the other 1 has no interest in striking. Trust grades aren’t going out (although I have agreed to short notice leave for the Thursday after the strike for two of them because they will work all through the strike to keep the patients safe.

As for our cons - my on call consultants will just run the wards with the specialty nurses and regs. Front load the workforce at the front door and watch admissions drop like a stone as they did during the last junior strikes

And that’s a result of making sure our juniors actually get their training - not just service provision. Allowing them time off and back filling with locums so they can present posters and audits, ensuring eduction sessions are ring fenced etc etc. They pay it back at times like this

Just wait until tomorrow when we start calling patients to cancel surgery and clinics.

Wait for the posts on here, there are real bloody people suffering because of this. Find another way to negotiate. Quit doing locums and extras. Walk out of the hospital bang on leaving time. Work to rule. Campaign.

Striking is not it

I'm so confused. You clearly despise junior doctors. Maybe just FY1/2 which shows your ignorance as everyone below consultant is "junior doctor".
So you feel they are useless and lazy and are "training" yet the service seems to depend on them? Which is it then?
I've met managers like you and they are awful bitter people with big heavy chips on their shoulders. Luckily like the junior doctors you describe they are the minority but do try very hard to make doctors lives a misery. Sad really.

Erm the regs are juniors too and will also be striking

And they really aren't "your" consultants what a horrible smug arrogant turn of phrase. You've been around a while right?

Do you think the junior juniors have always been like this @fissty , or is this some kinds of generational shift. People in all kinds of industries seem to complain about the current crop of entrants into the workforce. In medicine there seems to have been an “it was much harder in my day…stop complaining” attitude forever.

100% support them. I’m a midwife so work alongside junior doctors all the time

Definitely yes.

They can strike - they don’t have to and ours won’t be

It’s interesting when you’re all posting figures like 29k a year you’re only talking
about F1s basic salary but you then decide juniors is anything up to a consultant ….. I have specialty doctors on 80k a year…are you including them as juniors?

Juniors in the main means F1/F2. Be clear who you are talking about when you’re throwing out figures about low salaries or actually let the people see what the salaries are for every doctor except consultants. not just the lowest minimum hour salary

You mean finally got some balls and decided they didn't want to train for years with massive student debt and ridiculous working hours and pressures?
I don't recognise these juniors that fissty seems to know so well.

Fully support pay restoration. Nobody else would put up with a 26% pay decrease. We must pay our doctors and nurses and other HCP’s properly.

I am so grateful to our NHS and everyone working in it.

I’m going to ask it again because you’re all nearly skipping over it - are you, personally, happy to have your appointment or surgery cancelled to support these strikes? What about your family members surgery? A radical mastectomy? (Booked). Bladder cancers? (Booked). You happy to wait another week for your cancer results?

All of the above will be cancelled so consultants and registrars can cover the wards whilst the juniors strike.

*neatly

@fissty Junior doctor refers to all doctors in a training programme below consultant grade. It is not "in the main" FY1/2s. From the sounds of things you work in an unusual department with more associate specialists / staff grades, whose pay is generally better than training grades. I am in paediatric training which is 7-8 years duration post foundation and will be a junior doctor for that entire time. Almost 37,000 doctors voted in the ballot, 98% for strike action. There aren't 37,000 foundation doctors in England. Your view that the strike is a walk out of foundation doctors only or that the title junior doctor refers only to foundation doctors simply isn't factual.

Here is a link for you to help you get your facts straight: fullfact.org/health/what-junior-doctor/
I find it interesting that you resort to misinformation in order to undermine the strike action.

Well Dh is in an interesting position of being Consultant and patient. He is absolutely encouraging his juniors to strike (has been totally behind the nurses too). It’s possible his outpatient appointment with his surgeon will be cancelled. He’s due to discuss important MRI results and the resulting plan. He will suck it up. Now before you say “oh yeah but that will be his mate who won’t cancel him”, actually it’s in another Trust an hour’s drive away, Dh does not know this guy at all professionally, and has never received any special treatment from him.

I am aware of what a junior doctor is.

In the main from speaking to the doctors they may have voted to strike to send a message. They are not going to walk out to the picket line. Foundation doctors are more inclined to walk out. Interestingly one of my old SHOs has just messaged to say he’s on a rest day on the Monday and Tuesday and am I putting out any locum shifts in our division!

Fair enough. However he more than likely has insight into his condition which is more than 99% of the public will have.

I hope he gets to see his doc soon!

@fissty

Your department may actually be an example where the NHS is unable to recruit or more often retain doctors in training at registrar level because the pay and conditions for training posts arent attractive enough. You don't even seem to have an awareness of doctors training as you believe that junior doctor refers in the main to foundation doctors whereas the majority are senior specialists in specialty training. I guess that is what comes of thinking you know it all when you have an experience of one department/hospital only.

Just to enlighten anyone reading this discussion, associate specialists / staff grades are often very experienced and skilled doctors for the registrar rota but they cost substantially more than training grade doctors because they can take or leave what it offered to them, unlike trainees who are trapped in monopoly programmes with fixed pay and conditions on a national contract. This is why many (but not all) associate specialists such as those who work with @fissty may not particularly interested in strike action, because their pay and conditions are superior. Many of these senior doctors are IMGs because they may struggle to get their overseas training recognised or they are UK doctors who have left or never entered "training", because it's so shit or because they actually look at what being a consultant is like and have decided they don't want to be one.

Regardless training grades and non training grades tend to perform the exact same roles within a hospital setting. And many departments open up training and study for their specialist associates and staff grades, because of course it is better to train doctors to perform at their best. Many "trainees" on fact feel hard done by, because non-training grades may actually be treated preferentially as they tend to stay as an investment within the department for many years whereas training grades have to move on every few months usually. Something @fissty you seem to disparage junior doctors for as though it is their choice rather than something which interferes horribly with their personal lives and causes many to leave training. You wouldn't be the first admin/rota type person I've come across who prefers staff grades for their own short sighted convenience whilst regarding the more poorly paid trainee doctors with contempt.

Not only are non training grades more expensive but they also don't sufficiently address the question of where the next generation of consultants is going to come from, or what the quality will be like with doctors not entering training or leaving training early.

@fissty

@fissty you may choose to believe that the majority of doctors voting for strike action are foundation doctors, but that isn't factually possible as nearly 37,000 junior doctors in England voted for strike action and there are only around 12,000 foundation doctors in the whole of the UK (those outside of England are not involved in the strike action)

The BMA explicitly asked junior doctors to vote according to their intentions during the strike action. Its a reach to suggest that a majority ignored these instructions and voted to send a message only, and that it is only the foundation doctors who will be on the picket line. Not remotely my experience or that of anyone I know. I think this is something @fissty has conjured from their imagination to cover for their initial demonstrably false claim that the strike action involves / junior doctors are "in the main" foundation trainees.