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

162 replies

MumsnetGuestPosts · 01/03/2016 15:50

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.

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 [email protected] 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

OP posts:
meddie · 01/03/2016 22:29

Fully support you. Even if you think doctors shouldnt strike, please answer me this question Jeremy Hunt claims that the new contract will reduce junior doctor hours while offering an increased 7 day service.
Considering there are already gaps in many rotas, how can the same number of doctors cover more hours without employing more doctors? Its basic maths, Someone is telling big fat porkies over the reason for this contract and its not the doctors

NancyDroop · 01/03/2016 22:30

I support the doctors' strike action fully. The government's behaviour is underhand and terrible.

CockwombleJeff · 01/03/2016 23:31

Deputy ward manager here 100% supporting our wonderful doctors Thanks.

weasle · 01/03/2016 23:41

Belle did you read my post? Do you think I'm lazy?!
And I'm not unusual. All HCP work beyond their paid hours, that's how the service survives.

prh47bridge · 01/03/2016 23:50

Considering there are already gaps in many rotas, how can the same number of doctors cover more hours without employing more doctors

Who says they aren't employing more doctors? The number of doctors employed by the NHS went up by 9,500 during 2010-2015. On average the number of doctors employed by the NHS goes up by 2.5% per year. The government expects that rate of increase to continue.

soapybox · 01/03/2016 23:56

I support the doctors fully in their strike.

Those posters who think there is an endless supply of doctors just waiting to fill your shoes should be aware of the recent review that shows that there are 6000 vacant doctors posts and 23,000 vacant nursing posts, right now and no magically appearing doctors and nurses to fill them. All that is keeping the system from collapse is the unpaid overtime (significant) and goodwill of our doctors and nurses and for this sacrifice they are called 'lazy' REALLY? Are people really to stupid to see the difference between an underrescourced service, and the impact this has on their experience when needing care, and laziness?

Furthermore, being trained to be a doctor is not free. It costs a medical student around £75,000 of their own money to be trained to be a doctor. Are you aware that when publishing the costs of training to a doctor, the NHS has the cheek to include the amounts paid for by the students. And to make things even more laughable they include the costs of paying doctors in their FP1 and FP2 years, when they are actually working! It is all smoke and mirrors and I am shocked that people are too thick to see it! Maybe they should ask for a refund of their costs when the government breaches its contract with them, as they are threatening to do.

I've nothing to do with the NHS - I am an accountant, so no bias from me! I am just fed up with the way in which numbers are being used by the government to try to manipulate the masses! Thankfully, the vast majority are bright and savvy enough to see through it!

maydancer · 02/03/2016 01:10

Thinking your opinion is the only valid one is what is thick, soapybox

maydancer · 02/03/2016 01:17

There is not an endless supply of trained doctors, but there isca huge supply of potential doctors. plenty of people willing and capable of studying medicine are tur ed away.train more UK doctors and shackle them to the nhs before investing a penny

midsummabreak · 02/03/2016 02:11

Fully support the strike. Never give up on your quest for a safer and more fairly funded health system The Prime Minister can not stretch the system any further in good conscience

YoungGirlGrowingOld · 02/03/2016 05:35

Irrespective of the rights or wrongs of changing the doctors' T&C's, I no longer think the NHS is worth saving. Free at the point of delivery healthcare is delivered by our European neighbours outside a monopoly, government run system - no collective bargaining over pay there. I object to doctors holding patients to ransom and causing harm as a result. People already wait many months (if not years) for surgery under our system and cancellations will have a massively detrimental effect on them personally.

DH is a consultant so I have no particular axe to grind. He has been a JD in recent history. I deal with all our finances and I know exactly how much he was paid, and as a consequence I also know how much misinformation is being spouted by the JD's over pay. Smoke and mirrors from both sides - neither has any moral high ground here imo.

midsummabreak · 02/03/2016 06:01

It's about working conditions that enable the provision of safe healthcare not just pay. If no-one ever collectively bargained for fair working conditions throughout history, all employees would still be working 12 hour days, with no breaks Our tea break,lunch break and the eight hour working day all come from past collective bargaining for fair working conditions

YoungGirlGrowingOld · 02/03/2016 06:20

Midsummma my understanding is that the only point outstanding is the rate of pay for working on Saturdays. All other points (15 out of 16) are agreed.

So the wider dispute may not just be about pay, but pay is the one thing holding up a deal.

I am all for fair working conditions btw - I just find it pretty disingenuous to dress up a pay dispute as a protest about "saving the NHS". I find it very disingenuous.

YoungGirlGrowingOld · 02/03/2016 06:21

So disingenuous I said it twice! Sorry, typing on phone.

writingonthewall · 02/03/2016 06:38

maydancer applications to med school have fallen by over 10% in the last few years. Another 5 or so years of that and you won't find people to do it. And most final year students that I know are planning on going abroad asap.

YoungGirlGrowingOld · 02/03/2016 07:23

There will never be a shortage of bright young people wanting to do medicine, writing. Particularly amongst those who have actually done their homework and considered what a good deal it is compared to some (most?) other professions. I have heard a great deal from DH's colleagues about going to Australia or NZ and indeed some have already left. It's not really credible to suggest that those countries could take a significant proportion of the JD's though. It's a flouncer's argument really - not very edifying. Of course there may be shortages in particular specialities and we should of course look at how to make them more attractive. However I don't like the idea of giving a group of very well paid people a pay rise whilst telling the elderly they can't have cataract surgery or that they have to wait even longer for a new hip. It all comes out of the same pot, after all.

writingonthewall · 02/03/2016 07:36

younggirlgrowingold I think you're wrong there. Traditionally doctors children often go into medicine. I don't know a single doctor who would encourage their kids to do it. If the competition falls, you're not then getting the brightest and best going in to medicine which is in no ones interests.

lavenderdoilly · 02/03/2016 07:49

I'm with younggirl. The nhs as a whole needs an overhaul and we need to stop treating it as a state religion - pleased to say that is beginning to ebb away. I'm more concerned about protecting the pay and conditions of hospital cleaners.

YoungGirlGrowingOld · 02/03/2016 07:55

That's not unusual though writing - I can say exactly the same about lawyers (my profession) and actuaries (several of my family). Ultimately there are depressingly few jobs with equivalent pay and benefits (pension in particular) to medicine and that is precisely why there will never be a shortage of applicants. Low take up in particular specialities, yes - as I said above, that should be tackled.

Medicine also covers a vast range of different careers. My DH chose his specialism with one eye on potential PP income and now he earns about 50k pa just from doing that a couple of evenings a week. He has plenty of time to see PP's outside of his normal NHS clinics and is still home before me! I sincerely hope any children we have DO choose medicine, not just because DH is an excellent doctor, but because it offers both rewarding work and an excellent lifestyle. I probably wouldn't feel the same if DH was (say) an A&E consultant with no private income, but (like every career) it's horses for courses.

SilverMachine · 02/03/2016 08:18

Great post OP.

I fully support this strike. Respect and solidarity to you Star

writingonthewall · 02/03/2016 08:23

younggirl I just spotted what you said about a pay rise. Please tell me that you haven't fallen for the Govt spin that this is an 11% pay rise? Most doctors in acute specialties will see their pay fall often by as much as 25%. Would you accept that? The negotiations about Saturdays are damage limitation on the proposed pay cut, nothing to do with a rise.

writingonthewall · 02/03/2016 08:24

younggirl so you're happy for no doctors to want to do A&E? Who will look after you in an emergency then?

YoungGirlGrowingOld · 02/03/2016 08:38

writing I didn't say that. That kind of inflammatory "how very dare you" response has characterized this debate and it's disappointing that so many doctors and their supporters are unable to either see the other side of the argument or to debate it properly. I said that I may have a less positive view of DH's pay and working conditions if he was working in A&E and doing antisocial shifts without the - actually very considerable - benefits of a lucrative PP. A career that offers the chance to earn about double the national average salary by working only a couple of nights per week cannot be so terrible.

I don't think any member of the public is in a position to referee between Hunt and the BMA and decide who is fibbing the least. However, the last report I read (in the Times, not a particularly pro-conservative publication) indicated that only those doctors who already work excessive/unsafe hours would receive a pay cut. If this is the case, then the JD's seem to be hoist by their own petard, no? Who could possibly argue in favour of preserving excessive hours?

The JD's seem very muddled about what they actually want. To save the NHS? To be paid more for working on Saturday? To bring down the democratically elected government? There is no consistency or cohesion in their arguments. Few would argue that Hunt is not a twat but I cannot support those who willfully harm patients because they want more cash. And that is what -at least - next week's strikes are about.

soapybox · 02/03/2016 09:23

Younggirl, logically that just cannot be true (or at least all the statements being made by the govt cannot all be true).

If the purpose of the new contract is to have more doctors working at weekends and there is no additional funding to fund a seven day service then it can only be possible if doctors are working longer hours for the same or less money. If that isn't the case then there would have to be an increase in funding, which Hunt has said will not be the case.

I suppose it is possible that the seven day service is only really about moving hours worked from weekdays to the weekend but what would be the point of that? And even if that were the case for it to be cost neutral the 11% increase in basic pay would have to be completely offset by a reduction in overtime pay (otherwise it wouldn't be cost neutral) so where is that reduction coming from? Can the service really afford to lose 11% of overtime hours and still deliver a service?

I wonder whether you will be quite so glibly accepting if the next step in contract imposition is to impose a contract that no longer allows consultants to work in PP! It has certainly been one of the options discussed to increase consultants hours!

PausingFlatly · 02/03/2016 09:31

YoungGirl I'm not quite following your argument.

The doctors I know working illegal, unsafe hours have been scheduled to do so by their hospital. Although some have made complaints, nothing has changed (and the complainants have been "reminded" that their career depends on good reports from the hospital).

The fact that hospitals have to pay a much higher rate when they schedule excessive hours at least means management face a financial penalty for this decision.

IIUC (and as you describe) the proposed new contract means that specifically doctors working dangerous, excessive hours will become cheaper for management than at present. So hospitals will find it easier to schedule excessive hours.

It's a perverse incentive for the hospitals, likely to cause more excessive hours, not fewer.

YoungGirlGrowingOld · 02/03/2016 09:45

Soapy this constant rejection of successive research establishing a link between adverse outcomes and weekend admission by JD's does them no favors. One can see with one's own eyes that ward cover is skeletal and care is correspondingly riskier - quite apart from the ridiculous state of affairs that means expensive equipment is lying idle for 30% of the week. So yes, I am in favour of weekday cover being spread more thinly if that is what it takes.

I agree wholeheartedly that the other HCP's and staff are needed to make 7 days realistic - but that is not a reason not to do it.

And it's worth remembering that even if they do take away consultants' PP rights, they will still be amongst the highest paid people in the country! I am struggling to think of a single consultant we know who doesn't live in a house worth over £1 million. And we are a jolly long way from London!

I am not self-interested - on the contrary I benefit from doctors continuing to be very well paid (and I think they should be). I happen to think JD's should be putting their patients first, on this occasion.

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