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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:
tuesday123 · 02/03/2016 09:46

Beaufort Belle - you sound like you have a bee in your bonnet! The problem with the NHS is demanding patients like yourself - a broken back doesn't sound life threatening. My mother had a broken back and went about her usual routine , waited for an XRAY (organised by her GP), self medicated with pain killers and found out that she'd fractured her spine a couple of days later. Perhaps if people used services appropriately and didn't misuse the NHS it would function for all of us better.

It really bugs me when people whinge about the service they have received through the NHS. If you want a Waitrose type service, pay for it. If not, be happy with the Morrisons/Aldi type service. You get what you pay for and if you want it to improve pay higher taxes.

YoungGirlGrowingOld · 02/03/2016 09:56

Tuesday the patients at Stafford didn't even receive a Morrisons/Aldi type service though, did they? The problem with the NHS is not demanding patients (how dare the PP expect treatment for a broken back?!) it is sustainability in the light of current demographics. It is also -frankly - the terrible attitude of some of the staff as ably demonstrated by your post above.

Funny how none of the JD's were striking over patients being forced to drink out of vases, or the frequency of so-called "never events", but still expect us to believe they are concerned about patient safety... Hmm

wonkylegs · 02/03/2016 10:01

Younggirl- I am a consultants wife we don't nor do any of my husbands colleagues live in a million pound house. We are driving (or not as mine broke down this morning) 10 year old cars and that is with me as a professional with my own career (not in medicine). The consultants car park here is a right mix of old bangers and one or two nice cars. Yes we wouldn't argue that DH gets a half decent salary but he certainly works the hours for it and it's hardly up there with the 'highest paid'. He works in an acute speciality and we do not live in an area where there is an option for lots of of PP, nor does he really have time for it with the current rota challenges.
So I would challenge that your experience is the same across the board.
I have to also disagree that JD aren't putting their patients first on this one. I really think they are. Accepting such a poor contract that is politically idealistic rather than realistic (it does not take into account real issues in the recruitment and retention of drs nor real life conditions in acute specialities) will inevitably lead to poorer outcomes across the board.
I have read both sides of the argument and although there is some rhetoric from the JDs that I think is a bit OTT, I think it comes from real concern and passion. The government/NHSE side has some really glaring flaws in their arguments that can easily be pulled apart by applying logic and Their continual refusal to openly debate anything makes them look like they have something to hide.

tuesday123 · 02/03/2016 10:04

Am i right in thinking that there are more female doctors than ever before? And I presume many of them work part time. I don't think you can presume that all doctors are going to do private practice given the changing demographic of doctors. Therefore I think its highly unlikely that many doctors have £1million/houses based on an income of £75k full time.

I think doctors are well paid (and rightly so) but definitely not overpaid. I recently went to a private school's open day. I met a consultant with her GP husband on the open day. They lived in a very modest house and decided not to send their kids to private education as they couldn't afford it. They did pay for a nanny though (which is where i presume their money went) and I suppose it goes to show the expensive childcare they have to organise for the shifts they work.

It seems to me, that yes doctors are well paid, but they fork out a lot to do their jobs. If they're going to be asked to do more weekends for ELECTIVE care i.e. out patient clinics that are non urgent, then they are going to have to pay even more money on childcare (I don't see many nurseries being open at a weekend). On top of that, are they not allowed to have a work life balance? Or should we just flog them to death and screw their families and kids?!?

Carrie370 · 02/03/2016 10:04

The juniors are expecting a pay cut, which will disproportionately affect those in the acute specialties. Their hours are already punishing and these rotas are set to get a whole lot worse. If they were getting a rise, with no worsening of their conditions, why would they be striking?

tuesday123 · 02/03/2016 10:15

younggirl I think its fine to seek medical help for a broken back, but its about using services appropriately. People go to A&E inappropriately (as I think Jeremy Hunt did for his son) and then wonder why the NHS is crumbling. People are overly demanding and don't appreciate what they have.
I presume the lady who went to A&E with her broken back was deemed well enough to wait for medical care but was making a fuss about waiting. I really don't think the nurses and doctors would have left if she was having a medical emergency. They have to prioritise and people just don't like waiting. If you want a first class service, then we have to pay for it. I wouldn't mind taxes going up to get more funding for the NHS so we can have better care. Obviously that won't go down well with most people, because people don't want to pay for things but expect quality to improve.

Mid staffs was terrible - but why would junior drs go on strike about that?!?! Was staffing levels not a big contributory factor? How can you expect people to care for people at the level they want to if they physically don't have the time or if there is just not enough staff. In my opinion thats only going to get worse with contract changes.

tuesday123 · 02/03/2016 10:24

younggirl just re-read your post. I'm not a NHS worker. They would all be too polite to tell the lady with the broken back where to go. In fact, if I was going to have a whinge about NHS staff, it would be because they are too polite and pander to a demanding populations wants. As a consequence, too much is being expected from them.

YoungGirlGrowingOld · 02/03/2016 10:24

A country's healthcare policy cannot and should not be decided upon the availability of childcare for doctors. As I said upthread, the JD's might feel a little less aggrieved if they actually bothered to compare their pay and conditions to other professionals with similar training periods and demands.

I fully accept that my husband's specialty may not be typical when it comes to PP. However the main reason that it is so lucrative is that the NHS is so woeful in that specialist area that people scrape to be able to afford it. If the NHS is routinely in the lower bottom half of the survivor stats for your condition, most people would do what they could to get better, faster treatment. Many of those having to do so pay a lot of tax and yet they can't get treatment. Clearly the NHS is not working for everybody.

It still makes no sense to me that a MRI scanner (for example) shuts down at 5pm on Friday and excluding emergencies does not get going again until Monday at 9am. We already have the fewest numbers of these machines than most comparable countries and huge waiting lists. I just don't think that anything - including the JD's list of demands - is more important than improving access to timely healthcare for patients, the vast majority of whom will never earn anything like 75k. (Which is the starting salary for a brand new consultant btw, and goes up pretty rapidly every year).

lavenderdoilly · 02/03/2016 10:27

Tuesday, if patient safety was the key issue for them jds should have taken action over Mid Staffs. My own local hospital is now on the Naughty List too and I have personal experience of why that is. If hcps had made a fuss then I would be backing JDs now. It is my NHS too.

tuesday123 · 02/03/2016 10:34

Fair point that healthcare should not be decided upon by childcare but you then have to pay people appropriately. I have no idea how much your husband earns but a junior doctor earns around £45k. Now, thats for 48 hours a week (so already an extra 10 hours a week to joe bloggs). That works out to £18/hour (pre tax). They all say that they work more than that free of charge but on face value £18/hour doesn't seem too much for all the extra time they have put in studying and the expenses they have. Not to mention the £££s of debt they come out with after university.
If they're going to be asked to cover more weekends then that will be more costly for them as they will have to arrange childcare. A nanny charges around £10-12/hour. It just doesn't seem worth being a doctor and I worry that we're going to lose a highly skilled workforce because they are not appreciated by the public and not paid appropriately.

tuesday123 · 02/03/2016 10:37

lavenderdolly I have seen a petition on social media saying that junior doctors don't have whistleblowing rights.

Also, no one knew what was going on in midstaffs other than staff in midstaffs. Therefore how can you expect a bunch of NHS workers to fight a cause that they didn't know about?!?!

YoungGirlGrowingOld · 02/03/2016 10:45

Tuesday because the people who kept quiet about Mid Staffs were NHS workers. Could you watch a grandmother starve to death because of neglect? I couldn't. And yet there does not seem to have been so much as an anonymous call to the press. If the JD's expect me to believe they are now acting altruistically, then they have some explaining to do.

On pay, you are falling for the JD's spin (and I fully accept there is spin on both sides). The JD's want us to only consider their "basic" rather than the additional payments they already receive for working outside of plain time. This is why they are kvetching about managers from Pret earning more than them whilst failing to mention that they are already in a minority of one when it comes to professions that receive overtime for working outside of their contracted hours.

As I said, it's impossible to referee between two such entrenched sides when both have proved themselves more than capable of inflating their arguments and (being generous to JD's here) obfuscating the facts.

lavenderdoilly · 02/03/2016 10:48

Tuesday, I disagree. The appalling care was not confined to Mid Staffs as the Keogh report shows. If whistle blowing or contacting the police wasn't an option, I would rather leave my job than allow people to suffer or even die on my watch because of shoddy care. I accept that JDs have very good points to make but they should confine themselves to making arguments about pay and conditions and leave off the emotive "we are the last best hope of the people" rhetoric.

PausingFlatly · 02/03/2016 10:52

lavenderdoilly, the hospital doctors I know HAVE complained about patient safety issues. Including about particular wards or departments where the behaviour of nurses and other HCPs was consistently causing safety issues.

But Junior Doctors aren't the employers. They have no power over other staff. They can only report things to management, whose job it actually is. If management chose not to act, there's nothing a JD can do about it (other than work even harder to mitigate the daily problem in the short time they're on that ward).

And obviously this is the same for all other HCPs.

They can work their butts off and report till they're blue in the face, but only management have the power to fix some things.

Management were so heavily slated at Mid Staffs, not as scapegoats, but because they were the ones who should have actually been fixing the problems.

YoungGirlGrowingOld · 02/03/2016 10:59

So if patient safety is an issue and patients are unsafe because of inadequate staffing, why do JD's want those budgets stretched even further so they get more cash for working Saturdays?

They can't have it both ways. A nationalized system brings pay restraint and there is no 'market' to set pay in the UK (unlike other countries). As a consequence pay has to be set by reference to what the country can afford not what JD's think they deserve.

lavenderdoilly · 02/03/2016 10:59

As younggirl suggested, anonymous call to the press was an option available to any healthcare worker at any time.

soapybox · 02/03/2016 11:09

Young girl - they don't want more money for working Saturdays, they just want their existing Saturday pay to continue. And why should the burden of funding a seven day service fall solely on the junior doctors? Why is it their responsibility to pay for it, when there are consultants, other HCPs, NHS managers who could also take a pay cut to fund it?

Or if we really are serious about a seven day service, shouldn't we as tax payers be footing the bill? Why the junior doctors?

tuesday123 · 02/03/2016 11:10

younggirl i think you're mistaken about junior doctors pay. From what I've read, their basic pay starts at about £23k and goes up to about £45k. On top of this they have their oncall supplements which can be up to 50% of their wage but can also be significantly less. Therefore when I said an average of £45k I do not think I have been misled.

With regards to midstaffs - you keep saying that JDs should have reported it some how. I agree with the post above about management. Also, you're asking 53000 junior doctors to have reported something that maybe only 50 knew anything about. And I don't know what their whistle blowing rights are given the petition I have seen on social media.

As I said before did a lot of the problems not stem from staffing issues? Therefore if you're now expecting junior doctors to cover ELECTIVE NON URGENT work over the weekend that can only mean you're spreading staffing levels even thinner during the week. No other healthcare system has non urgent care over the weekend. At a time of austerity, why does this need to be pushed through?!? On BBC news this week it raised the points that there was a 10% shortage of staff (nurses and doctors) for current structure. This will only get worse if you're asking the same number of doctors and nurses to cover weekend non urgent work.

I think the '7 day NHS' is a manifest pledge that the tories should never have made and they are now being stubborn about seeing it through. They're being so stubborn about it that they're jeopardising the NHS to win political points at the cost of the hard working staff that still remain in the NHS.

From what i've heard NHS staff are happy to accommodate a 'truly 7 day NHS' but if its staffed properly. From interviews I've seen on TV, you can't get 7 for the price of 5. DOesn't add up.

lavenderdoilly · 02/03/2016 11:12

I want to hear more from support staff in nhs who would be required for 7 day nhs. Be very surprised to hear that a fabulous deal was offered to them while JDs get unsatisfactory deal.

TheFairyCaravan · 02/03/2016 11:16

soapy the burden of funding a seven day NHS isn't going to fall solely on the junior doctors. The contract will soon be rolled out to the nurses, AHPs, Consultants and everyone else. I highly doubt that the average nurse will be getting an 11% pay rise either.

My support is fading I'm afraid. I had an inpatient procedure cancelled because of one strike, now my out patient follow up appointment for next week looks like it could go the same way.

lavenderdoilly · 02/03/2016 11:18

Tuesday, seems odd that a group of well-educated, articulate individuals couldn't find a way to communicate concerns about poor care at Mid Staffs and/or elsewhere.

YoungGirlGrowingOld · 02/03/2016 11:20

Tuesday no need to use capitals, I understand perfectly well.

Elective care is available in most countries at weekends. I work much of the time in a country with a fully private system and I can have an appointment at midnight on Saturday if I want it. It costs me nothing and it costs my employer about £1k per year. In France (where I used to live), it was also possible to see someone out of hours (although the resourcing was more sensible in this system and it was arranged for the convenience of patients as well as doctors, many of whom - shock, horror - also work and have childcare responsibilities).

The kind of working conditions that the JD's are seeking have not existed in any other sector for many years. We should not print money to pay doctors more.

tuesday123 · 02/03/2016 11:27

This reply has been deleted

Message withdrawn at poster's request.

wonkylegs · 02/03/2016 11:30

The JDs aren't seeking a change though, they aren't asking for more. They are asking to not have reduction on pay and T&Cs. They did not seek out a pay rise/overtime etc they are just defending their position.
It is interesting that the government position about the manifesto pledge of a 7 day service came in some time after the contract negotiations started. So the statement that we must do this to fulfil our pledge is a bit disingenuous. They always planned to make the changes and are now using the 7day service argument to fit their case and make it more palatable to the public.

lavenderdoilly · 02/03/2016 11:31

Sorry, Tuesday. I don't think you can apportion any blame to victims of poor care for that poor care. When on the receiving end of it you are frightened and vulnerable.