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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:
YoungGirlGrowingOld · 02/03/2016 11:32

So the NHS worked for you and therefore everyone else's concerns should be dismissed? Trust me, your DS would have been seen much more quickly in France. I am constantly amazed by how much shoddy care is tolerated here.

If the NHS was so great, many other countries would have adopted it. The number that has is precisely zero.

YoungGirlGrowingOld · 02/03/2016 11:34

Wonky the gov has a mandate for 7 day NHS care - it was in the manifesto. Perhaps we would be closer to delivering it had the negotiations with JD's not dragged on for four years?

tuesday123 · 02/03/2016 11:34

younggirl apologies for the capitals but given that you misunderstood their pay, felt I couldn't take your level of understanding for granted.

It is my understanding that doctors in the UK are not well paid compared to doctors in other countries because most of them do not do private work.

I appreciate you have a rich doctor husband through his private practice, but unfortunately not everyone can afford private healthcare.

If we want the best doctors to stay in the UK, and work in the NHS, I believe they need to be paid fairly and it needs to be worth their while.

tuesday123 · 02/03/2016 11:38

younggirl not saying others concerns should be dismissed, but I think its all relative. My expectations are less and probably more realistic. If I wanted my child to be seen ASAP I could either play the system and be over demanding (and contribute towards the fall of the NHS), or pay to go private.
As I said, if you want a Waitrose service you have to pay for it. Either through private healthcare or higher taxes.
I'm grateful for the NHS that we have. I'm not surprised that its not been adopted by other countries - I don't think doctors or nurses in other countries would agree to working in such challenging conditions.

YoungGirlGrowingOld · 02/03/2016 11:41

I don't misunderstand their pay Tuesday. Conversely I am responsible for our finances and can see through a lot of the more disingenuous arguments about pay put forward by JD's. I know exactly how much DH's base salary was and how much he actually received. A good example is the JD who said he was only paid £1.20 an hour (or some ludicrous amount) to be on call over the weekend and conveniently forgot to include either his basic or uplift in that little "calculation". Many JD's are unfortunately playing us for fools.

I don't consider DH "rich" and I certainly haven't said that anywhere. He is amongst the highest paid workers in the country - as he should be - and I am grateful for that.

My private healthcare is compulsory in the country in which I am a migrant worker and I think that is absolutely fair enough. Maybe the UK could introduce something similar? Either way, the quality of that care is extremely good and an eye opener for those of us who have experienced the NHS on a not-so-good day.

tuesday123 · 02/03/2016 11:51

lavenderdolly similarly I don't think you can blame NHS staff. If they are trying their hardest and reporting that they are understaffed, what else can they do? If they were chronically understaffed they may have lost sight of what was acceptable - it just becomes the norm. I've seen interviews with doctors saying that they work on rotas with 11 people down. It just becomes acceptable. They're shouting out now, but people are not listening.

I do think the public have to take some responsibility for their own care and families care. If basic care needs were failing, then I do think its families responsibilities to ensure loved ones are cared for by them not just NHS staff.

YoungGirlGrowingOld · 02/03/2016 11:55

That would be a massive retrograde step Tuesday - it's what used to happen in Greece 30 odd years ago (speaking from experience!) And what happens to those with no relatives? If the NHS can't provide safe care for all patients, all the time, then perhaps we should just let someone else have a go.

wonkylegs · 02/03/2016 12:05

Younggirl - I am not saying that isn't the case now but it has been repeatedly said that the government changes to the contract are because of this mandate however the proposed contract changes predate the mandate so that reasoning is a bit misleading. It's interesting to see that a precursor proposal to the actual contract negotiations was looking at trying to make massive savings from the JD salary envelope rather than the 'cost neutral' line they are now using, however none of the trusts found the proposals workable.
It is also interesting to see that trusts that have managed to provide a 7 day extended elective service already (various pilot schemes) have managed to do that within the confines of the existing contract.

tuesday123 · 02/03/2016 12:06

younggirl I don't think the public are being played for fools by their pay. Its been all over the newspapers that they earn between £23-£60k.

My issue is that the NHS is fantastic for the budget it runs on. I've not had to pay a penny for all the treatment my kids and I have received. When my kids have been sick I have not had to worry about how things are going to get paid. Thats the beauty of the NHS and we need to keep it like that. Peoples expectations of what the NHS can offer has to be scaled down. Yes private healthcare is great, but not everyone can afford it.

We have the best doctors worldwide and we are treating them like cr*p. They get paid less than most doctors worldwide but yet are at the top of their game. They also work more hours (apart from maybe the USA).

I think I have so much gratitude because I have been on the receiving end of excellent care. Yes I've had to wait - but I've not whinged about it, I have accepted that I'm getting the best doctors seeing my kids free of charge to me. Yes, the toys in the waiting area are all broken, yes I've had to hang around A&E at times, yes the toilets are not great and the cots/bedding for the little ones aren't ideal. But Its all fine. And thats the pay off for getting excellent free care. If I wanted all that superficial stuff to be better, then I guess I should go private.

YoungGirlGrowingOld · 02/03/2016 12:10

It's not free, Tuesday. We all pay for it.

tuesday123 · 02/03/2016 12:13

with regards to families taking responsibilities I still think they should attend to their loved ones. Yes, if some patients have no relatives, then at least nursing staff are freed up to give better basic care to these patients. How can you expect a ward of 30 patients to be looked after by 4 nurses. Theres certain roles they can only deliver such as medications, dressings etc. but things like help at meal times and washing, families could and should get involved with.
Just because a loved one gets admitted onto a ward it doesn't mean that all responsibility of the family is washed away from them. Its asking too much of nurses to provide nursing care as well as basic care when this can be delivered by families.
If people don't like that idea, then fund the NHS more, get more staff in, so their loved ones can be looked after better.

YoungGirlGrowingOld · 02/03/2016 12:15

And in fact, doctors in many countries are paid much less and receive much less generous pensions. My actuary friend estimates that the NHS pension is the equivalent of adding 30% to the salary. Moreover, they are paid according to the market (which will vary depending on location/specialism) and not according to blue collar-style collective pay bargaining across the board.

tuesday123 · 02/03/2016 12:19

yes we all pay for it through taxes, but imagine footing the bill for a coronary artery bypass. Imagine paying for the long term care needs for a child with severe learning disabilities. British people don't have to worry about that. Whether rich or poor, we get the same standard of care and thats really comforting knowing that it doesn't matter how rich you are but you are going to get the same great level of treatment as joe bloggs next door.

YoungGirlGrowingOld · 02/03/2016 12:22

French and German people don't have to worry about that either - or do you think that French coronary patients have to fight their way past a heap of dead poor people to get to the operating theatre?

And I hardly think that equality of access to mediocre healthcare is much to be proud of - the rich will always go private.

tuesday123 · 02/03/2016 12:23

it is my understanding that the proportion of work done under private healthcare is far greater in other countries and therefore although doctors pay may be higher on the NHS compared to other state funded hospitals worldwide, private practice work is far less in the UK as many don't even work in private practice and those that do, only do a fraction compared to other countries.

lavenderdoilly · 02/03/2016 12:24

I work all the hours. I have childcare juggling to do. I have MS. I have great support from my employer to allow me to be with poorly parent in hospital when I can. But it is not my responsibility to make sure she is hydrated, clean, not suffering with bed sores and is getting enough nutrition. It is NHS staff. I will make sure that they are doing this. To extend the waitrose analogy you are so fond of, Tuesday, some of the so called HCPs, I have had the misfortune to deal with wouldn't last five minutes working at McDonald's with their bad attitude.

tuesday123 · 02/03/2016 12:28

we clearly differ in our appreciation of the NHS. I'm financially comfortable and have only once paid for a private outpatient appointment because my husband was worried he had cancer (when he didn't).
We would always use the NHS because we are not fussed by the frills that come with private practice. I'm comforted knowing that I;m being seen by the best doctors who are not driven by financially motivated decisions. - something you can't take for granted in private practice.

tuesday123 · 02/03/2016 12:32

lavenderdolly it is not your sole responsibility but i think its a sad state of play if you wash your hands off any responsibility to look after your loved one because they are admitted to hospital.

YoungGirlGrowingOld · 02/03/2016 12:33

Tuesday I suggest you educate yourself about social insurance based systems on the continent - you might find it very enlightening.

lavender interestingly when my DGD was in the national brain hospital, there were numerous tasks that the nursing staff were unwilling to allow me to perform because (rightly I suspect) I was not covered by their insurance. Despite this they were completely unable to provide anything approaching adequate care - and this in a supposed center of excellence.

lavenderdoilly · 02/03/2016 12:36

Not after "frills", Tuesday, I'm after decent care that I have paid for and would pay more. We have turned the NHS into an organised religion for our country. It is only now that people are being allowed to speak up about its failings. When I experienced it at its worst (just pre-Keogh), complaints were treated like blasphemy. Forgive me for not leaping to JDs defence when they didn't leap to mine.

lavenderdoilly · 02/03/2016 12:38

And, Tuesday, of course I haven't washed my hands of my dm's care.

tuesday123 · 02/03/2016 12:54

lavenderdolly so you feel the NHS is failing. Why is that? Is that because staff are lazy and not working hard enough?

tuesday123 · 02/03/2016 12:57

or is it because it is chronically underfunded and understaffed and therefore staff are trying their hardest to cover gaps in staffing.

Whose fault is that? The frontline staff? Or the Government?

On top of that, the whole junior doctors contract dispute is about increasing elective non urgent care at weekends which will contribute to worsening staffing levels as same staff providing non urgent cover over 7 days not 5.

Its all very well being disappointed in the system, but seems like you're biting your nose off to spite your face.

lavenderdoilly · 02/03/2016 13:29

I won't set out details of the shoddy maternity care I experienced and the catastrophic consequences it has had on my life and that of my family. I have lost my faith in the nhs I used to love and trust and now assume I have to chase good care within it for me and my loved ones. I am delighted when it all goes well (and it can). The op was trying to engage our support for the jd dispute and made some worthy points as would happen in any industrial dispute. But jds are not the guardians of the nhs and shouldn't try and enlist our support on the basis that they are.

PausingFlatly · 02/03/2016 13:31

I agree, it's very enlightening looking at healthcare economics on the continent.

The UK spent US$3235 per person per year in 2013.

France spent US$4124 (ie 27% more than the UK).

Germany spent US$4819 (49% more).

Switzerland spent US$6325 (96% more).

Greece spent US$2366 (27% less than the UK).

(All figures adjusted for Purchasing Power Parity, otherwise the gap between France and the UK looks even larger.)

We can have the NHS doing evening appointments like in France if we want. We just have to pay for it - regardless of whether that's entirely through non-profit general taxation, or also through profit-skimming private insurance companies.