The situation with Junior Doctors
What is actually happening?
Many junior doctors in England appear to be quite outraged by the release of example rotas that demand they work both Saturday and Sunday up to 3 weeks consecutively. In spite of a guarantee by Jeremy Hunt (Secretary of State for Health since 2012) to never press them to work this many weekends successively. Not only can this lead to exhaustion of the junior doctors, for instance by suggesting they must work for 48 hours straight on some weekends. This prompts fears among junior doctors that they may be required to work longer hours. On the other hand Mr Hunt contradicted what he stated in a previous speech where he claimed that “the maximum number of consecutive long days will be reduced from seven to five; and no doctor will ever be rostered consecutive weekends”…
The plans to change the contract arose in 2012 though this dispute began in 2014 when the junior doctors and the government disagreed on certain modifications. Ministers agreed that the doctors should receive an 11% basic pay rise, however this is counterbalanced by cuts to other elements of pay. For instance those that support unsocial hours that they may have to do. This is justified by the fact that it can create a more “7 day” service for the NHS. It can effectively make it much cheaper and easier to timetable extra doctors during the weekends. Moreover the small percentage of doctors who already do a lot of extra hours can qualify for premium payments under the existing contract, but are having this incentive removed and therefore will lose out.
In total there are 55,000 junior doctors in England, this represents a third of the medical work force. Many people are often misled by the term ‘junior doctor’, it doesn’t necessarily just mean the medics who have just recently graduated from medical school but it can also cover those who have more than a decade of experience in the field. These junior doctors have a major responsibility in the framework of hospital systems and the NHS, they are regularly leading teams, making life and death decisions and carrying out surgery.
Mr Hunt argues that it is mandatory to improve the health care during the weekends because a study published by the BMJ found that “those admitted on Saturdays had a 10% higher risk of death, 15% higher on Sundays compared with Wednesdays”. Although, some have rebutted that all these deaths can potentially be reduced through increased staffing as there currently are not enough doctors to cover the rotas. However with the proposal of this new and more challenging contract, could the number of staff employed diminish over time and may this spread remaining staff thinner?
“I remember walking down the corridor in the middle of the night towards the end of one of those (56 hour shifts) and talking to a person next to me who wasn’t really there. How can that possibly be safe?” Asks Dr. Ansari.
The junior doctors have been forced to take action and go on these strikes to send a message to the government that what they hope to impose on medics is highly unreasonable. Fortunately some strikes were called off which is beneficial to the patients because they would have had to cancel numerous operations. The doctors don’t want to put patients’ lives in danger, but these strikes occur to protect both the patient and doctor’s safety. Perhaps the government need to start listening to the doctors and try to sustainably preserve the NHS – one of Britain’s advantageous assets.
How may this affect us in the future?
This means that new doctors starting their career in the NHS under this contract may essentially be worse off than they would have under this existing deal. The starting salary for a junior doctor is currently just under £23,000 a year, but with extra payments for things such as unsociable hours, this can quite easily top £30,000. But is the pay really that great an issue? Many other fields of work may undergo economic instability and as a result some of the funds must be adjusted. With regards to what this means for us as future medics, the most important thing is that we can offer the appropriate service to the patients relying on the NHS.
In this time of need, almost half of the junior doctors finishing their foundation years are not entering the NHS. So many people have been diverted from the NHS route perhaps because all of the effort and hard work they put in is not being fairly recognised.
How we can support them?
Some suggestions made by junior doctors to show our support include:
- Writing to our local MP to explain why we support them and ask him/her to support junior doctors in parliament. I will copy a template below which you can personalise, rewrite and possibly send to your local MP and to the Department of Health at Richmond House, 79 Whitehall, London, SW1A 2NS. (It’s very simple, I have and so can you!)
- Using the #IAmTheDoctorWho to explain what they do.
- Sharing stories using the #IAmThePatientWho.
- Supporting them on various social media.
Remind yourself why it is you want to become a doctor in the first place. Despite all the political difficulties, we all have our own reasons that may go beyond the external struggles we could face. The NHS is a wonderful system that is envied by many other countries in the world because it provides everybody with an equal chance to receive great healthcare. Let’s try to maintain that.
“Dear [Add the name of your MP],
As a junior doctor/concerned member of the public. I have a duty to speak out when patient care is compromised. The new junior doctor contract being imposed by this government will remove vital protections on safe working patterns and could see a return to junior doctors working up to 90 hours a week. With the best effort and will in the world, they cannot be held responsible if such dangerously long hours put patients directly at risk.
The new contract will also impact on patients because it will lead to an exodus of highly-trained professionals out of the NHS and into jobs or to countries where they will be better respected and rewarded. Over the last decade, our job conditions have been gradually eroded by pay freezes, banding reductions, pension cuts, poor workforce planning, and the removal of free hospital accommodation.
None of us goes into the profession for the money but out of an innate desire to help save and improve lives. But the years of studying, training and acquirement of expertise, on top of the financial debt and personal sacrifices, do need to be fairly reflected in our pay. The basic full-time salary for a newly-qualified doctor is now £23,000. If the government impose the new contract, which reduces junior doctors’ pay by around 30%, then doctors who have graduated with well over £50,000 of student debt will be earning less than the national average.
Those who do not leave can be expected to fight the new contract which is not only unfair but unsafe. This may well mean strike action. At a time when the NHS is already under threat from under-funding, rationing, and creeping privatisation, both an exodus and a strike pose serious threats to the stability of the system. Either could have grave consequences for patient care. We call on the Health Secretary Jeremy Hunt to intervene as a matter of urgency and withdraw this ill-judged junior doctor contract and prevent what is likely to be vote for a strike for which he bears ultimate responsibility.