The junior doctor’s dispute with the government has been raging for some time now, and we recently saw unprecedented industrial action where emergency care was withdrawn throughout England by junior doctors last week. But why is all this happening, and what does it mean for you? Here I will offer my opinion as someone firmly on one side of the argument – but I’ll let you make up your own mind.
Are junior doctors greedy professionals attempting to siphon away every penny they can get from a government at the time of economic uncertainty, as some would suggest? Or are they hard-working altruistic wardens of the National Health Service (NHS), working for the health of the nation? After this column, you decide.
Becoming a doctor is hard work, take it from me! It takes good grades at school, solid work at college, relevant work experience, the best grades attainable at A levels, and even then there is no guarantee of a place in medical school. Medical school is a tough 5 years (as a minimum) where basic sciences are drilled into the future medic, they are pushed to the extreme and bombarded with exams. Once they finally graduate they will have two years as a Foundation doctor and then may look to specialise, the training for which can take from 3 years up to 7 years plus. And even now – the doctor is still a ‘junior’. Only when they become a General Practitioner or Consultant, some up to a decade later, are they no longer junior doctors.
As you can see then, it takes a long time to become a junior doctor! A lot of training, many years of experience and lots of hard work. There are over 50,000 junior doctors throughout England – all of different grades, and in different specialties. The government has proposed to impose a new contract on those 50, 000 junior doctors across England (not Scotland, Wales or Northern Ireland) – and they quite simply don’t think that it is suitable. Junior doctors say that this contract is unsafe for their patients and unfair on them and they are supported fully in this by their union, the British Medical Association (BMA).
Strikes have happened to bring the government back to the negotiating table and to not impose an unfair and unsafe contract on those doctors. The government has not listened. As a last resort, junior doctors last week went on strike for 2 days and withdrew their emergency care – a first in NHS history, leaving hospitals to be manned by more senior colleagues, clinicians and consultants. Again, you may ask though – why are they so opposed to this contract?
The current government in their last manifesto promised a ‘7-day NHS’. Sounds attractive, right? A dramatic title, promising 7-day complete care at no extra expense to the public purse. I’m afraid to say this is a notion with absolutely no substance to it and backed up by even more dubious evidence. Spreading your Nutella more thinly across your bread doesn’t mean you will have a better taste, just the same amount of product with a less attractive breakfast. Equally, spreading doctors thinly without investing in any extra resources or support is a true recipe for disaster.
The Secretary of State for Health, Jeremy Hunt says that the junior contract is being misunderstood by 50,000 doctors, and in fact they have all misread the terms. He continues to try to persuade the public that the doctors have it all wrong and the deal is a fair one.
So looking at this objectively – 50,000 doctors are misunderstanding and getting it all wrong, yet a few ministers who have never worked in the medical field, sitting in offices in London, are right?
Right now, whether you need emergency care on a Monday or a Sunday or a Christmas day morning you will receive it. If you walk into your local Emergency Department you will not be turned away if you have a life-threatening or other injury or acute illness. Emergency care is where the government get it all wrong. They fail to recognise emergency versus elective care. Elective operations, procedures and investigations are planned – emergency care is not. By the very nature of the word, emergency care is necessary and immediate, which is already a ‘7-day’ service.
Junior doctors work days, evenings and nights – and they also work at weekends, bank holidays and other public holidays. So what more does Jeremy want? He wants the public to believe that by increasing the number of doctors at weekends, the entire NHS will run more smoothly. He uses some misquoted statistics on the ‘weekend effect’ to sell his argument. What about the important work that is done by nurses, paramedics, lab technicians, porters, physiotherapists, occupational therapists (and the list goes on)? Doctors are a small cog in a very large wheel, and by pressing down on them, the government is setting an illusion that the NHS is delivering care throughout the week yet slacking on the weekends.
They don’t stop there however. The contract not only makes doctors work more, but reduces many doctor’s take-home pay. The new contract also discriminates against women doctors wanting maternity leave, against those who wish to go part-time and overall creates poor morale and unsafe care. Doctors already work very tough hours – would you like to be treated by an overly tired doctor? Jeremy’s ‘7-day NHS’ slogan is a smoke-screen – this contract won’t make your GP available 7 days a week, or any other community services – this is solely aimed at junior doctors.
Tired doctors, poor morale, less pay, a contract removing current safeguards and an upset union: where do you go from here? As a junior doctor myself, my logic is simple. The government is in power for ‘x’ number of years, and Jeremy is a politician for ‘x’ number of years along with Prime Minister David Cameron. The NHS has been serving the public regardless of which government is in power for over half a century, providing exemplary care that is respected worldwide as the best system that exists anywhere. What makes that system work? The people who work for it. Upset the people, you upset the system and unsurprisingly, you have a system that suddenly starts working less well.
Jeremy Hunt may not still be in power when the NHS starts to feel the real and lasting effects of this government’s uninformed and unpopular changes. But the junior doctors of today are tomorrow’s Consultants and General Practitioners. They will be around for much longer than any of the politicians once the dust has settled. They are here to serve the public, to ensure the NHS flourishes and attempt to prevent governments and parties from using the NHS as a political bargaining chip or battleground for their own benefit.
I leave you with this thought – would you like a NHS staffed by professionals who are treated well, are as well rested as they can be, and able to provide you safe care? The alternative is Jeremy’s plan – which may well see the junior doctors that treated you when you were in hospital last fleeing his new contract for Australia and the like. We should be trying to value and retain all of our NHS staff, whether they are junior doctors or other professionals from allied disciplines, as they are the future of the NHS – not simply a silly manifesto ‘title’ with very little substance.
I hope that leaves you with some questions to think about, and whichever side of the discussion you may sit, please always support the NHS where you can – it is a service which provides so much to so many people. Reflect and enjoy the journey! You can follow my Twitter feed on @Faraaz_Bhatti and let’s talk about important health issues. If you would like me to discuss any specific issue or get a conversation going then feel free to let me know.