I am a 36 year old wife and mother of two; I am also a junior doctor. I spent six years in medical school to get my basic medical degree with an extra BSc, I then worked in six different specialities over two years of foundation training. I am now in my eighth year of paediatric training: I still have two years left until I become a consultant. If I hadn’t had my children and gone part time I would have finished by now but, I am by no way alone in taking a career break in order to start a family.
I have been thinking about what to write as there is so much I want to say but it is important, I think, to stick to the facts that the government are trying to hide, their hidden agenda and how it will affect us all.
Firstly, let me make one thing clear: junior doctors are not striking for the first time in over 40 years because we want a pay rise and we don’t want to work weekends. I feel that, at present, we are paid fairly and well compared to many people in the country.
Jeremy Hunt has been saying that we have rejected an 13.5% pay rise; the truth of this claim becomes clear when the different parts of our wage are explained. Junior doctors working in the hospital work a compulsory full shift rota including nights, long days until 9.30 or 10 pm, twilights until 1.30 or 4.30am and weekends. This is not voluntary overtime, it is part of our normal week. Each week we will do anywhere between one and seven of these shifts. Our paycheck composes basic pay and then banded pay for the out of hours work. Without this banded pay my wage would be considerably lower than it is. The 13.5% pay rise is on the basic pay, to get this ‘rise’ we face losing the banding for out of hours work; a pay cut dressed up as a pay rise.
Jeremy Hunt has said that we need a seven day NHS: we already have a seven day NHS. There are junior doctors on site 24 hours a day, 365 days a year. On weekends there are consultants on site all day and often much of the night. When a junior doctor like me, with over a decade experience, is confident in managing patient care, the consultant will be accessible for phone advice or to come in when needed from home. None of the paediatric consultants I have worked for have chosen to not work weekends, and data shows only one in 100 across all specialties have done this.
What Hunt means is seven days of routine care such as an outpatient appointment about a non-emergency condition that may have been present for months or years. He wants this without paying us any more money, and without providing financing for more staff. Even if he is to be believed that we will not get a pay cut, how can we offer an increased service for the same pay without working more for less? More important to most of us is our time; the most important people in my life are my husband and children. When I work antisocial shifts I don’t see them, my toddlers become clingy and upset, and I miss important milestones. Other than the need to pay the bills, the threat of a pay cut is less worrying to me than losing more time with my family.
Doctors have been accused of only being worried about money. This is not true: the most important reason we are fighting these changes is due to concern for our patients. The NHS is already stretched, on one hand for example, David Cameron says parents need to attend parenting classes, what he doesn’t mention is that the funding for their provision has been cut and cut and cut. When I started my job, I had an array of courses to offer parents but I have seen these decrease over the last five years. Our A&E departments are closing and becoming urgent care centres where we no longer have the facilities to manage critically ill children carried in off the street by worried parents: the expertise yes, the facilities? No. This NHS that I, and my colleagues, love so much is stretched to breaking. Despite this, Hunt thinks we, who cannot meet the current demand, can provide more. We would love to offer you a routine appointment at 9am on a Sunday but let’s consider this in more detail: How would a patient who lives in Bacup and doesn’t have a car get to an outpatient appointment at Burnley General Hospital for 9 am on a Sunday? Buses do not cover this part of their route on a Sunday and the first train does not arrive in Burnley until after 11 am. When you arrive, will the clinic be cleaned by the weekend cleaning staff, who will be working less hours than during the week, as normally the clinic would be shut and not need cleaning? Will there be a clerical officer to deliver the notes, a receptionist to check you in, a nurse to measure your child’s height and weight and another nurse to check blood tests if needed so you don’t have to come back at another time? A clinic cannot run with just a doctor, the whole team are needed to provide this service. I also wonder who wants an appointment at the hospital during one of two precious days off during the weekend? Trials with GP surgeries suggests not many people do.
The only way this increased service can be provided without paying for more doctors, more nurses, more receptionists, secretaries, clerical officers, cleaners, pharmacists and so on, is by asking us all to work more for less and by spreading us more thinly. There may be a weekend clinic but, to provide this, there will be less doctors, nurses etc on the floor during the week. In our minds this is simply not safe.
Forcing doctors to work longer hours will lead to mistakes. Forcing us to miss more weekends and time with our families while working more nights and antisocial shifts will lower morale and lead to increasing rates of depression and time off work from stress and illness. This is why we felt strike action was unavoidable. We are not being mislead by our union, we all have the skills to read and correctly interpret the facts ourselves. We are not being greedy and demanding more money. We are worried. Worried for our health and families, worried for the safety of our patients and worried for the survival of the NHS. When our Secretary of State for Health is a co-author of a book entitled Direct Democracy calling for the privatisation of the NHS and when, as of November 2014, 70 members of parliament, including Jake Berry, had financial interests in private healthcare companies, I struggle to see how the NHS can survive. This government has been gradually privatising services and, among doctors and allied professionals, there is grave concern their fight with us is the first step to a two tiered, privatised system where those most in need cannot afford the care they deserve. Had Walter White received his cancer diagnosis in the UK, Breaking Bad and it’s plotline of illegal drug activity would have never come about. This is why we are fighting. Without the NHS the wealth divide that we are seeing increase will widen further and the very reasons for which I became a doctor will be undermined.
I see that, despite overwhelming opposition to the government’s plans, and our clear and united explanation for this, Mr Hunt has decided to ignore the doctors working on the frontline and plans to impose this new contract against our will. How can we trust a government who will not listen to us? After they defeat the doctors, the nurses, paramedics and other hard working members of the British public will be next. One of our cleaners who works in the same department as I do was telling me only recently that he has heard their out of hours banding pay is also to be cut and nursing students are facing working for nothing during their training with the loss of their bursaries. If these changes are allowed to continue, I fear in five years time the NHS will be no more.
Sign Rossendale Labour Partys petition in support of the Junior Doctors.