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Few people choose medicine for the glory and the riches. Far more likely is the opportunity to make a difference, to help people – but just because, for most, this is a vocation, that isn’t an invitation to undervalue what they do.
While politicians and commentators may try and portray the junior doctors dispute as being all about money, doctors themselves are clear that it’s more fundamental than that: it’s about valuing what they do – and what they have to sacrifice to do it.
Here, they explain it in their own words.
Guy Pilsworth is no longer a junior doctor:
“I have been a GP for 6 years. I still regret all the weddings and family gatherings that I missed due to being at work at the weekends. My wife is still a junior doctor, working part time but still regularly works nights, long days and evenings over weekends. This affects our children (age 4 and 6) as they miss their mummy. I often feel like a single parent for several days at a time.
“I am appalled to think that doctors’ weekend working is not valued as it should be. Unfortunately people get ill at all times of the week and so we need doctors to work at the weekend but please don’t diminish their value for political expediency to fulfil an ill thought out election manifesto pledge. Whilst the extra money does not make up for the missed bedtimes and playtimes, it does make junior doctors feel more valued by society. If you break this agreement you will find it very difficult to recruit and retain doctors in the UK. Ultimately, the public will suffer the most if this happens.”
This is not an isolated experience. Atif Khan says:
“The new contract proposals are not family friendly at all. Me and my wife are both doctors with a young family. If the new contract goes ahead unfortunately we will struggle to continue to work full time and meet child care needs. Under the proposed working conditions, my wife will have to go part time. This will be in paediatrics which already is struggling with doctors. Unfortunately there is no other way for us here. I know of many doctor families who are thinking on these lines leading to further staffing issues and rota issues even with the prospect of leaving it entirely if family life crumbles.
“Simply finding child care on a Saturday, which is now being considered as a normal working day for junior doctors, is impossible.”
Of course it’s not just about spending time with the family. Many doctors take on additional study so that they can develop their expertise, often meaning they have to work less than full time.
“I have now spent nearly three years understanding the genetics of why colorectal cancer spreads,” says Lennard Lee, an MRC Clinical Research Training Fellow in Oxford. “I have worked harder and longer hours than I have ever done as a junior doctor. I hope my project is worthwhile and some benefit might come out of it, but the cost to myself is that I will delay being a consultant for eight years and I have lost earnings as being in the laboratory for such long hours means I am unable to do locums or on-calls.
“Under the old system, I knew that when I return next year to finish my training my salary increments would be honoured. Under the new contract, I will be penalised. Effectively that will mean a £10,000 pay cut compared to my peers. With fees of £9,000 a year for doing research, this will hit me and others very hard.”
Dr Donald Somasunderam, a specialty registrar in medical virology, agrees.
“If these changes go ahead nobody will want to train in microbiology. There is already a shortage of consultants. The UK will need more Microbiologists to confront the issues of antimicrobial resistance, hospital acquired infections and to prevent avoidable deaths from sepsis which is killing thousands of patients a year.”
Many have made the point that the changes to the contract are based more in politics than efficiency, but few have summed it up better than Tracy Sharp, an ST4 anaesthetist, who worked at Salford Royal Hospital, often held up as an example of seven-day working by the Government.
“I did work one in two weekends during my ICU job and my A&E job there. I was paid fairly for the hours I worked and antisocial hours were recognised. I received 50 per cent banding and my hours were safely monitored. Therefore if this was achieved at Salford without cutting my salary and allowing me to work within safe hours why can it not be achieved within a new contract?”
They did a similar thing at the post office years ago, I sit next to a colleague who is on same grade as me but my new contract (broadbanding) means I'm on 4K less a year. Organisations can't treat it workforce this way, it's unfair..
My daughter is a 2nd year medic. She and several of her fellow colleagues have been discussing the possibility of discontinuing their training due to the appalling manner with which the government is treating junior doctors. What a truly awful state of affairs this government has created, for one of our most valued and important group of workers, to further their political promises.
This government are big business. Their ideals and their strategies. Which means they are intent on opening up the whole of e public sector to private business so that huge profits can be made. This is another step in making that more attractive, devaluing Doctors and making them cheaper to employ. Good luck to the doctors! Because we all need a public sector that is worth it's salt, that values, care for and strives to create a level playing field for all our children. And this industrial action is a part of protecting that ideal. Jennifer Haskew
Thank you for explaining these matters. Most people outside the NHS are likely unaware of many of these details. May I just express heartfelt gratitude for the time and effort that you all put into your work. I truly hope that you succeed in gaining an acceptable settlement.
Addendum: as for the Government, shame on them for seeking to impose any settlement which you deem unacceptable!
Do what you have to do, guys. You are blocking the destructive forces around you from continuing to destroy our NHS. Whatever it takes, we're behind you. If you have to get tough, we understand why. How can you talk to a man who won't listen? How can you negotiate with a man whose position is entrenched? How can you reason with a man of little cognitive development?
These statements are great- but the public needs a clear statement on this website:
What are the contractual changes proposed? What do junior doctors think will be their effect? Why are they opposing the changes?
Who is correct, you or the government ?
Please send me specific details of how the new contract will leave junior doctors dis advantaged
The first two comments are very valid. The media output concentrates on this being a dispute about pay. That's what journalists understand about the motivation for a strike. The fact that the particular version of 7-day working the Government is promoting was simply a gimmick to fill the need to have something about health in the manifesto is not made clear. Nor is it made clear that if juniors are moved to more out-of-hours work they will not be able to make their usual contribution to midweek activity.
As a patient in constant pain waiting for a hip replacement, which is being delayed, I have spoken to several junior doctors who have passed on their side of the argument with this government who seem have no interest in the welfare of junior doctors, just trying to look good and make money for big business. I am therefore wholeheartedly supporting the junior doctors in trying to get a better deal.
It's tragic that so many doctors who work so hard and with such commitment and have to study so hard alongside this feel so disenfrachised by a Health Secretary who will not listen because he is simply following a political agenda! It will help people understand your campaign better if you explain what 'week-end working' a la Jeremy Hunt means in real terms e.g. working 3 week-ends out of 4 because there isn't the staffing to cover otherwise. Also, related to the issue of staffing, few members of the public are aware of the fact that you are not protected in law if you raise issues of understaffing. This is something that people need to be aware of because the nursing profession is so protected. Also, some clear examples of how this new contract will actually work out for doctors and patients needs to be better and more widely publicised so that it is crystal clear to the public that this is not just a dispute about money. You are saying it but you need clear examples to demonstrate that this really is the case.
Whilst these are compelling anecdotes, but isn't it inevitable that some people will feel disadvantaged by a contract change of this kind? Is it really justified to make thousands of sick people wait longer for their treatment, just because some staff don't like the changes? Is it a coincidence that money is cited as a factor in 3 of the 4 statements above? I would find the BMA's case much more persuasive if they could tell us that this contract change is bad for the NHS.
It just doesn't add up- J r Drs do not wAnt to work at W/e - well tough you should not have gone into a profession that has no time or date for sickness. I have seen how people suffer because of 9-5, 5 days a week working in hospitals. It's appalling . What would you do if you couldn't go on holiday or go to a restaurant at the w/e because staff only wanted to work Monday to Friday. Or perhaps those people family life don't count. You are out of order - get on with what you were trained for and stop using the collapse of the NHS as an excuse to get holidays and weekends off. Very disappointed in the attitude of Some junior doctors.
Junior doctors/doctors in training/all doctors already work weekends and holidays. That is the whole point. Your opinions are very poorly informed, which is quite surprising considering how long this has being going on.
Please look into the training schedule for a junior doctor, which spans more than 10-15 years of hard work and exams, whilst dealing with sickness, death and a lot of sadness every day. This is a little more qualified and a little more onerous than restaurant staff.
Your attitude is quite disappointing.