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I work a lot outside my hours, you do, we all do. Most of this time is unrecognised. We do it because, despite assaults on our professionalism and our remuneration by the Government, we still want the best for those under our care, and for our profession
But what happens when we are forced to stay because of poor staffing? Or unmanageable workloads? Or even predictable rota gaps?
Ever increasingly, doctors are being asked to do the unreasonable. At present, we have banding appeals and a financial penalty imposed on trusts who push too far and misuse doctors.
Even with this safeguard, I have heard countless stories of doctors being abused in their position - unreasonable hours, 36-hour shifts, going way beyond the EWTD (European Working Time Directive).
So what will happen if this new contract is imposed? From what I see, there are no safeguards with any force. It's a very nebulous ‘EWTD will protect you’ approach.
I'm sad to say, it doesn't stop us being abused now, and that's with the stick of a financial penalty. What will happen to the junior doctors when that stick is taken away?
I'm approaching the end of my days as a junior medic, I'm on the more cantankerous side of the fence and can stand my ground when pushed unreasonably. I can also recall my first days as a medic, and the vulnerable position that new doctors are in.
We are giving the system a carte blanche to work junior doctors into the ground, and the consequences will only add into a worsening cycle.
In return, all we are being offered is a supplement for on-call commitments that is likely to bear no relation to the work involved, possibly as low as 5 per cent. Apply it to the vast number of hours that some doctors work on-call, and it equates to well under the minimum wage.
A clue as to who we’re dealing with here – in the DDRB’s report, it quoted NHS Employers on why they didn’t want a direct relationship between hours worked and pay.
It would create ‘an incentive to work slower’, they said.
So employers honestly think we would spin out our work in order to earn extra pay? When our patients need us, and might be in pain or danger, when our colleagues depend on us, when our hospitals are under intense pressure, we’d embark on a go-slow?
They have no reason not to trust the work ethic of doctors. We have every reason not to trust their ‘commitments’ on safe working hours when they no longer have any incentive to improve them – in fact, every incentive to make us work longer, when they can pay us the pittance supplementary rates.
No more incentives to make shifts more humane, or get staffing numbers right - think what that will do to us. As more strain is put on doctors (with less pay as well), more will leave or go off sick, and as the cycle goes on, the care we can give our patients will become less and less.
Zead is an ST5 in general adult psychiatry in south Yorkshire