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The following is a transcript of the speech delivered to the Junior Doctors’ Committee conference by co-chairs Andrew Collier and Kitty Mohan. You can watch a webcast of the speech here.
At the end of the 1990s, the junior doctors of this country stood up for high quality care and for the health of their current and future colleagues. They stood up for a profession who had sacrificed much, but were not willing to sacrifice on patient care. They stood up against 100-hour weeks and they stood up against employers who showed little or no regard for their working conditions.
Until the end of the 1990s, there was no effective recognition of the extra or anti-social hours that junior doctors were working. This meant there was no incentive for employers to make working hours safer. What safeguards we have in our workplaces today, we owe to them and now it is our focus to our negotiations to negotiate a contract which is fit for the next decade.
For many doctors, there is a chasm between the protections they should expect, and the reality of working in the health service.
We were promised that our hours would be monitored fairly and accurately. But we know that some doctors feel pressured to underreport on the hours that they work. Monitoring was meant to be simple and straightforward but it has become anything but.
Bad employers may be in a minority but we cannot tolerate them. An employer that doesn’t value or respect its staff has no place in our 21st century NHS.
Everyone accepts that junior doctors need to be trained, but too often we are forced to miss training sessions because of the demands of service provision. Every time this happens we are compromising the care of patients in the future.
We have a professional duty, not to simply endure a dysfunctional system, but to change it.
One doctor, one of the thousands who responded to our survey, told us how her working pattern has affected her performance.
She said: ‘If I’m tired and make a mistake on my twelfth consecutive day at work, I don’t think that anyone be comforted by the fact that I’ll get a rest day later in the week.’
When forced to work fatigue inducing rotas, it’s unsurprising that some of our colleagues have wanted to remove the working time regulations altogether. However it’s disappointing that this important piece of legislation designed to protect workers’ health and patient safety, has become a cause of resentment.
But does it really surprise you that the working time regulations have been implemented so badly? From the studio that brought you study leave you were unable to take, and rotas you were unable to see, we have legislation against unsafe working that still allows juniors to work in excess of a 90 hour week.
This has got to change.
We must also ensure that the concerns of junior doctors are not overlooked in impending training reforms. If the Shape of Training proposals are implemented this will change the definition of what it means to be a fully-trained consultant or GP, and will prevent doctors and their patients from the benefitting from pre-registration foundation year.
The Shape of Training report has some merits. We might even say it has good intentions. But you must remember, and we have heard before, that the road to MTAS was also paved with good intentions.
Conference, Andrew and I and our committee, will fight everything that holds junior doctors back from being the clinicians, the innovators, and the leaders that we want to be and that our patients expect us to be. However today is not about us. It is your chance to lead change, to have your say on key issues, and to set the direction of the JDC for the year to come.
So, tell us what’s happening to you, to your patients and your hospitals and what you want to happen.