Shoulder to shoulder

by David Smith

The quality of life for junior doctors falls lower and lower – we must act

Location: England
Published: Wednesday 8 March 2023
junior doctor protest

Junior doctors across England have voted overwhelmingly to take industrial action. More than 77% of eligible BMA members voted, with a resounding 98% stating they were prepared to take action to combat the chronic pay erosion that has so negatively affected our profession and lives.

The first wave of industrial action is planned for 72 hours from 13 to 15 March. On those dates, all junior doctors, regardless of their specialty or rotation, will be walking out of their planned duties.

This includes GP trainees working in their practice settings. We know that for many of those GP trainees, taking industrial action on those dates will be a difficult decision.

This is particularly the case for those due to submit their RCA (recorded consultation assessment) recordings on 21 March. I too will be submitting my RCA recordings. Despite the effect on my submission, I will still be standing alongside my junior doctor colleagues taking industrial action. I started my medical training in 2015 and every year since I have seen the quality of life for junior doctors fall ever lower.

Since 2008, junior doctors in England have seen a 26% real-terms fall in their wages. This is a problem that has been caused by the intentional actions of successive governments failing to ensure the wages of doctors reflect the annual rises in inflation.

Falling pay means many junior doctors, including GP trainees, feel overworked and undervalued during their training. This leads to us seeking alternative employment outside the UK or pursuing a reduction in the number of sessions we are prepared to work upon gaining our certificate of completion of training.

General practice has been hit particularly hard by the COVID pandemic. Despite GPs quickly altering how we work, being instrumental in delivering the vaccine roll out and rapidly modernising the way care is delivered in the community, we have been viciously attacked by the right-wing press. This has exacerbated the retention crisis in primary care, driving hard-working GPs from the profession.

GP trainees have also been affected by COVID, such as the sudden implementation of the RCA introduced to replace the clinical skills assessment exam, which could not be delivered during the pandemic. It is therefore understandable why many of you will have concerns about giving your time to support the industrial action.

I am an academic trainee and thus I have a 50% clinical split. In effect, I have a 50% less than full time clinical rota and have thus struggled to gather the cases needed to submit for the RCA. The ambiguity around which cases will be considered as passes create significant anxiety.

It also doesn’t help that the examples of patients in revision materials are so different from the patients I see in my current practice who are experiencing high levels of deprivation, and all have multiple issues that need my attention. Despite this, I still plan to take industrial action.

The GPTC (GP trainees committee) is working with the BMA GPs committee to produce guidance for practices whose trainees will be taking industrial action to ensure all trainees have adequate clinical opportunities to record their necessary RCA submissions. We have also written to the Royal College of GPs to ask that they take into consideration the effect of the strike action on RCA submissions.

GP trainees cannot legally join the picket lines at local hospitals. However, we can join the protests and demonstrations that will also be occurring at hospitals on days of strike action. This is where most junior doctors will be on strike days. Hundreds of hospital and GP trainees, stood together, stating that enough truly is enough and demanding full pay restoration. We encourage any GP trainee who wants to take part in strike action to join those protests and demonstrations.

I will be standing with my colleagues because we need to fight for our profession, our quality of life and the future of junior doctor training in England. Taking action that results in big societal change will always come with some degree of personal risk.

I will fight for those patients who are struggling to access an under-resourced NHS that can no longer retain the staff it needs. I will fight for my junior doctor and GP trainee colleagues who are perpetually undervalued. I will fight for those doctors who will come after us, who deserve a career that supports and sustains them. I strongly encourage all GP trainees in England to join me.

David Smith is chair of the GP trainees committee