Viewpoint: Why doesn’t my grandson want to become a doctor?

by Radhamanohar Macherla

More needs to be done to attract and retain doctors to the NHS, otherwise the next generation will simply not be interested

Location: International
Last reviewed: 15 July 2021
Radhamanohar Macherla

‘Ninety pounds for the first half-hour to assess and diagnose the problem. Then £75 per half-hour after that.’

I have no great skills in plumbing so I sighed, agreed to it, and switched the TV on. The news item was about doctors’ reaction to the Department of Health’s recommendation of a 1 per cent pay rise for NHS staff in England.

After all the sacrifices they and their NHS colleagues have made in the last 18 months, it seemed cruelly unfair.

I looked up the starting salary for an NHS consultant, and it is around £80,000 per year for 40 hours a week, although hardly any doctor works only for these hours, and none would leave a sick patient in the lurch.

To become a consultant in the NHS it takes at least 13 years from the start of medical school. It entails a number of rigorous examinations, assessments and extensive training. After all this, a consultant’s basic pay equates to around £20 for half an hour.

Compare this with that of £90 per half an hour I was charged by the plumber. I respect their and other skilled work, and how much they charge is up to them.

But if you have to attract people into the medical profession, such societal perspectives cannot be ignored.

We have seen recruitment problems and attrition, with more than one in five doctors considering leaving the profession altogether, and a third planning to leave early, according to recent surveys.

One problem is that the NHS has a strange business model. While the service as a whole is not profit-making, it has the culture of profit-driven enterprise hard-wired into its obsession with targets, and the financial penalties for missing them. It feels like the service responds by squeezing as many units of activity as it can out of every doctor, who tend to view the world instead through the lens of providing the best patient care.

But even in the most profit-driven of private companies, there is an understanding that they need to take care of workers’ well-being otherwise they leave. The NHS does not seem to have grasped this.

I was talking to my 13-year-old grandson the other day, and asked him what he wanted to be in the future. An astronaut, perhaps, he said. Law, he suggested, or architecture, the performing arts, flying planes. Very good, I said. And then I waited. Both of his grandfathers, his dad and his uncle are doctors.

‘And… medicine?’ I asked. He smiled. ‘Grandpa, hearing everyday about how awful and miserable life is being a doctor why would I choose to become a doctor?’ There’s a lesson there for we doctors.

Our children barely get to see us sometimes, and, when they do, we bring our troubles home with us. There’s a lesson for the Government too. It assumes that enough people will still want to do this job, and then when they’re doing it, they’ll be happy to live off fresh air and platitudes. It is complacent to assume that.

Perhaps my grandson’s choice is a right one. But then it is sad for the society if such young aspiring students are deterred by the unenviable state the medical profession is in the UK.

Radhamanohar Macherla, now retired, was for more than 20 years a consultant physician with Barts Health NHS Trust