Posted on October 27th 2015 by Gagan Bhatnagar on the clinioncdoc.
I am not a political creature.
I’m a doctor. I’ve spent the last 12 years of my life rigorously training to be able to look after the public. My training continues even now, as a clinical oncology specialist registrar (cancer specialist), and I look forward to many more years as a junior doctor. Up until now I did not worry myself with politics, perhaps naively assuming the UK government had the peoples’ best interests at heart.
Why is this important? Why is this relevant? Because today I am no longer that person. Today I am angry, I am frustrated, I am genuinely worried.
The NHS is under attack and it WILL NOT survive without public support.
The Health Secretary,Jeremy Hunt, and the government are in the process of undermining and attacking doctors throughout the nation with the imposition of an unsafe and unfair contract. The details of this contract have been covered extensively in the media but, put simply, will lead to:
- The removal of safeguards protecting junior doctors from overworking by removing financial penalties on hospitals for scheduling work-heavy rotas.
- Removal of pay progression if doctors go into clinical research (yes…including cancer research) or decide to work part time to have a family – essentially penalising doctors for doing research or having a family.
- Extending ‘plain time’ by 50% from 60 hours/week to 90 hours/week. (By comparison the average 9-5 job has plain time of only 40 hours)
- This will lead to a pay cut of up to 30% which will hit the acute specialties who do the most antisocial hours (Accident & Emergency, Intesive Care, Obstetrics, Acute medicine) that are already struggling to recruit doctors.
- Recommended 20 minute break every 6 hours. That’s right…if I do an 11 hour shift, I am afforded only 20 minutes (including my time for lunch)
These are amongst the few of the recommendations from the Doctors’ and Dentists’ Review Body (DDRB) which, suspiciously, lacks either a doctor or dentist on the panel. In fact, not a single front line health worker was on the panel to provide insight into what happens on the shop floor.
The government are suggesting these proposals are to provide a 7 day NHS while maintaining cost-neutrality. Let’s be very clear about this:
The NHS is a 24 hours/day, 7 days/week, 365 days/year service
Distinctions between emergencies and routine care is something our Health Secretary has been unable to do.
Emergency care is always covered, round the clock.
However, if you would like that routine operation to remove a bunion, it may not be available on a Saturday or Sunday. The simple reason for this is that there just aren’t enough doctors, nurses, radiographers, healthcare assistants, porters, pharmacists, secretaries, cleaners on the weekend to achieve this.
Herein lies the problem. The NHS is cash-strapped. Long term underfunding from the government has left the NHS on the brink of collapse. At present it is struggling to hold together a 5 day service and indeed may only be being held up by the good will of the staff who work an insurmountable number of unpaid hours for the benefit of the patient.
The government are imposing an increase in productivity of 40% (2 extra days) without providing any more money or more staff. It has been suggested that for there to be such an increase, the NHS would need to recruit over 30000 more doctors(currently there are 53000 junior doctors). It does not take an economist to tell you this is fool hardy and short sighted.
The proposals suggest same number of doctors will cover an additional 40% of the service. This will stretch the regular 5 days in the working week even thinner. At a time when staff are at breaking point, this will be the anvil that breaks the camel’s back.
Surveys have shown, if these contracts are unilaterally imposed by the government, up to 70% of junior doctors would move abroad or give up medicine entirely. Even if only a small fraction of this number leave the workforce due to unreasonable working conditions, this would have catastrophic implications for a stretched service.
So why? Why go against the advice of 53000 junior doctors and all the Royal Colleges who have unparalleled insight into how the NHS functions?
To paraphrase Noam Chomsky: Underfund, Villify, Demoralise, Privatise.
In the long run, doctors would benefit from a privatised healthcare system (case in point The United States Of America). It will be the patients that suffer. So it should be ringing alarm bells when as a workforce we are fighting desperately to avoid it. The reason is simple…patients will suffer.
From day one, we are indoctrinated with one mantra – Do No Harm. As a workforce we go above and beyond for patients, we dedicate our lives to serve the public.We are not perfect and we make mistakes – we are after all human, but our goal remains singular.
Our previous health secretary, Mr Andrew Lansley, now sits on the board for a firm promoting privatisation of the NHS. There is no reason the current health secretary will not follow suit.
The imposition of these contracts would only be the beginning of the downfall. Nurses would be next, then pharmacists, then radiographers. Then the reality of paying thousands of pounds for surgery for your burst appendix or for your grandmother’s hip operation, or hundreds of thousands of pounds for your cancer treatment may become a reality. Once the system is broken, there will be no going back. But those that have made the decisions on your behalf will already have lined their pockets.
So what can you do? Write to your MP. Voice your concerns. Join the debate. Support your junior doctors should they reluctantly ballot to strike. Start telling people. If you don’t stick up for the NHS when it needs you, it won’t be here much longer to stick up for you.
While it may not seem it now…this is everyone’s fight.
I am not a political creature.
I am a doctor.
#juniorcontract #notsafenotfair #saveourNHS
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See Gagan Bhatnagar's blog on the clinioncdoc.
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