As a CT3 in Psychiatry, I have spent five years as a junior doctor. I will spend at least another three years as a junior doctor in training, probably longer depending on the route I take through specialty training.
Today I am junior doctor on strike. I feel proud and strong, but at the same time I feel guilty and deeply saddened by what we have come to. Here's why.
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| Image from www.bbc.co.uk |
In September 2015, when I first heard talk of industrial action. I was on-call for the first planned strike in December, providing emergency cover, so the decision of whether to strike or not was made for me. I was secretly glad not to have had to make such a difficult decision. The strike was called off. I breathed a sigh of relief and hoped that negotiations would resume and industrial action would just fade into the background.
I couldn't believe it when talks broke down so soon, in January 2016. I admit, I buried my head in the sand. I felt extremely uncomfortable with joining the fight against an employer that gave me a job, gave me a salary and gave me the career I had dreamed of. I didn't fully understand the arguments on either side. I was frightened, confused and terrified of losing my job. Doctors had not been on strike since 1975. For a caring profession, it seemed such an aggressive act. On the 12th January, the day of the first strike, I went into work.
Where I was working at the time, there was no picket line to cross, no angry junior doctors to confront me on my way in to the building. It wasn't about losing pay. I just didn't know what to think. I have family members who have been involved in industrial action in other industries and I have witnessed the terrible fallout of this. While I was frightened of the pressure to strike, I was also ashamed as my colleagues from other professions looked silently stunned when I entered the office.
I didn't tell any of my friends about my decision not to strike. I only told two other doctors, and one of those was my consultant. Some of the changes in the new contract didn't seem that bad. My fear was that we were digging our heels in without compromise. I had struggled to understand the nuances of the current contract, let alone the endless possibilities of the new one. I started a new job in February 2016 and was faced with yet another day of industrial action. I felt torn by my loyalty to my employer and my loyalty to my colleagues, who stood outside with their placards as I persisted with my day-to-day work. I felt guilty about leaving colleagues overstretched and unsupported. I just could not convince myself that strike action would resolve anything.
However, when I did more listening and reading over the weeks, I found that actually, with industrial action taken so far, the contract proposition has changed for the better. It has been extremely difficult to obtain accurate information about the disagreements - and I am referring to both the government and the BMA when I say that. Neither side has handled this perfectly. What doctors really want is for the negotiations to restart in order to resolve all of the disagreements safely. What we're really angry about is how much uncertainty is left in the new contract and the way it has been imposed. You can read a basic explanation here about how we got to this point.
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| Image from www.bma.org.uk |
So here I am today, I am on strike.
Some will wonder why it took me so long to get here. I would argue that I am now more confident than ever that this is the only way to have the voices of junior doctors heard. No-one wants to be on strike but we have been backed into a corner. I still feel torn and confused, but we cannot have overtired doctors making mistakes. Some will wonder why I am not out there in the cold and the rain shoulder-to-shoulder with my colleagues on the picket line. I thought about picketing at the hospital where I work. I considered going to the hospital near where I live. I am hugely grateful to those who have picketed, but I thought I could reach more people on the digital picket line. According to healthcare social media site symplur.com, over 38,000 people used the hashtag #JuniorDoctorsStrike yesterday. Please help us spread our message.
The contract might actually be better for some specialties. With 56 different different specialties and thousands of different rotas up and down the country, it is near impossible to get one contract to suit all. But for the majority, the unwritten contract is unsafe. We need certainty about rota design, we need guarantees that we will be adequately rested. We need reassurance that steps will be taken to improve recruitment of junior doctors, instead of frightening them off with more hours for no more pay. We need details of how non-resident on-calls will be paid, we need guarantees that we will not be switching from day to night shifts like yo-yos. We need funding to be allocated so that a seven day service is not paid for by simply stretching a five day service.
Doctors don't mind working odd hours - quite frankly we expect it. People get sick all at times of the day and night. But we would at least like fair compensation for all the family time we miss, for the weddings and birthday parties we can't attend, for the Christmases we spend with our patients rather than our partners and children. The government will tell you they have offered us a 13% pay rise, which we have rejected. They forget to tell you this is to replace the 20-50% 'banding' top-up which most doctors receive for out of hours work.
I am striking for all those doctors who have missed out on family time. I am striking for my friend Anna, who did a PhD in the middle of her medical degree and now, while trying desperately to further scientific research as a doctor, risks being punished financially for taking time out to pursue academic work. I am striking for my friend Fiona, who works tirelessly as an Accident & Emergency doctor, already has one of the most antisocial shift patterns I have ever seen and needs the guarantee of a safe and well-staffed rota so that neither her nor her A&E department collapses.
I am striking for all those doctors who have fallen asleep in the middle of a shift from sheer exhaustion. I am striking for all those doctors who have stopped training in a specialty they love, a National Health Service they love, or even a country they love, because they can no longer cope with the demands placed on them. I am striking for the future trainees who will have to work on a contract we have negotiated for them.
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| Image from www.bma.org.uk |
Doctors are intelligent, kind and compassionate. We are highly trained to treat you with the best evidence-based practice. We are highly trained to analyse statistics from medical research. Doctors are not money-grabbing, champagne-swilling gluttons. My email inbox is topped up on a daily basis with offers of more money for fewer hours in the private sector. But we love and believe in the NHS and what it stands for. You trust us with your lives and rightly so. Please trust us when we say the new contract is dangerous - for doctors and patients.
The BMA website has further information on how you can support junior doctors.
There are more strikes planned. For everyone's sake, I hope they don't happen. I hope we can reach meaningful negotiations before then. We are one profession. We stand together.
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