By MedShr, 2017
With the latest political war over, the dust will now begin
to settle, talk will turn back to celebrities and frivolity, and the NHS will continue
on its current trajectory with Hunt at the helm. But what does the new
government mean for the NHS - and in particular the current state of morale for
junior doctors?
The morale of NHS doctors has been a concern for many years,
and results from the latest NHS staff survey show that 39% of NHS staff
admitted to experiencing work-related stress that made them feel unwell in the
last 12 months (NHS Staff Survey, 2016).
Why are junior doctors suffering from low morale?
Let’s start with Brexit. In 2016, 10% of doctors were from
elsewhere in the EU according to the English Health Service’s Electronic Staff
Record. If Brexit negotiations turn sour, and EU citizens can’t be guaranteed
their rights within the UK - or in fact just don’t feel welcome anymore - we
would face an NHS staffing crisis amongst doctors. The BMA polled over 1,000
doctors from the EU working in the NHS after the Brexit vote, and found that
42% are thinking of leaving, and a further 23% were unsure (BMA, 2017).
And then there is the 1% pay cap that was introduced by the
Conservative government, which means that with inflation, staff are actually
getting paid less year-on-year. This is simply an insult to the people we are
entrusting to save our lives, and was exacerbated by Theresa May’s
unsympathetic comments during the election campaign that there is “no magic
money tree.” Real term pay cuts for doctors and nurses are having a direct
effect on recruitment and retention across the NHS.
Next is the workforce crisis that is hidden from public
view. Already thinly stretched, junior doctors are reporting gaps in rotas and
regularly working longer than their allocated hours to protect patient safety
and complete essential clinical work. These excessive and often unrealistic
workloads, coupled with falling pay, are pushing doctors to leave medicine. The
Royal College of Physicians (RCP) even issued a warning at the end of last year
that patient safety was seriously compromised by gaps in junior doctor rotas.
For example, in paediatrics, the most recent workforce report shows hospitals
are currently having to cope with an average junior doctor vacancy rate of 14%
and 240 empty consultant posts (Politics, 2017).
And
finally, the lack of recognition. Politicians talk about increased spending and
promises about recruitment to the NHS, but what we must remember is that these
pledges affect real people; people who are doing their best to keep us safe.
Junior doctors are at the start of their careers, but face low morale and the
risk of burnout from year one, so it’s no wonder they are leaving to work in
sunnier climates with better working conditions (BMA, 2016).
What can we do about low morale?
We need to start focusing on the health and wellbeing, both
mental and physical, of those who look after ours. Nearly all political parties
promised an increase in NHS funding. More resources and increased staffing
would mean that junior doctors will feel less stretched, causing less
work-related stress and ultimately improving morale - but with an ever-increasing
population, is the UK government willing to put up taxes to pay for it? Is the
NHS as efficient as it can be, and if not, what streamlining and collaboration
can be introduced to improve services and reduce the workload on junior
doctors?
The NHS under the Conservative-DUP deal
During their 2017 election campaign, the Conservatives
pledged to support GPs in delivering “innovative services that better meet
patients’ needs, including phone and online consultations and the use of
technology to triage people better and support integrated working.” However,
they also want all newly qualified doctors to be forced to work for the NHS for
at least four years - a form of indentured labour which is highly unlikely to
make doctors feel valued and may exacerbate the antipathy.
Could the Conservatives’ health policies be the reason May
failed to gain a majority? And will the DUP block or support the Conservatives
in their healthcare plans? In 2016, the DUP released a document that states
they believe that the NHS needs to evolve to fit 21st century patients and
societal problems, an NHS that is “more efficient, more productive and embraces
innovation. One that realises the full potential of our integrated health and
social care systems” (DUP, 2016). This could mean that a Tory-DUP deal will
attempt to streamline NHS pathways and improve efficiency between primary and
secondary care. But is this even possible without a significant increase in
funding and resolving the lack of morale that is currently rife amongst
overworked junior doctors?
The literature and first-hand anecdotes are out there, and
it’s a well-trodden mantra - the NHS is underfunded. Without increased funding,
there simply will not be enough staff, and junior doctors will continue to feel
overworked and undervalued. And without junior doctors staying to progress
within the NHS, there may not be a free NHS forever. Aneurin Bevan – often
credited as creating the NHS - said in parliament on February 8th 1948, “take
pride…we are still able to do the most civilised thing in the world, put the
welfare for the sick in front of every other consideration,” - but perhaps we
no longer are.
