The battle between the Government and Junior Doctors sparked by the proposed Junior Doctor contract, has be raging fiercely over the past few months. With this in mind, I decided to interview a second year medical student about her opinion of the contract and her predictions for the future of medical care and the NHS.
1. What do you think of the Junior Doctor contract?
In an NHS where doctors are already overworked, have low morale and do not trust the government leading them, the junior doctor contract will only make things worse. The contract will result in an overall pay cut for doctors while they work longer hours. Quite apart from making doctors feel undervalued and not respected by the government, the changes are totally unsafe for patients. No one wants a tired, unmotivated doctor treating them. At medical school we sometimes look to the airline industry as a model for safety; pilots have strict safeguards on what hours they are allowed to work in order to stay safe- you wouldn’t want a tired pilot and nor would you want a tired doctor, but Jeremy Hunt wants to remove safeguards for working hours, resulting in overworked doctors who will make mistakes. A fully functioning 7 day NHS would be great (and by this I mean weekend services being the same as during the week with elective surgeries etc., there is already emergency cover at weekends), but is impossible when even the current service is struggling for funding and staffing. The health service is already stretched to its limit – any more and it will break.
You have to question the government’s motives and consider the changes on a wider scale- are they deliberately destroying the NHS in order to privatise it? We are so fortunate to have the NHS in our country and the thought of it not existing any more scares me. It’s amazing that you can get any treatment free at the point of service, regardless of who you are, and we should do all we can to preserve that. A lot of people in the UK have never known another healthcare service, and so perhaps don’t fully appreciate the NHS and just how expensive healthcare can be without it.
As a medical student now, if the contract is put in place/kept how do you think your experience as a junior doctor will differ from those before the contracts. I.e. the impact on junior doctors Junior doctors at the moment are stretched to their limits, so as a junior doctor of the future I am worried by what my experience will be like in comparison. I imagine it will be very hard work, the money won’t be brilliant (doctors have to spend a lot of money on their training, for example on exams, as well as just living) and I can’t see our relationship with the government being at all good after this contract. I hope my desire to be a doctor and to help people will drive me through, but I do sometimes consider what I could do if I end up hating it. Everyone who gets into medical school is clever enough to earn a lot more money more quickly and more easily in another profession.
The contract extends ‘sociable’ working hours to 7am-10pm Monday-Saturday while at the same time essentially cutting pay. While doctors tend to be motivated by a desire to help people rather than money, this shouldn’t be a reason to undervalue what they do. However much I want to help people I would not work for a salary that I can’t live off- it is a job at the end of the day. The contract will also be detrimental to patient safety and this will be frustrating and worrying for doctors who are trying to help patients.
The term ‘junior doctor’ refers to anyone who has just graduated from medical school right up to senior registrars about to become consultants, which is a lot of people! I would say it is likely that a lot of them will move abroad to somewhere with better working conditions, and this will only create more problems for the NHS. The contract removes the current pay banding system which “provides pay supplements based on an overall assessment of the length and unsocial timing of […] duties. It also has built-in safeguards to prevent excessive hours and to ensure [doctors] receive sufficient rest and breaks” (BMA http://www.bma.org.uk/working-for-change/junior-and-consultant-contract-home/ddrb-recommendations-analysis-for-juniors) this means that people will be put off training in certain specialities, for example A&E, which is an absolutely essential speciality that is already undersubscribed.
What was the protest like?
It was amazing to feel the support for the NHS at the protest, it made me feel very protective of our health service. Ambulances went past a couple of times and put their sirens on in support. We had some great speakers including one of our lecturers, Prof. Alistair Hall, who has written in the BMJ detailing how Jeremy Hunt is misrepresenting statistics when he refers to weekend death rates. The protest made me realise that the whole medical profession is behind the junior doctors- there were official representatives from every medical speciality speaking, and a huge range of people in the crowd, from doctors, nurses and medical students to patients. However, it also made the contract feel very real and made me feel worried for my future profession.
Are you worried to become a junior doctor with the contract in place?
Yes. From what I know about the contract it just isn’t sustainable, so everything about the future of the profession is very uncertain at the moment. Will I still want to be a doctor when I graduate given the working conditions? Will there even be an NHS when I graduate?
What do you think about junior doctors going on strike? Do you think they should find another way to protest that does not put patients’ lives in danger?
I agree with the strike. Having spoken to some junior doctors, they really don’t want to have to strike and regret that it has come to this- they would rather be providing normal care to their patients. However, there doesn’t seem to be any other way to get the government to listen. The fact that this is the first doctors’ strike in 40 years demonstrates just how strongly the medical profession feels about the contract. Fundamentally, doctors do have the right to strike. The government is trying to demonise doctors, suggesting that they are putting lives in danger, however, the service that is provided during the strikes is the same that is provided at weekends, night-time and bank holidays- there are still consultants working (possibly more consultants than normal during the strike) and patients are still treated. If anything the government’s suggestion that it is unsafe will put people off going to hospital if they are ill, which will of course harm them. It is unfortunate that elective procedures have had to be cancelled, but these are things that wouldn’t put someone’s life in danger if they are rearranged. I can’t really think of another way they could protest as powerfully, as I said, doctors are only striking as a last resort. I only hope it doesn’t turn the public against them.
How do you think it will affect the NHS generally?
Given that the government are pushing through a clearly damaging contract, I think they have a wider, threatening agenda: to privatise the NHS by making it unsustainable. Many doctors will move abroad or change profession, leaving gaps in the workforce, and the government are now trying to cut student nurses’ and midwives’ grants meaning that far fewer people will be able to train to do these essential jobs. This contract might be the start of the downfall of the NHS (but I really hope it isn’t.)
