Junior doctors are being treated so badly that we may be forced to strike / Junior doctors condemn new contract they say could cut pay by 40%

When a candidate completes an application form for Medical School they should not be thinking about money, but about altruism and service to patients. Medicine used to be a “benevolent” profession that charged the rich people more, and the poor people less or nothing, before the pre Blair NHS organised it to be fairer and inclusive. Reducing earnings has happened to other professionals in the Health Services. Since “agenda for change” nurses and other professionals have seen their position and future advancement “frozen”. Consultants who used to influence spending and care packages have disengaged and left the field open to managers to do as they wish. Everyone except the politicians sees that there is no way that the finance and the quality initiatives can be reconciled. The result is implosion. The civil unrest in the doctors will eventually extend to the patients…. Without overt rationing there is , and will be, no honesty, and therefore no real meaningful professional engagement. In Wales there are GP clusters, where managers and senior partners are paid to attend, but they don’t believe in what they are doing. Medical Executive committees are equally disillusioned in Hospitals. When the top feels disenfranchised, you can be sure they will unofficially support the bottom when it threatens action.

Amy Agahi in the Independent 19th September 2015 reports: Junior doctors are being treated so badly that we may be forced to strike and in The Guardian Dennis Campbell inflates the loss: Junior doctors condemn new contract they say could cut pay by 40%

Taking industrial action poses a huge moral dilemma, but with a 30 per cent pay cut and unsafe working hours on the horizon we may have no choice

In 1975, junior doctors went on strike over disagreements with the government about their contracts, restricting their work to emergency cases. Four decades later, junior doctors are once again faced with the same dilemma. This week the Government decided to force through a new working contract that the British Medical Association (BMA) has branded as “unacceptable” – both for the working conditions of doctors and the safety of patients.

The contract that the Government is imposing on doctors like me includes the removal of vital measures that protect against us dangerously long hours, and an estimated overall pay cut of 30 per cent.

Concerns about the impact these working conditions would have on patients and doctors were so grave that the BMA exited negotiations, and refused to sign up to the contract. Ignoring doctors’ warnings, and passing under the radar of the general public, the Government announced it would be driving through the changes regardless.

Doctors like me are left reeling in disbelief. We are questioning our future as professionals and agonising over the quality of care our patients will receive. It still feels unimaginable that such radical reforms could be forced through. The changes are unprecedented, and seem to abolish and undermine all the efforts our senior colleagues have made to keep patients safe.

I understand why the public thinks doctors earn a generous salary. I’m lucky to earn above the national average. But here’s a reality check: a junior doctor earns £22,636, which after four years increases to £30,002. In the past, this income has been supplemented by higher pay for working anti-social hours (from 7pm until 7am and during the weekend) – but that will no longer be possible under the Government’s new rules.

There are also huge, hidden costs to being a doctor which most people don’t know about, such as joining up to the regulatory bodies that you have to be a member of to practice. This year I have spent £385 on fees to the General Medical Council, £375 on a defence union, £220 on BMA membership and £150 on college fees. Since qualifying six years ago I have spent in excess of £15,000 of my income on compulsory training.

After the anticipated pay cut, a junior doctor’s salary will ignore the personal investment, long working hours, pressure and huge responsibility that they face. And for new entrants it also ignores the debts fee-paying students at medical school will have racked up on the long road to qualifying as doctors. I have already met medical students who say they feel hopeless, and consider their future depressing.

An online petition directed at the BMA to support industrial action has been gathering support online. So far over 30,000 people have signed it. Whatever happens, industrial action won’t be taken lightly. Most other professions wouldn’t think twice, but for us the decision to strike is a huge moral dilemma – our primary duty is the care for our patients, and our absence at work will not be without terrible risks. Yet I can’t help but think that we’d be doing an enormous disservice to our patients and the NHS if we let these radical reforms go unnoticed.

The NHS is a recruitment crisis already. Junior doctors are allured by the better lifestyles and pay packets offered abroad, or in other professions. I have so far resisted these options due to my staunch belief in the value and ethos of the NHS. But today, along with many of my colleagues, I am left feeling totally lost and in utter disbelief. Sadly these may no longer be preferable alternatives, but the reality for junior doctors today.

More on this:
‘I don’t blame doctors for walking out of pay negotiations’
‘The Health Secretary has lost the confidence of the medical profession’

This entry was posted in A Personal View, Stories in the Media on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

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