If we don’t support the junior doctors and the NHS now, we risk losing it.
My name is Sian, and I am a 29-year-old junior doctor working in the NHS. I have worked in the health service from the age of 16, firstly working as a Ward Assistant, and whilst at university as a Note Summariser for GP surgeries.
I studied for 6 years in medical school, and worked for my first two foundation years in the NHS. I then spent a year working in New Zealand, and the next year volunteering with Raleigh Borneo, working as a locum doctor in the NHS. I am now in my first of three years as a GP trainee. The first 18 months of this is spent in hospital, and the last 18 months in GP practices.
I have recently married, and my husband, who has decided to retrain as a radiotherapist (he will tell you that these are the people who shoot the lasers), will be at university for the next 4 years.
The job I have can be at times enjoyable, rewarding, energising and exciting. It can also be devastating, crushing, frustrating and exhausting. Working in the NHS and seeing, day on day, the situations that people are in and the conditions they face, and making the decisions needed to help them, expose all those who work in healthcare to knowledge that colours all their experiences, and leaves its mark.
In the space of a day, my job can include filling out many forms to ensure that patients get the investigations and further management they need; liaising with colleagues to create consistency of care when someone goes home or to another hospital; it could also involve giving someone the worst news of their life, and being there to explain it to their family when they arrive.
It can include spotting and starting treatment for a life threatening infection; explaining about a forthcoming procedure and helping someone to understand what to expect; reviewing someone acutely confused, who could be a danger to themselves or others; meeting with allied health professionals, patients and their families to help decide if a patient (often someone with a degree of dementia) is safe to go home, or will need alternative arrangements; certifying a death and sorting out the paperwork so someone can get released for their funeral.
And then we have to be able to see the next patient and help them as though we haven’t gone through the maelstrom of emotions of those we have seen before, so that we can treat the next person with the dignity, respect and focus of mind they deserve.
The changes to the junior doctor contract, if it proceeds as it is, will have a significant impact on our lives. Why does it matter? It’s professional: as it currently stands, there are staff shortages widespread among junior doctor posts. This means that those who are there are stretched thinly, often working with the minimal safety requirements.
It is routine to work hours beyond your shift, and to not get breaks. I don’t mean not getting half an hour to read the paper – I mean no time to wee. And nothing to wee, as they haven’t been able to drink anything either. We are already at our limits. Not all the time, and not in every place, but near enough to be worrying.
The new contract is going to make this worse. It will lengthen the hours considered ‘normal’ – encouraging hospitals to increase staff in these newly normal hours. This means people will either have total hours the same, leaving staffing gaps Monday to Friday, putting other staff under increased pressure, and leading to tired, pressured doctors.
Or they will increase total hours worked – again leading to tired, pressured doctors. And as we are all aware, this is when most mistakes are made. This will increase risk to patients.
Doctors are not stupid. They work hard and are motivated to do the best for their patients. We know that we would be able to do other jobs with better pay and better hours, but we work as doctors because we love the work. I don’t think I will like working in an NHS with this new contract – where decisions made by politicians will make my workplace dangerous and more stressful.
Doctors are dedicated to patient wellbeing, and given an environment that cannot do that, many will work elsewhere – in other roles, in other countries. This will leave those who remain in an increasingly dire situation.
But it’s also personal: I want to be the best doctor I can be. This means having the time and money to attend courses to keep myself up-to-date; to revise for and take exams to advance myself; to attend mandatory teaching when at work.
I am a doctor, but that is not all I am. I want to be a wife, and when the time is right I want to be a mother and to be able to afford childcare. I want to be able to see my family and to attend at least some family events. I want to have other interests, broaden my horizons and try to release some of the stress from work. I would like to eventually own a house and settle down.
I have worked in New Zealand, and know that I could work there as a doctor, with a better work/life balance, earn more and have better opportunity for learning. Whilst I remain dedicated to the NHS and want to remain working within it, there is a point beyond which it will be tolerable.
It’s not just about us. It has been heart-breaking over the last few years to see the NHS being torn apart piecemeal by successive governments which have had no personal experience of what they were destroying, and this is another bite taken out of us. It is so frustrating and demoralising to hear the trite sound bites from the government and NHS employers, which neither answer questions nor bear direct links to the questions debated.
This contract, and the way it is being implemented, is unprecedented. Anyone working in the public sector or anyone reliant on the government for their benefits should be watching this very carefully. If the Conservatives succeed in pushing this through, this will not be the worst of it. If they are not opposed on this, they will continue to demand more and more for less and less, and will not allow reasonable discussion or negotiation.
Support the junior doctors, support the NHS, and support maintaining a safe and effective service. Or risk losing it.