Monthly Archives: November 2015

We fully support the junior doctors & the BMA in the fight to save the NHS

Article explaining the reasons behind the junior doctors’ industrial action – fully supported by doctors and staff at Carlton House Surgery.

Junior doctors have voted to take industrial action and over the next few days we expect to see them demonised by the government and by the media. This is a summary of some of the lies expected to be used in the forthcoming days. This is written by a GP who used to be a junior doctor, who is not part of the BMA committee, and who has no involvement in any of the planning of this action.

1) “They’re only doing it for the money”. “The offer of an 11% pay rise is generous, and they are being greedy”.

Not true. Junior doctors are straight ‘A’ students who have been through a vigorous selection process, five-six years of arduous training with no pay, and amassing tens of thousands of pounds worth of debt. Most of them could succeed in better paying fields than medicine. Most of them couldn’t care about the pay, other than expecting that society should take care of them. The 11% pay rise is on basic pay only, which only makes up around half of the hours worked. There will be a big cut in the rest of the pay, the ‘on call’ hours. And overall, in terms of pay per hours worked, there will be a relative pay-cut.

2) “They are being led by a bunch of militants”.

Not true. The chair of the junior wing of the BMA is a trainee gynaecologist, who does the BMA bit as a side-line. All those organising the action are working junior doctors. There is no ‘hard core’ element, just a few junior doctors who have been elected by other junior doctors to speak for them. The media will be hunting for smear stories. So far, they have found out that the chair has photography as a hobby, and sometimes does wedding photos. I expect they’ll find more stories somewhere.

3) “There is a secret forum of militant doctors”.

Not true. Three Daily Mail journalists uncovered this story by using the Facebook search function, and found a large group called ‘Junior doctors contract’. The only screening tool was a moderator asking if they were doctors. Over 2/3 of junior doctors in the UK are registered with this group. It is not secret – it is a social media debating area. The group have even created the twitter hashtag ‪#‎meetthedrs so that the public can engage.

4) “Jeremy Hunt says his doors are open for negotiation”.

No they are not. The reason that the BMA walked away from the contract talks is because preconditions were set by Hunt and his team. Of the 23 points of the DDRB recommendations, the BMA were told that 22 needed to be accepted before any negotiations took place, and only the section on ‘relocation expenses’ was open for discussion. Do you blame them for not engaging? Since then, Jeremy Hunt has used soundbites in the media, rather than serious negotiations.

5) “They just don’t want to work weekends”.

Rubbish. Since well before I started training as a junior doctor in the 1990s, there has always been a 24 hour NHS, and all juniors go into the job knowing that they will spend vast numbers of weekends, evenings, and nights working. The DDRB proposals simply recommend reclassifying many night or weekend hours as ‘normal pay’, meaning junior doctors will get paid less for antisocial hours.

6) “They are only a few inexperienced trainees”.

Not true. Let’s give an example. When you come into hospital at midnight with a burst appendix, the first doctor you see, an A+E SHO doctor, sorts out your pain relief and gets all your medical details, and is likely to have had around seven years of training. The surgical SHO doctor, who prepares you for your operation, will have had eight years of training. The anaesthetic registrar, who keeps you alive during surgery will have had 12 years of training. So will the surgical registrar, who operates upon you. All of these are ‘junior’ doctors. These are the doctors who deliver your care. They may need to ‘consult’ a senior doctor, called a ‘consultant’. But they are the medical workforce of the NHS.

7) “The public will suffer”.

Actually, no. The opposite will happen. Worldwide, for every junior doctor strike in history, mortality has gone DOWN. Yes, you are in fact LESS likely to die during a strike. This is probably due to the fact that many medical procedures have risk, and for short strikes, disease and illness is usually slow enough not to be affected. The BMA are proposing only short spells of industrial action.

8) “These strikes should be banned”.

Why? Why would anyone work in a field where pay is less, hours are longer, conditions are becoming worse, with no legal redress? Training a doctor takes a lot of time and a lot of money, and only a select few can do it. And those select few have top A-grades, degrees from well recognised institutions, and transferable skills. For training in the UK, there is a monopoly employer – the NHS. Why shouldn’t medics have the right to strike?

9) “We need a 24 hour NHS and the junior doctors are opposing this”.

There is already a 24 hour NHS. It already provides one of the best medical services in the world, 24 hours per day, while remaining impressively cost efficient. At weekends, there is comprehensive emergency cover. The Tory party seem to want an NHS where normal services also run seven days per week. They have based this on specious interpretation of some research papers, and on trials which in fact showed that the public didn’t really want to see doctors on a Sunday. (81% of patients are happy with the hours their general practice is open – far more than even vote in a general election). Never the less, they want to steam-roller this through. A sensible person would think that this could be done by increasing NHS funding by 2/7, or around £50 billion per year. However, the Tory party seem to think that £8 billion is enough. It would seem that none of this would be going towards the pay of junior doctors, who would be expected to provide the medical manpower.

10) “The proposed contract change is to improve medical safety”.

Quite the opposite. The number of applications to medical school has dropped. There will be no increase in UK doctor numbers. The safeguards which currently exist mean that the more a hospital works junior doctors during antisocial hours, the higher the hourly pay. The new contract makes this a flat rate, regardless of how hard you work them, and promises some sort of fine or official sanction if they work beyond a certain limit. This is no safeguard to prevent doctors having inhumane shift pattern, or from being used as fodder at times when training is impractical. Lastly, if the numbers don’t increase, how will the same number of doctors who work a five day routine week plus emergency hours cover work a seven day routine week? Well, they’ll have to be spread more thinly.

11) “They are already the best paid doctors in Europe”.

Not correct. They will leave medical school with an average of £50,000 worth of debt. The starting salary is £22,000. They will be expected to rent a room in or commute into a major city for their daily job. The salary of junior doctors is about average in Europe, behind Germany, Belgium, Austria, Luxembourg, Ireland, and Denmark.

In reality, the junior doctor contract is being imposed on them by a Tory Government who wants them to work harder, for less money, in less safe conditions, and is not prepared to listen to their concerns. The junior doctors are not greedy, they are not workshy, and they are certainly not militant. They are opposing Jeremy Hunt, a man who co-wrote a book on how to dismantle the NHS.

So – who do you trust? The junior doctors? Or the Tory Government?