17 Jan 2016

my week #196 (plus a little about the junior doctor contracts)

Last week of paediatrics placement done... I'm now officially halfway through my penultimate year! This is super scary. I'm already getting a slight feeling of fear about being a foundation doctor next August (eek!) and this sort of thinking isn't helping. Deep breaths!

Although I originally said I wasn't overly excited by it all back in December but actually, paediatrics was really good! It's so diverse and it's almost like general practice but much more fun and with the same, if not wider, variety of conditions seen. However, there were a few safeguarding issues that came up during the placement and I still can't comprehend how anyone could abuse a child (or anyone for that matter). For that reason, paediatrics probably isn't for me but never say never!

Junior Doctor Contracts

One thing I want to talk about this week are the junior doctor strikes here in the UK. Essentially, the media have portrayed doctors as 'greedy' people and as a medical student who will be a junior doctor in 2017, I want to just say this. Doctors aren't in it for the money - my starting base salary will be in the region of £23,000 (however, it'll be 'topped up' if I work unsocial hours). Let me put this into perspective for you: I'll be graduating with about £70,000 of student debt and upon graduation from medical school, I'll have to pay GMC fees, for my own insurance, for BMA registration, etc and that's even before we talk about rent, food, bills, petrol and the like. If the social hours are moved, I'll be paid even less and am not even sure I'll be able to afford to be a doctor in this country.

If we were in it for the money, trust me, we'd all be doing something else. Not to blow our own trumpets but we are all intelligent people (more so at times, less so at others!) and there are probably many other better paying industries we could all be working in. As a graduate entry student, I've seen people in their 30s and 40s who have given up extremely well-paying jobs to come to medical school. Let me say this again, we are not in it for the money. However, that's not to say we don't want to be paid fairly. Re-classifying social hours is not only unfair, it is unrealistic. Anyone who tells you 9pm at night is the same as working at 9am in the morning is just ridiculous.

With regards to a 24-hour NHS, it already is operating 24 hours a day, 7 days a week, 52 weeks a year. My best personal example of this is an emergency caesarean section I saw at 4am in the morning during a night shift. The consultant was present, the senior registrar was present and the senior house officer were all present, as was the anaesthetist, the midwives and the scrub nurse! Even the cleaner was in the corridor mopping the floor!

What we are fighting for is the future of the NHS. If these changes go ahead, there will be a mass exodus of healthcare personnel because not only will junior doctor's pay be cut, nurses, midwives, consultants, etc will be next on the agenda. Our skills are transferable - we can move abroad (healthcare personnel will always be needed around the world!).

Furthermore, reclassifying social hours to 7am to 10pm will result in overworked and tired doctors making increasingly poor decisions. This is a compromise to their own safety when commuting but even more so to the patients they will be treating. Would you like a doctor treating you when they are in their 13th hour of their shift? The current government also want to remove any financial penalties local trusts would have to pay if they overwork their doctors and this will further compromise on patient safety and allow them to overwork already exhausted doctors.

You might argue that there is a European Working Time Directive at play which caps our work at 48 hours per week but I can tell you this: I've rarely seen a doctor leave work early when I've been on the wards and this is especially true in some of the surgical specialties. And to add to this, my mum is a midwife and the number of times she has finished work on time in the last ten years can be counted on one hand. Healthcare workers cannot guarantee the finish time of their shift - how many jobs do you know of that can also say this aside from those in the public sector?

To finish, I want to say this. I want to work for the NHS. I went into medicine because my goal in life is to have as many days as possible where I've made a difference for someone else other than myself. I want to be paid fairly for what I'll be doing (factoring in the level of responsibility I'll have) and that's essentially why I chose medicine. I know I'll never earn megabucks as a doctor but that's ok as long as I am paid fairly. Essentially, the new contracts are not fair and more importantly, they are not safe.


How has your week been?

13 comments

  1. Congrats for finishing your paeds placement! Mine isn't for about another year so I'm definitely looking forward to that! I've seen so much in the media about the NHS and I must admit that I don't really know much about it. However, I do hope that it turns out alright for you guys as I do think that people tend to forget that health isn't something that you want to compromise for a nation.

    sayyip.blogspot.com.au

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    1. Thanks Yip. Paeds is really enjoyable because it's such a broad specialty in that you might be in A&E and see one kid with a respiratory problem and then the next will have a gastro one, etc. I'd definitely be tempted if it weren't for all the safeguarding issues I saw x

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  2. Working long hours and not for the money when you are a doctor is something common in all European countries nowadays. Unfortunately I can't see things changing in that matter as the European laws don't go in that direction. When entering that profession you must be aware of it and choose that job knowing what you will have to sacrifice.
    I agree working long hours is not ideal and can even put the patients at risk when the decisions are not made properly but once again it's part of the job and no one said that being a doctor was an easy job.

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    1. Definitely hit the nail on the head there, Joanna. We all go in knowing that the job will be hard and there will be long and also unsocial hours. However, that doesn't mean it's right to not pay us fairly for those long and unsocial hours as we would've given up something in order to work these hours. Ultimately, the changes not only compromise doctors' wellbeing, it also compromises patient safety and that is the bottom line. Overworking doctors won't improve the health service - it'll cause more harm and will, in fact, cripple it.

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  3. Please know that even I as an American, support you all.Would that my country had an NHS!

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    1. Great to know! The NHS is a wonderful thing and it means that there is free healthcare for all citizens when they need it. This is one less thing on everyone's mind which can only be good for the economy (and mental health) of the country :) x

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  4. Thank you for explaining this to us! I was just chatting about it on a residency interview last week in the USA. In Ontario (canada - my country of origin) they implemented many physician pay cuts, plus slashing reimbursements for several services. It has been an uproar for the docs, since many clinics started closing (esp addiction clinics) due to the loss of income, and several young docs are deciding to leave the province instead of settling to open their own practices. None of the cuts was discussed with the medical board beforehand, and the repercussions this is going to have are going to be astounding unless they come to a resolution. Crazy.

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    1. Really crazy. Sounds like Canada are seeing doctors as disposable (much like the UK government if their actions are anything to go by). I think if the changes do go ahead, similar things will happen in the UK with many doctors leaving the country or the profession altogether. For me personally, having factored in living costs and the like, working as a doctor would actually leave me in the negative. And I don't live an extravagant lifestyle! Sad times x

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  5. You know, I would happily pay more in taxes if I knew it was going towards the NHS to improve the help available and increase salaries.
    I think extending the social hours will result in poorer medical care. And that's not to say the doctors aren't bloody amazing at their jobs - you guys do a brilliant job and take a lot of crap without moaning in my opinion - but being overworked and tired means they won't be at their best throughout the whole of their shift. And anyway most doctors will already do long hours! Even a 9 hour shift in a hospital compared to the average 9 hour shift in an office is completely different.

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    1. Great to hear that we have your support, Katie! Your point is exactly the one the medical profession is trying to make and it's gutting that those at the top don't recognise this. Added to the fact that the prime minister himself has openly lied to the public about the death statistics speaks volumes about the government. These are dangerous times for the NHS and if the changes go ahead, we can pretty much guarantee that the end of a free health service is near.

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  6. Have been watching and listening to the concerns the docs in the UK have been raising and though I am from the U.S., have to say what you are asking seems reasonable. How I wish we had a NHS!!
    Love your blog:)

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    1. Great to hear that of your support on a more international scale :) x

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